Venous congestion and Venous insufficiency

Veins are the blood vessels responsible for returning de-oxygenated blood back to the heart.  Abnormalities in the pelvis and leg veins can interfere with that normal blood return leading to a variety of problems including unsightly and painful varicose veins, leg swelling, skin discoloration, spider veins and in more advanced cases, non-healing leg wounds.  The experts at APEX Endovascular provide comprehensive management of complex venous issues starting with in-house, state-of-the art imaging diagnosis, minimally invasive treatment, and post procedure care.  Call us, your local Fort Collins vein clinic serving the entire northern Colorado area.   

If you have one or more of the following SIGNS AND SYMPTOMS, you may have underlying vein disease.

  • Leg Pain
  • Leg Swelling that is worse at the end of the day
  • Varicose veins
  • Leg cramping at night
  • “Restless” legs
  • Skin discoloration
  • “Spider” veins
  • Leg wounds

 

What are varicose veins?

Varicose veins are bulging superficial veins just under the skin surface in the legs.  They are caused by abnormal “leaky” valves in the veins that allow blood to flow in the wrong direction. Wrong-directional blood flow can also lead to the formation of smaller, unsightly “spider” veins which are named for the pattern they make on the skin as the vein shows through. If you are interested in leg vein treatment, contact us today! We are your local Fort Collins, CO vein clinic!

What are varicose vein treatment options?

The symptoms associated with varicose veins are the result of decreased movement and pooling of blood within the veins.  Varicose vein treatment involves closure or removal of the abnormal veins which allows the body to redirect blood flow into normal deeper veins in the legs. Treatment may involve one or more of the following procedures:

(hidden) Endovenous laser therapy (EVLT):

EVLT is a minimally invasive procedure in which a small laser is used to close abnormal veins in the legs.  The procedure is performed through a tiny nick in the skin and can be performed with or without minimal “twilight” sedation.

Endovenous laser therapy (EVLT):

EVLT is a minimally invasive procedure in which a small laser is used to close abnormal veins in the legs.  The procedure is performed through a tiny nick in the skin and can be performed with or without minimal “twilight” sedation.    

Venaseal Ablation:

Venaseal ablation is a safe, minimally invasive procedure which involves the use of glue to close abnormal veins in the legs.  The procedure is performed through a tiny nick in the skin, usually without the need for sedation.  

 

Phlebectomy:

Phlebectomy is a minimally invasive procedure in in which the abnormal vein is removed through several tiny punctures in the skin.  The procedure is performed with minimal “twilight” sedation.   

Foam Sclerotherapy:

Foam sclerotherapy is typically performed after ablation to treat leftover varicose veins.  The procedure involves injection a foam “detergent” that is designed to irritate the walls of the veins thereby causing their closure.  The procedure is performed with local anesthesia and typically takes about 30 minutes.  

 

What is Deep Venous Thrombosis?

Deep venous thrombosis (DVT) is clot in the deep veins of the legs.  DVT is a serious condition that can be life threatening and requires immediate medical attention.  Clot can form within the veins of the legs during periods of prolonged inactivity, following major surgery, or simply as a result of sitting for prolonged periods during a road trip or long flight. Less frequently, DVT can be due to other underlying medical conditions including cancer.  Conditions that cause narrowing or compression of the veins, such as May-Thurner’s Syndrome, can also slow blood flow significantly which can lead to DVT.  

How would I know if I have a DVT?

DVT usually causes pain and swelling in the affected leg. Sometimes the clot in the leg can go unnoticed and the first symptom is chest pain or shortness of breath brought on by movement of the clot into the lungs (pulmonary embolus).  Ultrasound is used to confirm a DVT and CT is needed if there is concern for pulmonary embolus.

How is DVT treated?

The mainstay of therapy for DVT is anticoagulation with a blood thinning medication.  In most cases, a blood thinner is sufficient to keep the clot from worsening while your body breaks down and dissolves the clot that has already formed.

In some cases, the clot in the leg is so extensive that it extends up into the pelvis causing very significant blockage of blood flow and severe leg pain and swelling.  In these circumstances, the body struggles to dissolve all of the clot effectively resulting in scarring of the veins over time and potentially lifelong problems with leg swelling and pain referred to as post thrombotic syndrome.   In the case of extensive DVT, your doctor may recommend removal of the clot both to decrease immediate symptoms and lessen the risk of developing potentially debilitating post thrombotic complications in the future.

At APEX, our vein specialists are skilled at dealing with DVT. We use the most cutting-edge, minimally invasive techniques to remove clot in the safety and comfort of our state-of-the-art outpatient Fort Collins, CO facility.

What is May-Thurner’s Syndrome?

May Thurner’s Syndrome is a condition in which a vein in the pelvis draining the left leg (left common iliac vein) is compressed by an artery bringing blood down to the right leg (right common iliac artery).  The compression over time causes scarring and narrowing of the vein which limits the flow of blood out of the left leg. This can cause left leg swelling and pain and can also contribute to the formation of varicose veins in the left leg.  In severe cases, the compression slows blood flow so significantly that the blood clots resulting in extensive left leg deep vein thrombosis (DVT).  

How is May-Thurner’s Syndrome Diagnosed?

Diagnosis can be made with CT or MRI.  Venography and intravascular US (IVUS) are the gold standard for diagnosis and offers the advantage of allowing treatment at the same time.  

How is May-Thurner’s Syndrome Treated?

May-Thurner’s Syndrome can be diagnosed and treated by performing a single safe and minimally invasive procedure called a venogram.   The procedure involves starting a small IV in the vein behind the left knee and injecting contrast into the veins with X-ray visualization.  A small catheter with a tiny ultrasound probe is then advanced into the veins allowing us to look at the veins from the inside.  If it is determined that the compression is severe enough to account for your symptoms, a small stent is placed into the vein. The stent holds the vein open and allows the blood to flow freely out of the leg.  The procedure takes about an hour and is performed with minimal “twilight” sedation.  If you have left sided leg swelling or have been diagnosed with May-Thurner’s Syndrome and live near Fort Collins, CO, contact us today. Our vein clinic with board certified surgeons is located in Northern Colorado and serves Fort Collins, Loveland, Greeley, Windsor, Timnath, Longmont and Cheyenne. 

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