01.19.16 Dr. Garth Rosenberg Swelling

Is Your Leg Swelling Due To Venous Disease?

Left leg swelling, even without visible varicose veins, can be due to venous disease, so an evaluation of your veins can be very beneficial. The vein flow in the leg should travel from bottom to top, against the force of gravity. Tiny valves in the vein propel the blood up the leg, into the pelvic veins, and eventually into the central circulation and back to the heart. Venous insufficiency occurs when this process is interrupted.

leg swellingAn interesting phenomenon can occur in the left side of the pelvis, where the iliac artery crosses over the iliac vein. In some patients, especially women, the pressure from the artery over the vein can cause narrowing of the vein, eventually impeding flow of blood up the leg. The result is left leg swelling, either with or without varicose veins. This entity is known as May-Thurner Syndrome.

A thorough evaluation with venous duplex scanning can give very helpful information. Sometimes we see associated saphenous vein reflux with iliac vein compression, and this saphenous vein reflux is easily treated with endovenous ablation. The best ablation success has been seen with the VNUS Closure Procedure, though VenaSeal and Varithena are two new techniques we can use in certain situations. All of these procedures are done under local anesthesia and allow immediate recovery. Symptoms of leg heaviness, fatigue, cramping and pain often dissipate within a day.

May-Thurner Syndrome is easily treated with a stent which stretches the iliac vein open and allows normal flow up the leg. This is done in a radiology department by placing an IV in the left leg and inserting a catheter through the narrowed vein. Results are very durable. Left leg swelling often is dramatically improved in these cases.

May-Thurner Syndrome, as with other unusual types of venous problems, can be difficult for patients. Reliable advice can be hard to find. A complete evaluation by an experienced vascular surgeon can help guide you to the proper diagnosis and treatment.

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