Venous Insufficiency

What Is Venous Insufficiency?

Venous insufficiency, also known as venous reflux, is a condition that develops when the veins in your legs become unhealthy or damaged. This causes blood to reflux or pool in your veins which leads to a number of uncomfortable symptoms such as leg pain, burning, itching, restless leg, heaviness and fatigue. When left untreated, venous reflux can lead to more significant clinical issues such as pain, chronic swelling, skin discoloration, thickening of the skin and ulceration. More than 30 million people in the U.S. are affected by this disease with only 1.9 million seeing treatment annually. This leaves the vast majority undiagnosed and untreated. Without treatment, those with the disease may experience progressive symptoms such as swollen legs, skin damage and/or ulcers that can be debilitating and significantly impact their quality of life.

Diagram illustrating venous insufficiency that can cause leg cramps, aching, swelling, and other leg pain

When diagnosing venous insufficiency, a duplex ultrasound is performed on the lower extremities to look at the diameter of the vein. Veins of certain diameters are considered abnormal and qualify for treatment under an individual’s insurance requirements. Also looked at under ultrasound is reflux or backflow of blood in the veins. Individuals with known dilation, reflux and bothersome symptoms can benefit from treatment to their diseased veins by having them shut down.

Conservative treatment options like compression stockings, leg elevation, low salt diet, daily exercise, weight management and analgesics for pain can all be used for relief of symptoms. Although this will not fix the physiological problem at hand, these measures can help an individual manage their symptoms prior to treatment.

Chronic Venous insufficiency (CVI) is a condition in which the saphenous veins of the legs become enlarged.

This leads to a malfunction of the vein and poor flow of blood back to the heart.  This also causes the formation of varicose and spider veins.  Often these varicose veins are not seen on the surface of the skin but are deeper in the leg and can only be seen under ultrasound.  This poor circulation, pooling of blood, and enlarging veins of the legs can cause significant symptoms.

These symptoms can include:

  • Generalized leg pain, aching, swelling, heaviness or fatigue
  • Burning or itching of legs
  • Skin discoloration and/or ulcers, open wounds or sores
  • Restless leg syndrome or cramping
  • Bleeding from varicose veins
  • Pain and tenderness of varicose veins

Risk Factors

Vein problems are common. In fact, almost half of men and women can expect to develop some sort of venous disease before they reach their 60’s. Factors that contribute to the development of venous insufficiency:

  • Family history of vein condition
  • History of pregnancy
  • Occupations requiring prolonged standing or sitting
  • Obesity or history of being overweight

Treatment of Venous Insufficiency

Radiofrequency ablation equipment and VenaSeal glue catheter used for varicose vein removal

Radiofrequency Ablation

Radiofrequency ablation is an ultrasound guided, minimally invasive treatment option for superficial venous reflux. A thin catheter is inserted into the vein through a small opening. Using radiofrequency energy, the catheter disrupts the tissues of the vein wall as it heats and seals the vein shut. This is an in office procedure done in 30-60 minutes, with local anesthetic only and no down time after the procedure. Our patients are able to walk right out of the office with no need for a “recovery” period. Following the procedure, a simple compression dressing is placed on the treated leg to aid in healing. A compression stocking will be worn for a short period of time post procedure for optimal results. You will be encouraged to avoid prolonged standing or sitting  in addition to any extremely strenuous activities for a period of time.  Closure of the saphenous veins may also be done by a procedure known as laser ablation where laser energy is emitted inside the vein to close it down. However, studies have shown that those treated with radiofrequency ablation experienced less leg pain, less bruising and less complication resulting in a faster and less painful recovery than those treated with laser ablation. Also reported was improvement of their quality of life up to four times faster than those treated with laser ablation. For this reason, we provide radiofrequency ablation in addition to what is known as VenaSeal as our treatment of choice for closure of saphenous veins. Radiofrequency ablation is covered by insurance once all requirements are met. Individual insurance requirements can be discussed with Heart of Dixie Vein and Vascular team.

Diagram illustrating how a radiofrequency ablation catheter closes and removes varicose veins

VenaSeal Closure

The VenaSeal closure procedure improves blood flow by sealing or closing the diseased vein. The system delivers a small amount of specially formulated medical adhesive to the diseased vein. The adhesive seals the vein and blood is rerouted through nearby healthy veins. Though this treatment is not covered by insurance, it is the treatment of choice by those who wish to seek immediate treatment and do not want to wear compression stockings required by insurance for radiofrequency ablation. Details of the procedure, pricing and scheduling can be discussed with Heart of Dixie Vein and Vascular team.

To learn more about VenaSeal, click here

VenaSeal glue catheter used to close swollen varicose veins

For more information regarding the technology used at Heart of Dixie Vein and Vascular Center visit

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