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Venous Problems

Veins are thin-walled structures inside of which a set of valves keeps blood in the body flowing in one direction. The heart pumps oxygen-rich blood to the body’s tissues through thicker-walled arteries; the veins return that blood to the heart. Veins located close to the surface of the skin are called superficial veins and the veins found in the muscles of the arms and legs are called deep veins.

Damaged vein walls hinder the circulatory system, allowing blood to collect and flow in a retrograde (backward) fashion when the muscles relax. This creates an unusually high pressure buildup in the veins. This buildup causes further stretching and twisting of the veins, increased swelling, more valve incompetence, sluggish blood flow and potential blood clot formation. Eventually, this condition can lead to various disorders known as venous disease.

Venous disease is quite common. Approximately 15 percent of the United States population is affected by varicose veins, which generally do not pose great health risk. However, thrombophlebitis can be much more serious, even life-threatening, affecting millions of people each year.

Deep-vein Thromboembolism: Deep-vein thrombophlebitis (DVT)  is a blood clot in the deep veins.  DVT carries the risks of pulmonary embolism (when the clot detaches from its place of origin and travels to the lung) and chronic venous insufficiency (impaired outflow of blood through the veins), leading to chronic swelling of the legs.

Varicose Veins: Varicose veins are swollen veins near the surface of the skin of the leg, and occur when weak or defective valves allow blood to flow backward or stagnate within the vein.  Varicose veins are quite common, though women are affected twice as often as men.

Superficial Thrombophlebitis: Thrombophlebitis is the inflammation of a vein (usually in an extremity, especially one of the legs) that occurs in response to a blood clot in the vessel. When it occurs in a vein near the surface of the skin, it is known as superficial thrombophlebitis, a minor disorder commonly identified by a red, tender vein.


When to Call Your Doctor

Call your doctor if you have a painful, swollen vein that does not disappear in a few days, or if you have unexplained swelling in an arm or leg.

Symptoms

  • Deep-vein thromboembolism (DVT): generalized swelling, warmth and redness in the affected limb; distention of superficial veins; bluish skin color in the limb or toes.
  • Varicose Veins: enlarged, swollen, knotted clusters of purple veins; edema (swelling in the legs); aching or a sensation of heaviness in the legs; itching skin above the affected veins; skin discoloration and ulcers on the inner aspect of the ankles (in advanced cases).
  • Superficial thrombophlebitis: a red, engorged, cordlike vein, associated with localized swelling, pain or tenderness.


Causes

  • Stagnation of blood flow due to immobility. This is common among bedridden patients (such as heart patients and those who have undergone any type of major or orthopedic surgery, especially of the hip or knee) and healthy persons who sit or lie still for an extended period --for example, on a long trip.
  • Blood vessel injury, caused by trauma, intravenous catheters or needles, chemotherapeutic agents, or infectious organisms.
  • Conditions that increase the tendency for blood to coagulate, such as a familial deficiency in anti-clotting factors or disorders like systemic lupus erythematosus.
  • Pregnancy and varicose veins are associated with a higher risk of superficial thrombophlebitis.
  • Deep-vein thrombophlebitis is associated with a number of different cancers.


Prevention

Follow prevention tips as recommended by your doctor. These can include walking, controlling weight, wearing low-heeled shoes and avoiding long periods of sitting or standing in one position.

Support stockings can be very helpful in preventing progression of vein problems.

Be sure to stand up and walk around often on long trips in airplanes or automobiles.

Following a heart attack or major surgery, low doses of an anticoagulant (such as heparin or warfarin) may be recommended. Getting up and walking around again as soon as possible following either of those events is also advised.


Diagnosis

Deep-vein thromboembolism (DVT) An ultrasound examination to see how efficiently the veins are returning blood to your heart is performed. This test detects blood clots in the legs.

Varicose vein diagnosis is made by an ultrasound examination.

Doctors can usually diagnose superficial thrombophlebitis based on your medical history and a physical examination.


Treatment

Most treatments for Vericose veins are minimally invasive procedures.  They include:

  • Radiofrequency Ablation
  • Sugical Ligation and removal of the vein
  • Sclerotherapy of small veins

DVT and Thrombophlebitis are treated in various ways, including the following treatment options:

  • If superficial thrombophlebitis is the diagnosis, your doctor will recommend you be up and active. You also should be checked frequently to make sure that the blood clot does not progress.
  • Some patients with deep-vein thrombophlebitis may require hospitalization.  The doctor will usually prescribe an anti-clotting medication.
  • Your physician may remove the clot with clot-dissolving agents.
  • Special elastic support stockings may be prescribed to aid circulation in the lower limbs.
  • The doctor may implant a small filter in the main vein of your abdomen to prevent clots in the legs from going to the lung.
 

                   

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