All About Varicose Veins and Venous Reflux Disease

Updated on: November 28, 2018

Varicose veins can make legs look unsightly, they can cause pain and swelling, and the source of it all is venous reflux disease.

What is venous reflux disease?

Healthy leg veins contain valves that open and close to assist in the return of blood back to the heart. In venous reflux disease, the valves that keep the blood flowing out of the legs and back to the heart do not close properly, allowing blood to flow in reverse and pool in the leg veins. This causes the superficial veins to swell and bulge resulting in unsightly varicose veins, leg swelling, pain and fatigue. Without treatment, venous reflux disease can also lead to skin pigment changes in the legs as well as ulcerations that are slow to heal. Elevating the legs, wearing compression stockings, rest and pain medications can offer temporary relief of some symptoms of venous reflux disease, but do not fix the underlying problem. Although more common in older adults, varicose veins can also be seen in young people, and early treatment may prevent later complications.

Treatment options

In recent years, a new procedure has become available to treat venous reflux disease. This procedure, known as endovenous saphenous vein closure, can provide a permanent solution to the cause and symptoms of venous reflux disease. Venous reflux disease is diagnosed with an ultrasound of the legs. The procedure is performed if venous reflux is identified by ultrasound. Under local anesthetic, a small catheter is inserted into the saphenous vein, a superficial branch of the larger, deeper femoral vein. Using radiofrequency (RF) energy delivered through the inserted catheter, heat is applied to the vein wall, which causes the vein walls to come together and close. Once the vein is closed, blood is re-routed to healthy veins.

Upon completion of the procedure, which takes about an hour, a simple bandage is applied, and the leg is gently wrapped in dressings to aid in healing. You are encouraged to walk frequently after the procedure and typically return to daily activities within a day. A follow-up visit is then scheduled for three days after the procedure, to check for any complications and to verify that the vein has remained closed. Any discomfort is usually well controlled with over-the-counter pain medications.

Another way to perform endovenous saphenous vein closure is with laser. However, data has very recently been published in medical journals that shows that RF has a lower rate of complications, specifically bruising and pain, compared with laser, allowing patients to return to their normal activities quicker. Therefore, many physicians are now switching to RF to treat varicose veins.

The results

The procedure can be done safely in an outpatient office, and is usually covered by most major insurance companies. About 95% of patients remain free of varicose veins over the long term, according to medical data. To reduce the risk of complications, the procedure is best performed by a physician who has formal training in endovenous techniques.

If you are experiencing any symptoms of venous reflux disease or have unsightly, swollen varicose veins, talk to your primary care physician about a referral to a vein specialist. You can have beautiful legs again!

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