Venous congestion and Venous insufficiency
Veins are the blood vessels responsible for returning de-oxygenated blood back to the heart. Abnormalities in the veins of the legs or pelvis can interfere with that normal blood return leading to a variety of problems including unsightly and painful varicose veins, leg swelling, skin discoloration and in more advanced cases, non-healing leg wounds.
If you have one or more of the following SIGNS AND SYMPTOMS, you may have underlying vein disease.
Leg Swelling that is worse at the end of the day
Leg cramping at night
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.
How are varicose veins treated?
The symptoms associated with varicose veins are the result of decreased movement and pooling of blood within the veins. 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):
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 is a minimally invasive procedure in in which the abnormal vein is removed through by way of several tiny punctures in the skin. The procedure is performed with minimal “twilight” sedation.
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 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.