Venous Disease 101

Venous disease can range from cosmetic issues to potentially life-threatening conditions. Varicose and spider veins are some of the most common symptoms of venous disease. At one time, these and other vein conditions were treated mainly using surgery. However, there are now many minimally-invasive vein treatments to help your legs look and feel better.

Types of Venous Disease

Some of the most common types of venous disease include:

  • Spider veins. Small, red or blue veins near the surface of the skin that look like spider webs or tree branches. These are caused by blood backing up in the veins. They often occur on the legs and face.
  • Varicose veins. Swollen, twisted veins near the surface of the skin. These are caused by blood backing up in the veins due to weak or damaged vein walls or valves. They most often occur on the legs.
  • Chronic venous insufficiency. Collecting of blood in the deeper veins of the leg due to weak or damaged valves in the vein. It can also occur as a result of a blood clot in the legs.
  • Superficial thrombophlebitis. A blood clot in a vein near the surface of the skin. It is often the result of injury, surgery or being inactive for a long time.
  • Deep vein thrombosis. A blood clot in a deeper vein in the leg, due to pooling of blood in the vein. This can be caused by injury or surgery, sitting or lying down for a long time, or a condition that causes blood to clot more quickly.

Causes of venous disease

Each type of vein disease has its own cause, although some have similar causes. These include:

  • Weak or damaged valves in the veins. Valves in the veins act like a one-way flap to keep blood from flowing backwards. When the valves don’t work properly, blood collects in the vein, which increases pressure in the vein and causes other symptoms. Weak walls of the vein can also cause the valves to not work properly. This occurs in varicose veins and chronic venous insufficiency.
  • Pooling of blood in the veins. Blood also pools in spider veins, although these are caused by exposure to sunlight, hormone changes and injuries.
  • Blood clot. If you cut yourself, your blood will clot in order to help stop the bleeding. Blood clots can also occur in the veins. When this happens, it can slow the flow of blood, as with superficial thrombophlebitis and deep vein thrombosis (DVT). If a blood clot in a deep vein breaks free, it can flow to the lungs and block an artery. This is called a pulmonary embolism and is a life-threatening condition.

Risk factors for venous disease

Several factors increase your risk of developing varicose or spider veins, such as:

  • Increasing age
  • If you have had other vein diseases in the past
  • If one or more members of your family have similar vein problems
  • Hormone changes that occur during pregnancy, puberty and menopause
  • Pregnancy
  • Being overweight or obese
  • Sitting or standing for long periods
  • Exposure to the sun

Risk factors for superficial thrombophlebitis and deep vein thrombosis, both of which involve clotting, include:

  • Sitting or lying for long periods, such as during bed rest or while traveling
  • A personal or family history of blood clots
  • Injury or surgery in the pelvis or legs
  • Having another condition that causes your blood to be thicker or clot more quickly, such as certain types of cancer or autoimmune diseases
  • Obesity
  • Pregnancy
  • Smoking cigarettes
  • Taking estrogen or using birth control pills, especially if you smoke
  • Old age

Minimally-invasive treatments for venous disease

Several minimally invasive treatments are available for varicose and spider veins and chronic venous insufficiency. Treatments are not necessarily a permanent cure for these conditions, and new varicose or spider veins may form later. When a vein is closed off, blood will naturally flow through other healthy veins in the leg. Treatments include:

  • Compression stockings. These apply pressure to the legs to push blood in the veins of the leg toward the heart. They can relieve symptoms, but they are a conservative approach that is often combined with other treatments.
  • Sclerotherapy. A liquid or foam chemical is injected into the vein with a small needle to cause the vein to collapse. Over time, the vein will fade away.
  • Surface laser and intense pulsed light treatments. These use focused light to heat the veins and cause them to collapse. The veins will eventually disappear.
  • Endovenous thermal ablation. A small tube (catheter) is inserted into the vein. A probe uses radiofrequency or laser energy to heat and collapse the vein.

Surgical treatments for venous disease

Although minimally-invasive treatments for varicose and spider veins are more common, surgery is still needed for certain cases. Surgical techniques include:

  • Vein ligation and stripping. The varicose vein is tied off and removed through small cuts in the skin. This procedure has become less common as endovenous thermal ablation has replaced it in most cases.
  • Ambulatory phlebectomy. The vein is removed using a small hook through small cuts in the skin. This procedure is often combined with other treatments.

These treatments may also be used for superficial thrombophlebitis. However, the main treatments for this condition and deep vein thrombosis involve using medications to prevent the formation of blood clots or break apart existing clots. In some cases, a filter may be inserted into a vein to keep clots from going to the lungs.

Compression stockings may also be used with deep vein thrombosis to help blood flow toward the heart. This can relieve symptoms, help keep new blood clots from forming, and may prevent more serious problems from occurring.

Updated Oct. 13, 2017

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