Non-cardiac leg swelling can be a significant problem for many patients and may be a very treatable condition if the venous reflux studies document significant reflux.
What is leg swelling?
Non-cardiac leg swelling is a common and significant clinical problem for many patients and often reflects underlying venous insufficiency. Both deep and superficial vein reflux can lead to significant venous hypertension in the leg. The pooling of blood causes the swelling as gravity exerts it downward pressure.
Leg swelling with venous insufficiency does not always accompany visible varicose veins. Some patients manifest surface varicosities, but others only experience the swelling without the obvious surface veins.
In the evaluation of patients for leg swelling, the venous insufficiency duplex scan gives us one of the best data points on which to base therapy. With significant superficial venous reflux, percutaneous ablation of the refluxing segments can lead to notable improvement in the swelling symptoms as venous flow and hemodynamics normalize. Deep vein reflux is generally not correctable, and support hose can help manage these symptoms.
When the venous studies are normal, and other general medical causes for swelling are absent, the diagnosis is often lymphedema. Physical therapy with manual lymphatic drainage and decongestive therapy is instrumental in mobilizing the lymphedema. We work closely with several centers that excel in these options for patients with lymphedema.