Maryvale Cardiology

Experts in diagnosing and treating venous disorders

Millions of Americans suffer with venous disorders. Some vein conditions are primarily a cosmetic concern, but others can cause debilitating pain and lead to serious, even life-threatening complications. But, there are many new treatment options available at Maryvale Cardiology for longtime sufferers of vein disorders that affect patients of all ages.

The vein and vascular specialists at Maryvale Cardiology are committed to utilizing the most current diagnostic tests and treatment services available in determining the causes of venous disease. They may include recurring deep vein thrombosis, disabling swelling, pain, cramping, hyperpigmentation, venous valve incompetence, chronic venous insufficiency, varicose veins, spider veins, recurring non-healing ulcers or other vein disorders.

Varicose Veins

What are varicose veins?

Varicose veins are enlarged veins located beneath the skin that are swollen, gnarled, and twisted. They can be raised above the surface of the skin. Superficial varicose veins look dark blue or purple through the skin. Varicose veins usually occur on the legs, ankles, and feet.

What causes varicose veins?

Varicose veins are usually caused when valves in the veins stop working properly. In a normal vein the muscles contract forcing the blood upwards toward the heart. The valves are a one way valve allowing the blood to pass through in only one direction, preventing the blood from backing up. When the valves fail to function properly they remain open allowing the blood to flow backwards and pool in the lower veins. This causes the veins to get larger and painful.

What are spider veins?

Spider veins are tiny dilated veins located just under the skin. They are usually found on the lower legs and ankles. They appear red or dark blue and resemble a spider’s web or branches of trees. Spider veins are caused by the backup of blood due to improperly working valves.

How common are varicose veins?

Varicose veins affect about 50 – 55% of women and 40-45% of men. Varicose veins usually occur with increased age, family history, pregnancy, obesity, or leg injury. People who stand for prolonged periods of time also are likely to develop varicose veins.

How can I prevent varicose veins?

Nothing can be done to completely prevent varicose veins. However, there are some actions you can take to reduce the chances of varicose veins and spider veins spreading or becoming uncomfortable.

What are the signs and symptoms of varicose veins?

In addition to the unsightly appearance of varicose veins you may also experience other symptoms such as:

Should I see a doctor for my varicose veins?

Yes, especially if you experience any of the above symptoms. Only a doctor can diagnose the cause and severity of your varicose veins. Your doctor can advise you on an appropriate treatment. It is best to see a doctor who specializes in vein disorders and phlebology.

What tests are required to diagnose varicose veins?

While a simple history and physical examination is all that is usually required to diagnose varicose veins other tests may be required to determine the cause. Finding the cause of varicose will determine what treatment is necessary. The most common diagnostic procedure is an ultrasound examination to determine the condition of the vein valves.

What is an ultrasound test?

An ultrasound examination is a machine that exposes the region of the body to high frequency sound waves. The sound waves are reflected back to the machine and an image of the underlying body parts are viewed on a screen. An ultrasound examination is noninvasive and painless.

What are the treatments for varicose veins?

Recent studies in endovascular techniques and laser technology have revolutionized the treatment for varicose veins. What used to be an operation with ugly scars and long recovery times are now a simple procedure with no recovery time. Most procedures are performed in the doctor's office or clinic and the patient returns to normal functions immediately.

Endovenous Laser Treatment

What to expect:

A tiny catheter is inserted into the vein and laser energy light is directed toward inner vessel to collapse the vein.

Results

Almost all resume all activity < 24 hr.

Sclerotherapy

Today, many small varicose veins and spider veins are treated with sclerotherapy. In this rather simple procedure, veins are injected with a sclerosing solution, which causes them to collapse and fade from view. The procedure may also remedy the bothersome symptoms associated with spider veins, including aching, burning, swelling and night cramps

What You Should Look For in a Vein Doctor

Is your doctor a member of the American College of Phlebology? This organization is dedicated to the diagnosis and treatment of vein disorders, especially cosmetic problems. The vein therapy field is changing surprisingly quickly and it is important to keep up with the latest advances. Physicians from many specialties are now treating vein conditions. Make sure you check out the credentials of the doctor you plan to visit.

If you have varicose veins, be sure your doctor does an ultrasound examination to determine the source of the problem. Do not undergo any procedure on large veins if an ultrasound is not done.

If you have spider veins, does the doctor look for the source of the veins with special lights? If the source is not treated, the spider veins will soon return.

Lasers are seldom as effective as injections (sclerotherapy) for spider veins. Lasers simply cannot destroy the source of the spider veins. If your doctor offers only laser therapy, be prepared for mediocre results.

Deep Venous Thrombosis

What is deep venous thrombosis?

Deep venous thrombosis, also known as DVT, is a blood clot in a deep vein of the upper (arm or neck) or lower (leg or pelvic) extremities.

A blood clot from a DVT can break loose (embolize) and travel to the heart or lungs. An embolus can be life threatening. It is estimated that over half a million hospital patients in the United States develop a DVT each year, causing 50,000 deaths a year due to pulmonary (lung) emboli.

Who gets a DVT?

DVT is more likely to occur in the following situations:

  1. Major surgery, particularly hip and knee replacement, increases the risk of DVT due to venous injury and immobilization. This is true even in patients without any other risk factors for DVT. Persons affected are generally older.

  2. Persons with inherited deficiencies of anticlotting factors are at greatly increased risk of DVT. Persons with such deficiencies often develop DVT at a much younger age (20's to 40's) without major surgery or leg trauma, suffer recurrent DVTs, and have family members who have had DVTs. Factor deficiencies, which can be mild or severe, may include:

    • Leiden factor 5 (most common)

    • antithrombin

    • protein C and/ or protein S

  3. Patients who have one the following characteristics:

    • Congestive heart failure

    • Prolonged immobilization (not walking or moving)

    • Pre-existing small clots

    • Hormones (birth control pills, pregnancy)

    • Cigarette smoking

    • Certain cancers

What are the symptoms of a DVT?

Symptoms of a DVT are variable, occurring in less than half of persons with DVT. Symptoms, depending on the size and location of a DVT, can include: Warmth, swelling, redness, and /or pain in a leg. DVT of the calf may cause symptoms in the calf while that in the thigh can cause symptoms in both the thigh and/or calf. The vast majority of DVTs occurs in only one leg at a time

Is a DVT serious?

A DVT can be lifethreatening if a large enough blood clot breaks loose and travels to the heart or lungs. Pulmonary emboli (blood clots traveling to the lungs) occur in over 300,000 persons each year in the United States killing at least 50,000 Americans each year. Pulmonary emboli can disrupt blood flow to the lungs by directly blocking blood flow to part of the lung and by triggering certain reflexes that can cause the heart to suddenly stop beating.

How does a Doctor diagnose a DVT?

Your doctor or an emergency physician may order certain tests if he/she suspects, based on symptoms and risk factors, you might have a DVT. Several different tests can be used to diagnose or exclude a DVT but the most commonly used is venous ultrasound.

How is a DVT treated?

Treatment of a DVT may depend on both its location and underlying cause. Anticoagulants (blood thinners), which keep the clot from getting larger, are the mainstay of DVT treatment. In certain life-threatening circumstances clot dissolving (thrombolytic) medications and interventional (catheter-based) procedures may be used.

Thrombophlebitis

Superficial thrombophlebitis is the name for a blood clot in a vein just below the skin, such as a varicose vein. This is almost never a life threatening condition. Deep venous thrombosis is not the same as superficial thrombophlebitis. Deep veins, in which a DVT occurs, cannot be seen or felt under the skin.

Post-thrombotic Syndrome (PTS)

Post-thrombotic syndrome is another complication of DVT, particularly recurrent DVTs. Chronic stretching and injury to deep veins may cause blood to pool and stagnate in the lower legs. This can cause chronic swelling and pain in the affected leg. Leg sores may also develop. Although not life threatening, this condition can be unpleasant.

In established DVT patients, anticoagulation, compression, exercise, and skin care measures are needed in order to prevent DVT recurrence and long-term sequellae such as PTS.