Vascular Surgery

Diagnosing and Treating Venous Disease and Lymphedema

Venous Insufficiency

Spider and varicose veins are caused by venous insufficiency. The leg muscles help circulate blood from the lower extremities through the veins and back to the heart. Valves situated along the course of the veins keeps blood from pooling back once it passes through. However, if a valve or valves weaken or get damaged, the blood can leak back. This causes the vein to become varicose, or enlarged and corded in appearance.

Veins in the legs are under a great deal of pressure, as they carry blood from the feet (against gravity) back up to the heart. Excess body weight also adds pressure, which can put too much force on the vein’s one-way valves—resulting in spider or varicose veins. 

 

The Blank Vascular Center diagnoses and treats a variety of vein conditions, including:

  • Spider veins
  • Varicose veins
  • Deep Vein Thrombosis (DVT)
  • Chronic venous insufficiency
  • Lymphedema

Specialists use state-of-the-art Doppler ultrasound evaluations to listen for changes in the blood flow that might indicate a valve problem. Duplex imaging enables doctors to bounce sound waves off the vein, resulting in images that show the vein’s size, shape, and amount of blood flowing through it.

Treating Varicose Veins

Jagged, webbed blue or red lines near the surface of the skin are usually spider veins and are not harmful. Varicose veins may or may not be serious. At the minimum, they can be very uncomfortable and cause pressure and swelling after standing for periods of time. In more serious cases, blood in a varicose vein can clot, and result in phlebitis, a painful condition.

In addition to lifestyle adjustments such as elevating the legs and exercise when possible, specialists at The Blank Center may recommend:

  • Compression Therapy – To alleviate pain, swelling and help support the circulation, a center physician may prescribe compression stockings.
  • Sclerotherapy – To treat spider veins and small varicose veins, a center physician injects chemicals into the vein to seal off the damaged area.
  • Vein removal – through an outpatient procedure requiring anesthesia. Vascular surgeons excise (cut) or clamp off twisted, ropey veins and remove them in sections. They can also “strip” the vein and remove it in one piece.
  • EVLT® – a minimally invasive laser procedure that is performed with a local anesthetic. Using ultrasound to locate the problem vein, surgeons will then insert a thin laser fiber through a tiny entry point around the knee. Laser energy is directed at the faulty vein, sealing the damaged part. The procedure leaves no scars, and patients can return to light normal activities within a couple of days. 

Treating Deep Vein Thrombosis

When a blood clot forms in veins deep beneath the skin, usually in the legs, the condition is known as Deep Vein Thrombosis (DVT). Risk factors include long periods of inactivity, leg injury, smoking, medical conditions such as heart disease and certain types of surgery. The problem can be painful and result in swelling, or cause more serious risk if a portion of the clot breaks loose and travels to the lungs.

The Blank Vascular Center specialists treat deep vein thrombosis in conjunction with the primary doctor. Treatment involves the use of anti-coagulants, also known as blood thinners. These can be given in pill form or via intravenous line. Our specialists are happy to follow up on patients with DVT at the request of their primary physicians.

Treating Chronic Venous Insufficiency

This deep vein condition occurs when the valves that keep blood from pooling back become damaged. The result is ongoing leg swelling, a problem called chronic venous insufficiency (CVI). There is no cure for CVI, but Blank Vascular Center specialists work with patients to prescribe a regimen of daily exercise and lifestyle modification. For example, by frequently elevating the legs, patients can control leg swelling. By using compression stockings, individuals can reduce their chances of developing open wounds.

Center physicians can prescribe compression stockings and/or compression pumps as necessary. For patients who have reflux (pooling of the blood) in their surface veins, doctors may recommend vein removal surgery or the minimally invasive EVLT laser procedure to seal off damaged areas.

Lymphedema

Lymphedema may be caused by surgical removal of the lymph nodes (for biopsy or radiation for cancer) or vein harvest for heart surgery. Even accidental trauma such as bruises, cuts, burns, sunburns, sprains, insect bites or pet scratches can cause lymphedema. It can occur immediately after such an event, or months or years later. It might also develop spontaneously, which is known as “primary” lymphedema.

The lymphatic system drains the body’s excess protein and water from all tissues. Lymph nodes filter this fluid and return it to the circulatory system. When the lymphatic system becomes blocked, the lymph fluid can cause mild to severe swelling, usually in the arms or legs. Unfortunately, it can result in slower tissue healing and infection if not monitored and treated.

Blank Vascular Center specialists provide education on dealing with the condition day-to-day, and also prescribe compression stockings and lymphedema pumps when necessary.

To refer a patient to The Blank Vascular Center, please call 215-887-5934.