Varicose veins, on the other hand, is a condition of which many people are aware. Unsightly, bulging and bluish, varicose veins have marred the appearance of otherwise healthy legs for as long as anyone can remember. They occur when the valves within the veins weaken and allow blood to pool, usually in the legs.
Until recently, the treatment for varicose veins had been just as ugly as the veins themselves. Either put up with the veins, which can become painful over time, or endure a process called stripping, which involves removal of the saphenous vein, the main conduit for blood that runs the length of the leg. Recovery from this procedure can take several weeks.
Varicose vein sufferers, take heart because vascular surgeons at Northwest Hospital are using a new procedure—Closure®—for the treatment of varicose veins.
The Closure® technique involves only a single, needle-sized incision near the knee through which a slender catheter is inserted into the affected vein. The catheter delivers radiofrequency energy to the vein wall. This energy heats the vein wall, causing it to collapse and seal shut. The catheter is then slowly withdrawn, closing the vein along its path. Once the desired length of vein is treated, the catheter is removed. Soon, other healthy veins begin to take over and empty blood from the legs.
News of this new procedure sparked the interest of Kevin Wojciechowski, an athletic 36-year-old from Eldersburg, Md. About 10 years ago, Wojciechowski noticed a small varicose vein developing below his calf. As the assistant general manager of a large warehouse store, Wojciechowski spends a lot of time on his feet, walking the concrete floors. Over time, Wojciechowski’s varicose veins became more than just a cosmetic complaint.
“In the past two years, it has become very painful,” Wojciechowski says. “It feels like there is a lot of pressure in my leg and it aches more. My leg sometimes feels warm to the touch.”
Symptoms such as Wojciechowski describes should be taken seriously, says Juan Juanteguy, M.D., chief of Surgery at Northwest Hospital. “When varicose veins become troublesome—when there is pain, swelling and a tingling sensation in the legs—it should not be ignored.”
In addition to standing on your feet for long periods of time, varicose veins may be brought on by obesity, leg injury and aging. Also, some folks have a genetic propensity to develop them.
A few years ago, Wojciechowski considered having his veins stripped, but his physician could not guarantee that the veins would not reappear. Although the Closure® procedure reduces the likelihood that varicose veins will redevelop, it may have no impact on pre-existing conditions in the deep veins, Juanteguy warns. (See sidebar.)
Wojciechowski says he looks forward to the relief the Closure® procedure will provide both physically and cosmetically. And, because the procedure is minimally invasive, he will have little downtime from family or work.
To be referred to a physician who can discuss the Closure® procedure or to find out about a vascular disease screening, call 410-601-WELL (9355).
While the symptoms of varicose veins are quite obvious, other types of vascular disease may have no visible symptoms at all. The most common of these that you may never have heard of include abdominal aortic aneurysm (AAA); deep vein thrombosis (DVT); and peripheral arterial disease (PAD), such as intermittent claudication (IC).
An aneurysm is a bulge in the wall of a blood vessel that can occur suddenly or as the result of an injury in any blood vessel throughout the body. According to the American Heart Association, the abdominal aortic aneurysm is most common. People over 50, with a family history of atherosclerosis or coronary artery disease, are at risk for developing aneurysms, says vascular surgeon Michael Zatina, M.D., of Northwest Hospital.
Deep vein thrombosis results from a blood clot (thrombus) inside a vein located in the calf or thigh. “DVT can lead to complications such as pulmonary embolism or a blood clot leading to the lung that can be fatal,” Juanteguy explains . The late NBC news reporter David Bloom reportedly shrugged off pain in his leg that developed while he was embedded with American troops in Iraq. “Crouching inside a tank for days at a time, Bloom developed DVT, which then led to his death from a pulmonary embolism,” Zatina explains.
Peripheral arterial disease is an arterial blockage in the legs or lower extremities. IC is a common type of PAD that prevents the leg muscles from receiving enough oxygen. This makes walking for even short distances very painful and the leg muscles feel weak and heavy.
There are simple noninvasive ways to diagnose vascular disease, such as ultrasound, magnetic resonance angiography (MRA) or computed tomography (CT) scans. Problems sometimes show up when testing is done for an unrelated complaint, such as gallstones or even a backache, says Juanteguy. Measuring the systolic blood pressure in each leg (the Ankle/Brachial Index) is also a quick way to screen for PAD.
Treatment can include minimally invasive endovascular surgery, stenting, angioplasty, open surgery or a course of clot dissolving medications. But, short of a medical emergency, lifestyle modifications may be all you need to thwart the progress of vascular disease.
First, Juanteguy says, quit smoking. It is the best thing you can do to reduce your risk.
Next, exercise. Thirty minutes or, better yet, one hour of moderate, heart-rate-elevating exercise per day is recommended. Even folks with IC should exercise, Zatina says. During a long airplane flight or car ride, or if you are laid up from injury, try to find a way to get up, stretch and move around. People have developed DVT from sitting or lying down for too long.
Switch to a low-fat diet. By low fat, Zatina suggests one in which less than 25 percent of your daily caloric intake comes from fat.
Study your genealogy, says Juanteguy. If your parents or another close relative suffered from a form of vascular disease, you may be next in line Keep your blood pressure under control. Take your prescription medication and, if your doctor agrees, take a baby aspirin (81 mg) everyday.
Finally, reduce sources of stress in your life. Modern society can place all sorts of demands on you, says Juanteguy, so slow down.
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