03.19.14 Dr. Garth Rosenberg Blood Clots and Flying

Venous Insufficiency Can Occur Without Varicose Veins

I saw a very interesting patient in my Leesburg, Virginia office yesterday. This 37-year-old woman has experienced bilateral achy heavy legs for well over 10 years. Her symptoms become more notable toward the end of the day and she needs to elevate her legs at work and at home. Her father has significant varicose veins and had vein stripping many years ago. Genetics are a prime factor in determining who will develop varicose veins, as most patients have a first degree relative with venous insufficiency.

Even without visible varicosities, her history was significant enough that I felt a duplex ultrasound exam was necessary to investigate venous reflux. As expected, her great saphenous vein was incompetent in both legs, allowing reflux of blood down the leg. This pooling of blood in the lower leg, accentuated by gravity, leads to the common symptoms of aching, heaviness and fatigue. This patient is the perfect example of how venous insufficiency can lead to very significant and debilitating symptoms, even in the absence of visible varicose veins. The optimal method of treating this condition is the Venefit Procedure (VNUS Closure), which allows us to place a small wire in the vein through an IV access near the knee. After a small dose of local anesthesia, the problematic vein is painlessly heated, leading to its collapse and elimination of backflow of blood. Normal veins in the leg take over and bring blood up the correct direction, improving circulation and eliminating leg symptoms in the matter of a few days. This office-based procedure allows normal activity immediately afterward. The key instructive point of this patient's experience is that venous insufficiency can most definitely cause very real symptoms, even in the absence of varicose veins. When patients experience heavy, achy tired legs, a thorough investigation with a venous duplex ultrasound is a reasonable and recommended option. Seeking the advice of an experienced vein professional is key to getting the help you need.

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