Varicose Veins (Venous Insufficiency)

  • Venous Reflux is a medical condition that affects the return of blood flow from the legs to the heart
  • Veins have tiny valves that normally force blood back up towards the heart and keep it moving in one direction… UP

When these valves no longer function, it causes blood to flow backwards and pool in the veins of the legs. These veins become swollen, large, and eventually painful

  • Venous reflux disease commonly produces varicose veins, the abnormally swollen and discolored superficial leg veins that affect more than 25 million Americans
  • Varicose veins can range from small, thin purple lines just under the skin (known as “spider veins”) to thick, bulging veins that can protrude well beyond the skin surface
  • In any form, varicose veins are signs of venous reflux, a progressive disease that can cause significant circulatory problems as it worsens
  • Although often mistaken as a cosmetic problem, venous insufficiency can produce a number of clinical problems including pain and severe swelling
  • Venous insufficiency can significantly impact a person’s lifestyle, especially when the person’s job requires extended standing
  • Market research indicates that over 2 million workdays are lost annually in the US and $1.4 billion is spent each year on this common medical condition

Of the 25 million Americans with venous insufficiency, approximately 7 million exhibit serious symptoms such as edema (swelling), skin changes such as darkening or leather-like appearance, and venous ulcers. It is estimated that in America, 72% of women and 42% of men will experience varicose veins by the time they are in their 60s.

The veins in the lower limbs are classified into two systems:

  • Superficial Veins (including the Great and Small Saphenous Veins)
  • Deep Veins the deep vein system is the MAIN return route for blood back to the heart. When a blood clot is found in one of the deep veins, is called a DVT (for Deep Vein Thrombosis)

The Deep Vein system is NOT treated with radiofrequency ablation. Problems with the deep vein system are managed by a specially trained Vascular Surgeon and are not a part of outpatient Varicose Vein treatments

The two systems are connected by perforating (connecting) veins that pass through the deep fascia

Anatomy of the Venous System

What is the Great Saphenous Vein? 

The greater saphenous vein (GSV) is a large superficial leg vein running from the foot to the groin

It is the vein Cardiovascular Surgeons harvest and use to create bypass grafts during Open Heart Surgery!

What is the Small Saphenous Vein?

The short or small saphenous (SSV) vein runs up the back of the leg from the ankle to the knee.

Three factors influence the return of blood back to the heart:

  • Respiration – when we breathe, the movement of the diaphragm creates a negative pressure that helps the return of blood from the legs to the heart
  • Vein Valves – only veins have valves. Arteries do not.  Healthy valves close, preventing blood from refluxing or pooling in the legs
  • Calf Muscle Pump –when we walk, the action of the calf muscle helps to force blood upward (sitting or standing too long can stress the valves by slowing the return of blood and increase blood pressure in the vein, damaging the valves)

Venous insufficiency, also known medically as venous reflux disease, in the greater saphenous vein is a primary underlying cause of varicose veins

The great saphenous is also the most common superficial vein to be treated with radiofrequency ablation to restore healthy circulation and eliminate varicose veins

Common Symptoms of Venous Reflux

  • Leg pain, aching, tired or weak legs, especially after long periods of standing or sitting
  • Varicose veins
  • Burning or itching of the skin
  • Swollen legs and/or swollen ankles (edema)
  • Color and texture changes of the skin
  • Open wounds (skin ulcers)

Patients presenting with symptoms of venous insufficiency, such as those listed above, should undergo an in-depth evaluation, including a Venous Reflux Ultrasound study

Patients who are high risk for needing Open Heart surgery may not be candidates for treating varicose veins. Your Vascular Surgeon or Vascular Nurse Practitioner will review your medical history, symptoms, and risk factors and discuss this with you at your consultation.

For people without any symptoms, cosmetic concerns due to the presence of varicose veins might be evaluated with only a physical examination; however, an ultrasound is still needed to determine the severity of disease in the veins of the legs

Radiofrequency endovenous ablation (RFA) is a minimally invasive treatment procedure for venous reflux disease, using radiofrequency to heat and seal diseased great saphenous, small saphenous, and perforator veins – the underlying cause of severe varicose veins

The ClosureFast™ Procedure catheter for the treatment of venous reflux delivers radiofrequency energy to a heating element to heat and contract the collagen within the vein walls causing the vein to shrink and collapse