Dr. Daniel Pepper, Dr. Kathleen Gibson, Dr. Brian Ferris, and Dr. Leonard Su
are board certified surgeons who are fellowship trained in vascular
surgery. They have a special interest in treating vein problems. Our
surgical team uses state-of-the-art treatments such as laser endovenous ablation and echosclerotherapy
to improve cosmetic results with minimum downtime and discomfort. These
advances have replaced traditional surgical therapies in most patients.
There are a number of options available for
treating varicose veins. Treatment recommendations may include
compression stockings, sclerotherapy (injections into surface veins to
close them), Laser therapy or surgery.
Veins
differ from arteries in their basic anatomy. Veins need valves to
keep the blood from pooling, whereas arteries do not have or need
valves since the blood is being pushed
directly by the heart's pumping action. (Only the Giraffe has valves in
an artery: the carotid artery carrying blood up their long necks to
their brains!)
When the arterial blood is pushed through the
small capillaries and enters the smallest veins, the pressure in the
veins is very low. In order for the blood in the veins to rise up to
the heart again, veins need valves. Veins valves
are as thin as 'Saran Wrap', yet are normally able to hold against the
pressure of gravity pulling on the blood above the valve.
Three categories of veins work in our upper and lower extremities:
- The deep veins
lie within the muscle compartments surrounded by fascia, a canvas-like
white material that separates the subcutaneous fat from the muscles.
With every step you take, the muscles contract and squeeze the deep
veins, forcing the blood upward from valve to valve.
- The superficial veins lie outside the fascia. The greater saphenous vein is a superficial vein which runs from the inside of the ankle up the leg and thigh to dive deep in the groin to join the femoral vein (a deep vein).
In our lower legs, the lesser saphenous vein
is a superficial vein which runs from the outside of the ankle up
towards the back of the knee where it usually dives deep to join the popliteal vein (a deep vein).
- Communicating veins
connect the superficial veins to the deep veins. These communicating
veins have to cross through small holes (perforations) in the fascia in
order to reach the deep veins. That's why they are also known as perforator veins.
Each communicating (perforator) vein has a valve which lets the blood
go from the surface into the deep system, but not the reverse. When
your calf muscles squeeze as you walk, the venous blood in the deep
veins should only go upwards towards the heart, not outwards to the
superficial veins in the subcutaneous space.
When valves
do not work, then blood that should be rising towards the heart falls
downward. If the non-functioning valves (incompetent) are in the deep
veins, then we call that
"deep venous insufficiency",
and the patient will often have leg or ankle swelling, may have brown
discoloration above the inside ankle bone, and may or may not have
varicose veins as well. The main treatment for deep venous
insufficiency is prescription grade compression hose. There is no
surgical or medical solution to replace or fix the valves (except in
experimental or most severe cases).
When the valves do not work in the superficial
veins, then those veins tend to gradually dilate, and lead to varicose
veins. Often the varicose veins that are visible are side branches
coming of an incompetent greater or lesser saphenous vein. Other sources for varicose veins include incompetent communicating veins (perforators), and veins from the deep pelvis in some women.
Our highly skilled vascular technologists use duplex ultrasound machines to painlessly evaluate your leg veins to determine the source of your vein problems: deep veins, superficial veins, communicating veins, or no major underlying vein problem.
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Varicose veins are veins that have become dilated or bulging because of
valve failure. Valves are thin membranes inside veins that keep blood
flowing from the feet towards the heart. When the valves fail, blood
can pool in the veins, causing increased pressure and dilation.
Varicose veins usually occur in superficial veins just under the skin, but could be a sign of a deep vein problem.
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Varicose Veins
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Varicose veins tend to run in families and are common in women. They
are influenced by hormones and often appear during pregnancy. Prolonged
standing can worsen varicose veins.
Varicose veins also occur in men. Treatment options are the same for both men and women.
Previously recognized or unrecognized deep vein clots can damage valves and cause varicosities.
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The symptoms can vary. In many cases there may be no symptoms and the
veins are a cosmetic concern. Varicose veins may be tender to the
touch, or may cause aching or swelling in your legs. In rare cases, the
varicose veins may cause skin changes or ulcers.
Your clinic evaluation will determine whether your vein problems are a health issue, a cosmetic issue, or both.
For more information, simply click on the links below:
Download Varicose Vein Brochure (PDF)
(Requires Adobe Acrobat Reader - Click here to download the latest version)
To view patient information videos, follow this link: www.venacure.com
Additional information:
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