VASCULAR SOLUTIONS - Vascular and Endovascular Surgeons Treating Peripheral Vascular Disease in Cleveland, Ohio

Vascular Solutions

Common Signs and Symptoms

Because the blood in superficial venous incompetence (varicose veins) and deep venous incompetence does not move in the correct unidirectional fashion, it produces pressure, inflammatory responses and other pathophysiologic responses that are undesirable. Over a period of time, this can cause a number of manifestations, including:

Aching, heaviness and cramping of the legs, which are made worse by standing for long periods of time.

Skin rash, thin skin, and poor skin healing (Sometimes an ulcer will form on the lower, inside aspect of leg, often just above the ankle)

Itching around the veins and surrounding effected skin

Aesthetically unappealing appearance of the legs

Diagnosis

Typically the diagnosis can be made by taking a good history and doing a physical examination. Noninvasive testing is often used to supplement and provide independent verification of the findings. Venous duplex testing, in a good vascular laboratory, is the most common test. Harmless ultrasound waves are used to image the veins. The sound waves bounce back off of structures (an echo) and provide a visual appearance on a screen. Obstruction due to scarring and clots can be seen with this test. It also provides an opportunity to visualize and assess the function of the valves and the relative directional flow patterns. The deep veins are the more important veins in the legs. They provide the most significant and substantial drainage in the lower extremities. The superficial veins, consisting of the greater and lesser saphenous veins, are of less significance and in some conditions may be removed or obliterated. In fact the superficial veins, of the lower extremities are the preferred vein for heart bypass surgery. In patients with heart bypasses using leg veins, the veins are normal and the leg post operatively remains with minimal consequence due to the robust nature of the deep venous system.

Treatment

The ideal treatments have the following goals:

Restore a more physiologic, unidirectional flow pattern within the lower extremity

Relieve the heaviness and cramping in the legs

Heal and prevent future skin problems and wounds

The actual treatment of a patient depends on whether the problem relates to the superficial, deep venous systems or both.

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