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Although veins and arteries are both part of the circulatory system, they work in very different ways from each other. Blood is pushed throughout the arteries of the body by pressure created from the pumping of the heart. Veins, unlike arteries, carry blood against the force of gravity. They rely on leg muscle contraction and one-way valves inside the veins to carry blood back toward the heart. If the valves in veins fail, gravity keeps blood from flowing back to the heart efficiently. This produces a back up, pooling or congestion, of blood, a condition called venous insufficiency. As a result, pressure builds up and the diseased veins become enlarged, eventually bulging to the skin's surface. The same disease process can affect veins of any size; however when larger veins fail, they are typically called varicose veins. When smaller tiny veins are affected, they are typically called spider veins.
Pain in the legs is frequently related to abnormal leg veins. Severe varicose veins can compromise the nutrition of the skin and lead to dermatitis or a rash, discoloration, or even ulceration of the lower leg. Since most veins lie deep to the skin's surface, vein disorders are not always visible to the naked eye. As a result, using vein light helps to discover extent of the disease. This would be confirmed by ultrasound exam.
Some predisposing factors include aging, standing still occupations, and leg injury or trauma (leading to immobilization or cast applications) & obesity. Heredity is the number one contributing factor that causes varicose and spider veins. Women are more likely than men to suffer from abnormal leg veins. Up to 55% of American women may be affected in their lifetime. Hormonal factors seen during puberty, pregnancy, menopause, and the use of birth control pills affect the disease. It is common for varicose veins to become more prominent during pregnancy and worsen with successive pregnancies.
Varicose veins are known to cause symptoms that may include leg aching, pain, heaviness, fatigue, ankle and leg swelling, edema, muscle cramping, restlessness, itching and burning. Symptoms often worsen with prolonged standing. Skin changes may occur. These include brownish discoloration over the veins or near the ankle. A purple discoloration related to congestion of small veins around the foot and ankle may also develop. Varicose veins may also lead to complications such as blood clots, bleeding, rashes, and ulceration. Vein treatment causes abnormal veins to disappear and symptoms to improve. It prevents more extensive vein disease from developing and also helps to keep serious complications from occurring.
Procedure done in Dr's office, your physician will give anesthesia locally to numb the treated vein.
Once the local-regional anesthesia is done, no pain is experienced. Giving the anesthesia requires very tiny needle injection in the skin and after that, minimal discomfort from applying the anesthetic around the vein.
After endovenous laser ablation (EVLT, EVLA), depending on length of vein to be closed. For laser procedure, duration will vary from 30-45 minutes. Including preparation prior and post procedure care (you will be asked to walk in the office or on a treadmill for 20 minutes prior to leaving), average time in office is 2 hours.
You will be asked to be active and walk frequently for 2-3 days, with compression stockings kept on most of the time during 1st week and then 1-2 weeks after that (specific instruction to your case will be given). No strenuous activities (heavy lifting) for 1-2 weeks.
The symptoms start improving the same day. Though you may feel tenderness in some cases, little bruising may happen and occasional numbness for few weeks.
Like all interventional treatments possible risks and complications will be discussed with Dr. Haddadin. Potential complications may include: bruising, numbness, skin burns, vessel perforation, clots, pulmonary embolism, phlebitis and infection. Also, slight tenderness for weeks after procedure.
It will remain closed. It will fibrose and probably get absorbed. Studies show 90%-96% remain closed for years.
Most insurance companies will determine authorization of some or all requested procedures based on medical necessity. We will discuss with you your insurance coverage.
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