Skip to main content

Diseases of the Veins

Diseases of the Veins

Venous disorders are classified as conditions that damage the veins in your legs leading to chronic venous insufficiency. The veins in your legs are responsible for transporting blood back to your heart using valves to prevent backward blood flow into your ankles or feet. Damage to these valves can cause venous incompetence leading to increasd blood pressure in the veins in your legs which may cause serious complications and put your overall health at risk.

At 901 Vascular, our specialists can diagnose and treat all venous disorders, providing comprehensive care and relief from symptoms. Learn more about various venous diseases and their available treatment options.

dialysis imaging

An ultrasound scan is the only definitive way to diagnose vein disease. A technician uses this test to take an image of the inside of the veins in your leg. A qualified medical doctor will review the test results to determine if the valves inside the veins are working properly.

Varicose veins and chronic venous insufficiency (CVI) are recognized by many insurance companies, including Medicare and private insurers, as treatable medical conditions.

Varicose Veins

Varicose veins are large, raised blood vessels that commonly appear on the inner legs or in the lower pelvic region that are caused from the increased blood pressure in the veins in your legs. These superficial veins can be seen through the skin in a bulging, bluish-purple hue. While varicose veins themselves are not a threatening medical condition, they can be uncomfortable and even painful to some individuals. Venous disease can worsen over time and to treat progression would require professional treatment.

Varicose veins are not just a cosmetic issue.

Vein disease in the legs can cause varicose veins and other painful symptoms that can impact how you live. We believe life shouldn’t be limited by pain caused by leg vein disease, and that’s why we’re here to help you understand your pain and break free from it.

Vein disease in the legs can cause varicose veins and other painful symptoms that can impact how you live. We believe life shouldn’t be limited by pain caused by leg vein disease, and that’s why we’re here to help you understand your pain and break free from it.

Common signs and symptoms of venous disease

  • Aching or pain in legs
  • Swelling of legs or ankles
  • Cramping
  • Heaviness or tiredness
  • Itching, sores, or ulcers
  • Restlessness
  • Skin changes and/or darkened calf discoloration
  • Skin Color and Texture Changes*
  • Leg Swelling*
  • Varicose Veins*
*Images courtesy of Rajabrata Sarkar, M.D., Ph.D. via Medtronic Venous Asset Library
  • Known risk factors

    • Family history
    • Smoking
    • Current or previous pregnancies
    • Obesity or excess weight
    • Prolonged sitting or standing
    • Leg injury or trauma
    • Lack of exercise
    • A blood clot (deep vein thrombosis)
  • Causes of leg vein disease 

    There are a number of factors that can put an individual more at-risk for developing varicose veins. Some of these include:

    • Obesity
    • Personal history of peripheral venous disease
    • Family history of blood clots
    • Family history of varicose veins
    • Hormonal changes (Through pregnancy, puberty, or menopause.)
    • Previous skin injury/surgery

Spider Veins

Similarly to varicose veins, spider veins are very superficial blood vessels that can be seen directly under the skin. These veins have a red or bluish hue and can be uncomfortable or cause itching. Spider veins affect only the capillaries, the smallest blood vessels in the body, and typically appear on the legs or face.

Varicose veins are not just a cosmetic issue.

Treatment for spider veins is typically considered a cosmetic venous option by most insurance carriers.

They can occur with varicose veins or be a solitary skin issue without a medical venous disease accompanying the spider veins. They can occur due to a family history of spider veins, in response to weight gain such as pregnancy, or in response to skin injury/surgery.

While both varicose and spider veins can be uncomfortable, most complaints of pain come from patients suffering with symptomatic varicose veins. These swollen blood vessels are larger than spider veins, causing cramps and aches in the legs. Additionally, varicose veins can cause swelling, ulcers. Less commonly, chronic venous insufficiency can lead to inflammation or superficial thrombus to develop in affected veins. 

Deep Vein Thrombosis

Deep vein thrombosis (DVT)  occurs when a blood clot forms in a vein located deep in the body, typically in the lower legs, thighs, or pelvis. These blood clots may partially or completely block off the flow of blood in the legs and could potentially embolize other parts of the body such as the lungs and cause major problems. While on its own DVT is not life threatening, the potential for the clot to break loose and lodge elsewhere makes it a serious condition you must receive immediate medical attention for. 

While DVT can occur without obvious symptoms, be aware of new swelling in the leg, leg pain, a change of color of the skin (red or purple), and or one leg acutely becoming larger than the other leg. These can all be signs that you are experiencing deep vein thrombosis and may need to speak to your medical provider for an evaluation.

DVT can be caused by anything that prevents blood from properly flowing back to the heart from the legs. There are several risk factors that can cause deep venous thrombosis to develop.

  • Clotting Disorders
  • Sedentary Lifestyle
  • Previous leg injury or surgery
  • Hormonal changes (Through pregnancy.)
  • Family history of deep venous disease or pulmonary embolism
  • Use of birth control pills
  • Recent cancer treatment such as radiation or chemotherapy

Leg Ulcers

Similarly to varicose veins, spider veins are very superficial blood vessels that can be seen directly under the skin. These veins have a red or bluish hue and can be uncomfortable or cause itching. Spider veins affect only the capillaries, the smallest blood vessels in the body, and typically appear on the legs or face.

Early diagnosis is critical

When left untreated, leg vein disease can progress into a more serious condition known as Chronic Venous Insufficiency. If CVI is left untreated, legs can sometimes develop painful sores or wounds on the skin’s surface, called ulcers. Ulcers typically appear near the ankle or lower leg and are brought on from the increased buildup of fluid and blood pressure from veins affected by CVI.

A venous leg ulcer is a chronic sore that takes more than two or three weeks to heal and is caused by increased venous pressure in the legs. Unlike typical cuts and scrapes, these ulcers may not heal without proper treatment and may also cause discolored skin around the wound, or give off discharge. While they are not life-threatening, there is always a risk for infection and further complications. Leg ulcers may also come back repeatedly if the underlying issue is not addressed. 

Venous leg ulcers can also form if you have previously or currently experienced varicose veins.

veinous leg ulcer

Venous Leg Ulcer*

Patients who receive early vein closure treatment along with compression stocking therapy for venous leg ulcers experienced significantly shorter time to healing and extended time free from ulcers.

  • More than one million people in the United States suffer from venous leg ulcers.
  • 70-90% of ulcers below the knee are venous (caused by vein disease).
  • More than 50% of venous ulcers treated are recurrent ulcerations.
  • Due to pain, mobility limitations, and other consequences, venous leg ulcers have been associated with increased rates of depression and substantial decreases in patient quality of life.

Treatment Options

While many of these afflictions have no concrete cure, there are several treatment options to reduce inflammation and appearance. Compression stockings are a conservative treatment option utilized by practitioners to reduce overall swelling and discomfort but they do not treat the vascular source but can help relieve symptoms of chronic venous insufficiency. 

Sclerotherapy

While these passive methods can eventually help lower the visual appearance and pain of varicose veins, there are also procedures that can minimize symptoms more rapidly. For one, sclerotherapy is a minimally invasive procedure where a solution is injected directly into the veins. This solution scars the interior of the spider vein or varicose vein, causing it to eventually collapse and fade from view once absorbed by the body naturally. Blood is then naturally rerouted through the healthier veins through competent venous valves. 

Venous Laser Ablation

Additionally, patients can undergo venous laser ablation. Much like sclerotherapy, this procedure is minimally invasive. After the skin is numbed, a small wire is inserted into the vein and delivers laser energy, sealing off the vein while remaining healthy veins continue to move blood around. After venous laser ablation, you may have some mild bruising around the treatment site, however these bruises will eventually fade and leave you with clearer legs and less painful veins.

ClosureFast Procedure

  • catheter into the diseased vein

    Step 1: Thermal catheter is placed

    Using an ultrasound, your physician will position the catheter into the diseased vein through a small access site.

  • injections numb the area

    Step 2: Local anesthetic is applied

    A series of injections numb the area around the vein that will be treated.

  • vein wall is heated

    Step 3: Heat is delivered to vein wall

    The vein wall is heated and the catheter is withdrawn from the vein.

  • the catheter is removed

    Step 4: Vein is closed

    The vein is “heat sealed” as the catheter is removed. A multilayer compression wrap is applied from foot to groin post procedure.

Before The ClosureFast Procedure

You will have an ultrasound imaging exam of the leg being treated. This exam is important for assessing the diseased superficial vein and planning the procedure.

During the procedure

Your doctor will discuss the procedure with you. Here is a brief summary of what to expect:

  • The ClosureFast procedure is performed on an outpatient basis. Your doctor will perform the ClosureFast procedure. Using an ultrasound, your doctor will position a catheter in the diseased vein through a small opening in the skin.
  • The small catheter delivers heat to the vein wall, causing it to shrink and seal the vein. Once the diseased vein is closed, blood will reroute itself to other healthy veins.
After the procedure
  • You will be taken to the recovery area to rest.
  • Following the procedure, your doctor will apply a simple bandage over the insertion site and will give you compression stockings to aid in the healing process. Your doctor may encourage you to walk and to refrain from extended standing and strenuous activities for a period of time. The average patient typically resumes normal activities within a few days.1,2
  • Your doctor will recommend follow-up care as needed.

Patient results: Before and After

  • before closurefast procedure

    Before ClosureFast procedure*
  • Six weeks after ClosureFast procedure

    Six weeks after ClosureFast procedure*
  • *Individual results may vary. Images courtesy of Dr. Kathleen Gibson via Medtronic Venous Asset Image Library

Benefits of the ClosureFast procedure

  • Relief of symptoms after two days, with a noticeable improvement in one to two weeks
  • Minimally invasive outpatient procedure
  • Less pain and bruising than laser treatment
  • Faster recovery than laser treatment
  • Proven results with positive patient experience
  • Rapid recovery — on average, patients resume normal activities within a few days
  • Lasting results — the only radiofrequency energy procedure with published long-term clinical data demonstrating safety and efficacy, with a 91.9% closure rate at five years.

    Adverse events can include nerve injury, hematoma, phlebitis, thrombosis, and/or pulmonary embolism.

    What type of therapy is ClosureFast

    Thermal shrinkage of the vein wall with radiofrequency energy or heat

    • Inpatient or outpatient procedure: Outpatient procedure
    • One- versus two-leg treatment: Typically, each leg will be treated in separate appointments
    • Needle sticks required: One needle stick for vein access. Typically, 5 to 10 needle sticks for anesthesia.
    Typical post-treatment recovery

    Healing of vein access site, anesthetic needle stick sites, and also healing of ablated vein section

    • Compression hose: Required for approximately one week
    • Procedure success rate: 91.9% after five years

    ClosureFast procedure FAQ

    Is the ClosureFast procedure painful?
    Most patients report feeling little, if any, pain during the ClosureFast procedure.3 Your doctor will give you a local or regional anesthetic to numb the treatment area.

    When can I return to normal activity?
    Patients treated with the ClosureFast procedure may resume normal activity more quickly than patients who undergo surgical vein stripping or laser ablation. With the ClosureFast procedure, the average patient typically resumes normal activity within a few days.2 For a few weeks following the treatment, your vein specialist may recommend a regular walking regimen and suggest you refrain from strenuous activities (heavy lifting, for example) or prolonged periods of standing.

    When will my symptoms improve?
    Most patients report relief of symptoms after two days, with a noticeable improvement in one to two weeks.

    Is there any scarring, bruising, or swelling after the procedure?
    Most patients report limited to no scarring, bruising, or swelling following the ClosureFast procedure.3

    How is the ClosureFast procedure different from endovenous lasers?
    Both ClosureFast and lasers use thermal technology to deliver heat into the diseased vein, but they each use a different method of delivery. Despite their similarity in using heat, a 2009 study showed that the ClosureFast procedure is associated with lower rates of pain, bruising, and complications and a faster improvement in patients’ quality of life when compared to 980 nm laser ablation.4

    How is the ClosureFast procedure different from vein stripping?
    During vein stripping, incisions are made in the groin and calf, and a tool is threaded through the diseased vein to pull the vein out of the leg. With the ClosureFast procedure, only one small incision is made at the insertion site and the vein is then treated and left in place. ClosureFast is a minimally invasive approach that reduces the likelihood of pain and bruising, associated with vein stripping surgery.1

    Is the ClosureFast procedure covered by insurance?
    Many patients have access to the ClosureFast procedure through their insurance coverage plan. Insurance companies detail access to the ClosureFast procedure and other radiofrequency ablation procedures in coverage policies for varicose veins or chronic venous insufficiency. As with all healthcare procedures, you may also have some cost associated with receiving treatment, such as a copay or coinsurance. Please reach out to your insurance company to discuss your specific plan coverage and potential costs prior to seeking treatment

    VenaSeal Procedure

    The VenaSeal procedure delivers a small amount of a specially formulated medical adhesive to seal — or close — the diseased vein, rerouting blood to nearby healthy veins and providing symptom relief. The VenaSeal closure system is a safe and effective treatment, offering significant improvement in quality of life.
    • catheter into the diseased vein

      Step 1: Catheter is placed in the vein

      Using an ultrasound, your doctor will position a catheter into the diseased vein through a small access site.
    • injections numb the area

      Step 2: Specialized adhesive is placed

      A specially formulated medical adhesive is placed in the diseased vein via a small catheter.
    • vein wall is heated

      Step 3: Light external pressure is applied

      Light external pressure is applied to adhere the vein walls together. This step is repeated for the length of the vein.
    • the catheter is removed

      Step 4: Catheter is removed

      The catheter is removed and a single adhesive bandage is applied to the vein access site.
    • VenaSeal Live Procedure

    • VenaSeal Animated Procedure

    Before The VenaSeal Procedure

    You will have an ultrasound imaging exam of the leg being treated. This exam is important for assessing the diseased superficial vein and planning the procedure.

    During the procedure

    Your doctor can discuss the procedure with you. Here is a brief summary of what to expect:

    • You may feel some minor pain or stinging with a needle stick to numb the site where the doctor will access your vein. 
    • Once the area is numb, your doctor will insert the catheter (i.e., a small hollow tube) into your leg. You may feel some pressure from the placement of the catheter.
    • The catheter will be placed in specific areas along the diseased vein to deliver small amounts of the medical adhesive. You may feel a mild sensation of pulling. An ultrasound will be used during the procedure to guide and position the catheter.
    After the procedure
    • After treatment, the catheter is removed and a small adhesive bandage is placed over the puncture site.
    • You will be taken to the recovery area to rest.
    • Your doctor will recommend follow-up care as needed.

    Patient results: Before and After

    • before closurefast procedure

      Before VenaSeal procedure*
    • Six weeks after ClosureFast procedure

      Three months after VenaSeal procedure*
    • *Individual results may vary. Images courtesy of Dr. Kathleen Gibson via Medtronic Venous Asset Image Library

    Continue reading

    Vascular Wound Care

    901 Vascular provides comprehensive treatment for difficult and hard to heal wounds. Our compassionate team of wound specialists treat all types of wounds to help alleviate suffering and improve a patient’s quality of life. Experiencing a disruption in your quality of life with a chronic or non-healing wound can be a very difficult experience. At 901 Vascular, we offer wound care services to meet your needs, manage your wound and promote wound healing.

    Causes of non-healing or chronic wounds:

    • Poor circulation or peripheral arterial disease
    • Diabetes
    • Venous stasis or chronic edema
    • Pressure related injuries
    • Lymphedema
    • Burns
    • Infection or increased bacterial burden

    We offered personalized treatment options including:

    • Specialty wound dressings
    • Compression therapy
    • Treatment of wound infections
    • Pressure offloading
    • Negative-pressure therapy
    • Cellular and tissue-based products
    • Debridement of the wound
    • Education

    Uterine Fibroid Embolization (UFE)

    If you have been diagnosed with uterine fibroids, uterine fibroid embolization (UFE) may be an option to help relieve symptoms. UFE, also known as uterine artery embolization, is a non-surgical, minimally invasive procedure used to treat fibroids. UFE is recognized by the American College of Obstetrics and Gynecology as a safe and effective treatment for fibroids and offers women a dramatic improvement in their symptoms. The procedure decreases the size and softens uterine fibroids. UFE is often a same-day procedure and can be an alternative to traditional surgical hysterectomy or myomectomy.

    Benefits of the Procedure

    • Reduced recovery time compared to conventional surgery
    • Quick symptom relief
    • Preservation of uterus
    • Lower complication rates
    • Reduced pain and blood loss

    During UFE, our interventional radiologist makes a tiny incision (about the size of the tip of a pencil) at the wrist or the groin and inserts a thin catheter into the artery. The interventional radiologist guides the catheter to the fibroid’s blood supply and releases small particles which block the blood vessels.

    This results in the fibroid softening, and shrinking in size.

    Preparing for Uterine Fibroid Embolization

    Before the Procedure:

    Patient’s may have had an MRI or ultrasound to determine if fibroids are the cause of symptoms and to adequately assess the size, number, and position of the fibroids.

    Before the procedure, tell the doctor about:

    • Medications you are taking
    • Allergies
    • Whether you have had anesthesia in the past or x-ray dye and any reactions
    • Whether you take aspirin or a blood thinner
    • Any recent illnesses or medical condition
    • Any possibility of being pregnant
    • Your doctor will provide instructions for you to follow the day before your procedure and which, if any, medications you may take the morning of the procedure.

    After the Procedure:

    During the recovery process, you may experience some level of pelvic pain or discomfort. This is common and is most severe during the first 24 hours after the procedure. The pain will slowly go away within one week. Some women may also experience mild fatigue. However, most women recover quickly and return to normal activities within a week.

    Peripheral Arterial Disease

    Peripheral arterial disease (PAD) is a buildup of plaque inside the arteries, which carry fresh blood and oxygen to your organs, limbs and all tissues in the body.

    The plaque buildup causes the artery to narrow over time, which decreases blood flow to your limbs and tissue. If unrecognized or left untreated, this can lead to complete blockage of the arteries, resulting in painful ulcers, non-healing wounds, gangrene and eventually amputation.

    Symptoms of PAD Include

    • Pain, weakness, or numbness in the legs (buttocks, thighs or calves) with walking or activity. This leg pain with walking is known as claudication and typically improves when a person stops walking but will reoccur once walking is resumed.
    • Claudication can also occur in the arms and may present during repetitive movements of the arm.
    • As the blood flow diminishes, the pain may progress to unrelenting aching type pain in the feet or toes at night or when at rest. This pain is known as rest pain and often causes a person to hang a foot over the side of the bed to provide a bit of relief.
    • Non-healing wounds or ulcerations
    • Darkening of the skin
    • If left untreated, rest pain will undoubtedly progress to ulceration and gangrene. Gangrene refers to dead tissue which cannot be salvaged.

    Risk factors for PAD include:

    • History of smoking and tobacco use
    • Diabetes
    • High cholesterol
    • Obesity
    • High blood pressure
    • Family history
    • People with PAD are three times more likely to die of heart attacks or strokes than those without PAD.

    Peripheral arterial disease is not curable but with early treatment and lifestyle changes we can prevent amputation.

    If you are experiencing any of these symptoms, please contact us for evaluation. We will schedule an office visit to evaluate your circulation with examination and ultrasound, performed by one of our experienced clinicians.

    An angiogram, a procedure injecting dye into the arteries to outline the exact location of blockages, can be performed in the comfort of our office on a same day basis.

    Treatment options may include:

    • Balloon angioplasty (a small balloon is inflated inside the blocked or narrowed artery to open the blocked area and restore blood flow)
    • Atherectomy (the plaque buildup inside the artery is “shaved” away or “cleaned out” by a small device on the end of a catheter)
    • Stenting (a small coil is expanded inside the artery to open the blocked area and is left in place to provide structure, keep the artery open and maintain blood flow)
    • Vascular surgery is needed in some cases. A bypass graft using a vein from another part of the body or a tube made of synthetic material is used to reroute blood flow around the blocked artery.

    At 901 Vascular we are committed to providing excellent patient care and preventing amputation.

    Dialysis Access Procedures

    From surgical creation of dialysis access (AV Fistula or AV Graft) to minimally invasive procedures to help maintain a healthy access, our expert staff will help navigate you through your journey as we work closely with your nephrologists/dialysis centers. 

    Warning Signs 

    A Functioning Vascular Access is Vital for Dialysis. Warning Signs Your Access May Be Failing – 

    Fistula/Graft:

    • Prolonged Bleeding 
    • Pain 
    • Difficult Cannulation 
    • Arm Swelling 
    • Aneurysm Formation/Growth 
    • High Venous Pressures 
    • No Thrill/Change in Thrill 
    • Infiltration
    • Non-maturing Fistula 
    • Redness/Drainage
    • Poor Clearance 
    • Clotting of Needles or Lines 
    • Abnormal Arterial Pressures 
    • Recirculation 
    • Poor Flow 

    Catheter:

    • Pain 
    • Poor Catheter Flow (less than 300ml/min) 
    • Redness/Drainage 
    • Poor Clearance
    • Clotting of Lines
    • Recirculation 
    • Unable to Aspirate 

    If you notice ANY of these symptoms, please inform your doctor or nurse immediately. 

    What can I do to keep my dialysis access healthy? 

    • Examine your access daily to ensure there is a thrill
    • Keep site clean
    • Wash skin daily with soap and water
    • Avoid sleeping on your access arm
    • Avoid carrying heavy objects with your access arm
    • Avoid checking blood pressure on your access arm

    I have a catheter: 

    • Keep site clean and dry
    • Dressing changes will be done at dialysis center
    • Transition to a fistula or a graft as soon as possible