The University of Chicago Vein Clinic at Vanguard Weiss Memorial Hospital offers numerous non-surgical, minimally invasive, and open surgical treatment options for patients with venous disease. Our vascular surgeons are skilled in sclerotherapy, microphlebectomy, vein ligation and stripping, and minimally invasive radiofrequency ablation (commonly known as the VNUS Closure procedure).
Our experts will evaluate you in our outpatient clinics, often using non-invasive duplex ultrasound to evaluate vein anatomy and function. Treatment is then tailored to each individual patient’s needs. What is venous disease?
Venous disease refers to all conditions related to or caused by diseased or abnormal veins. Common in the United States, venous disease affects approximately 15 percent of the adult population. Mild venous disease is usually not a problem for patients, but as venous disease worsens, it can become crippling chronic venous insufficiency.
In the normal circulation, arteries carry oxygen-rich blood from your heart to the body, and veins return the blood to your heart. Veins have one-way valves along their length to keep the blood flowing to the heart. As muscles contract, they squeeze the blood forward in the veins. When muscles relax, the valves shut to prevent blood from flowing backward.
There are three types of veins in your legs: superficial veins, perforating (or communicating) veins and deep veins. Superficial veins lie just under the skin and carry 10 to 15 percent of the blood in your legs. Superficial veins drain into perforating veins, which drain into deep veins. Deep veins lie inside the muscles (remember muscles are responsible for pumping) and carry 85 to 90 percent of the blood back to the heart.
If vein walls become weak or damaged, or if the valves are stretched or injured, the system stops working normally and the blood begins to flow backward (towards the feet) when the muscles relax. This creates unusually high pressure in the veins, resulting in even more stretching, twisting and swelling of veins. The abnormal veins with their sluggish blood flow create disorders known as venous disease.
Venous diseases include:
Risk factors for venous disease include:
- Spider veins
- Reticular Veins
- Varicose veins
- Leg swelling and leg pain
- Chronic venous insufficiency
- Leg skin changes
- Leg ulcers
Spider Veins (Telangectasias) and Reticular Veins
- Family history
- Prolonged standing
- Prior history of blood clot formation in the veins
Spider veins are clusters of small veins that lie very close to the surface of the skin and may appear red, purple or blue. They are usually only a cosmetic concern, but in some people, they may cause pain. Commonly, spider veins appear on the thigh, calf and ankle. Although they are connected to the larger venous system, they are not essential to it. Researchers estimate that spider veins affect about 50 percent of adult females.
Reticular veins are slightly larger than spider veins and often appear bluish. Like spider veins, they can be of cosmetic concern or contribute to symptoms. Spider veins and reticular veins can be treated with injections called sclerotherapy. Varicose Veins
Varicose veins are subcutaneous dilated veins, typically greater than 3 mm wide. Varicose veins are usually blue and tend to bulge. As they enlarge, they may become twisted, tortuous or cord-like. They can occur anywhere in your leg from your groin to your ankle. In some patients, as more and more blood flows backward in the abnormal vein, the vein becomes leaky. Symptoms can include: leg swelling, aching, cramping, tired legs, heaviness, burning, throbbing or itching. Initial therapy often includes the use of compression stockings, but symptomatic varicose veins usually require additional treatment. Varicose veins can be treated with radiofrequency ablation (RFA), commonly called the VNUS Closure procedure, or with other techniques including vein ligation and stripping, and microplebectomy. Chronic Venous Insufficiency
When venous disease is long standing, it can become chronic venous insufficiency (CVI). CVI occurs from chronic pooling and congestion caused by leaky varicose veins, from chronic obstruction in veins due to clots (thrombosis) or from inflammation of the veins (phlebitis). As this condition worsens and becomes severe, skin changes and leg ulcerations can occur. Treatment is aimed at relieving the swelling in the legs and also limiting progression of the disease. This can be achieved with compression stockings and radiofrequency ablation (VNUS Closure). Leg Skin Changes
The skin changes associated with chronic venous insufficiency are called venous stasis dermatitis. Eventually the constant swelling, decreased blood flow to the area and increased pressure result in decreased movement of oxygen and nutrients to the skin. The tissue becomes damaged and the skin inflamed, eventually turning a reddish brown and becoming hard, thick, leathery and itchy. Although treatment will not reverse the skin changes, treatment aimed at relieving the swelling and decreasing the pressure in the veins will improve symptoms and prevent progressions to skin ulceration. Treatments aimed at reducing the swelling may involve a combination of treatments such as prescription drugs, compression stockings and radiofrequency ablation (VNUS Closure). Leg Ulcers
When venous disease becomes severe, venous stasis ulcers can occur in the skin. These ulcers usually occur around the ankles. Long standing congestion is suspected to cause obstruction in the blood flow. With the blood flow obstruction and decreased oxygen levels, skin ulcers begin to form. These venous ulcers can be painful, and treatment can be lengthy and frustrating. In many cases, if venous insufficiency is diagnosed and considered a cause for the ulcer, treating the veins with radiofrequency ablation (VNUS Closure) will help redirect the blood flow to functional veins, relieve the venous congestion, improve the leg ulcer, and reduce the likelihood of ulcer recurrence. Contact Us
University of Chicago Vein Clinic
Vanguard Weiss Memorial Hospital
4646 North Marine Drive
7th Floor Vascular
Chicago, IL 60616
Phone: (773) 564-5770
Fax: (773) 564-5991 Links www.rethinkvaricoseveins.com www.vascularweb.org
Illustrations courtesy of Covidien.