Venous Insufficiency and Restless Legs Without Varicose Veins

One of my Leesburg, Virginia patients is the perfect illustration of how you can have significant venous insufficiency without visible varicose veins. This woman is a 39-year-old IT specialist who sits at her desk most of the day. She notes aching and heaviness in her legs almost daily, requiring her to prop her legs periodically, most notably near the end of the day. The patient has no visible varicose veins, but has numerous spider veins. What's most interesting is her family history, which is significant with both her parents having rather advanced venous disease. In fact, her father had his veins stripped many years ago.

We conducted a venous duplex scan, which showed that she has significant saphenous vein reflux in each leg. This leads to elevated pressures and causes the heaviness and even restless legs that she complains of on a regular basis. We know that there is a strong correlation between venous insufficiency and restless leg syndrome, and about 80% of patients see notable improvement in their symptoms once the venous disease is corrected.

My patient will undergo endovenous ablation (VNUS Closure) of her saphenous vein in the office under local anesthesia. This procedure will eliminate the venous reflux and allow normalization of her venous flow, thereby relieving her aching and heaviness within a day or two. Patients see dramatic benefits very quickly. She'll also be able to resume her normal activity immediately.

Both the patient and her referring doctor deserve credit for understanding that someone can have very significant venous disease while there are no surface varicose veins. This illustrates that patients with leg symptoms ought to consider venous reflux as a potential cause and seek evaluation by an experienced specialist in venous disease.