Blogs | The Vein Centre

Nov 05
0

Treatments for Deep Vein Thrombosis

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Deep vein thrombosis, or DVT, is a serious and painful complication of the veins. In layman’s terms, it is a clot in one of the deeper veins of the body, most common in the arms and legs. Clots can form when blood pools in one location for too long, which is why people with varicose veins have a higher likelihood of getting DVT.

These clots don’t just cause pain in the legs. If they break off, they can lodge elsewhere in the body. If they get to the heart or the lungs, it can be deadly. Therefore, it’s important to get treated for DVT as soon as it is detected.

Fortunately, there are several treatments for DVT, including: 

Blood Thinners

Over time, blood rushing past a clot will dissolve it. But if pooled blood sticks to the clot, it can grow bigger. Blood thinners make it harder for blood to clot and help the body remove it over time. It can also keep new clots from forming. There are many different thinners and your doctor will work with you to find the best one.

Going on blood thinners can mean that you’ll need to change your diet. Certain thinners like warfarin will stop working if you eat too much vitamin K. You may also need to get regular blood tests to measure how well the medicine is working. There are newer medicines on the market that don’t require diet changes and testing, but they can be more dangerous. Your doctor will explain the risks.

Catheter-Directed Thrombolysis

If the clot is large, not in a leg, or dangerous in some way, your doctor may also recommend catheter-directed thrombolysis. This involves injecting medicine directly into your clot to dissolve it. This is done through a catheter inserted into the vein. It requires a trip to the hospital because a dissolving clot might break up in unexpected ways and cause other health problems, including stroke. This procedure may also be combined with other treatments like angioplasty or a stent placement, depending on the condition of the vein.

Vena Cava Filters

If you’re at high risk for clotting, your doctor may recommend a vena cava filter. This is a special filter that sits in your vena cava, an important vein on your body. The purpose of the filter is to catch clots before they can reach your heart or lungs. This is a surgical procedure and may be recommended if your clots do not respond to other treatments. Once the danger of DVT has passed, you may need to get it removed.

Venous Thrombectomy 

Finally, in some cases, a doctor might recommend surgery for cutting the clot out. This is called a venous thrombectomy. This is a rare surgery and is only done in severe cases of DVT, as the surgery can increase the chances of further clots. Clots from DVT often respond very well to the other treatments, but not always.

In addition to these medical treatments, there are lifestyle changes you can do to help with your DVT. You might need to wear compression hose to reduce the pain while the clot dissolves. Moving more often will keep blood from pooling and help shrink existing clots. Ultimately, DVT is most often caused by poor circulation. Stay active and get your varicose veins treated!

Oct 15
0

What is DVT and How do I Know if I Have It?

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DVT or deep vein thrombosis means just what the name suggests.  A blood clot in one of your deep veins.  The most common location for the occurrence of DVT is in your lower legs, although it can occur in other parts of the body.  If the clot becomes dislodged and begins to travel it is no longer known as a thrombus and becomes an embolus, which depending on where it travels, may lead to a life-threatening situation.

Risk Factors for DVT

DVT has multiple causes and multiple risk factors which include the following:

  • Family history of blood clots
  • Diabetes
  • Poor circulation resulting from peripheral vascular disease
  • Smoking
  • Sedentary Lifestyle and prolonged crossing of the legs
  • Frequent Flying
  • Varicose Veins

Any condition in which blood flow is restricted may cause blood to pool in the affected area and lead to clotting.  Main complications from the clot include blocking the circulation below the affected area, leading to further swelling and potential infection of the vein, an increase in the size of the clot or formation of more clots in the area, and complete loss of circulation to the area.  These complications may lead to the injury and death of tissues surrounding the area.

How do I know if I have DVT?

In some cases, there are no early symptoms of DVT.  That is why it is important to know your risk factors and take measures to prevent DVT from occurring if you are at risk.  The primary symptom of DVT is pain to the affected area, the pain is described as a deep pain.  If the DVT is located in the calf, the pain is worse upon flexing the foot and lower leg upwards at the heel.  This is known as a positive Homans sign.  Your venous specialist or healthcare provider will actually perform this test upon examination.  Other symptoms may also include swelling, numbness and tingling in surrounding areas, and discoloration.  If the clot is in the lower leg, the leg may appear dusky or darker in color.  Sometimes, skin ulcers may also occur.  If the tissues surrounding the clot become infected, redness with or without streaking, may be present, and the area will become hot to the touch.  You may even develop a fever.

Your doctor will take a full medical history to determine your risk factors and make an initial diagnosis of the condition.  Tests will be ordered that allow for direct visualization of the clot, such as ultrasounds as well as determine the effect of the clot on circulation.

When should I call my doctor?

If you notice any of these symptoms, call your doctor or vein specialist right away.  Do not massage the area and assume bedrest to reduce the possibility of dislodging the clot, causing it to possibly travel to the heart, lungs or brain. DVT is an emergent medical condition and should be treated right away to avoid potential life-threatening complications.

Sep 26
0

Varicose Veins Affect More Than Appearances

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Complications from Varicose Veins

Varicose veins are large, twisted, clustered visible veins.  They commonly appear in the legs and lower body because of gravity and blood pooling.  Unlike arteries, vein walls do not contract to push blood flow back through the lower body and to the heart.  Venous circulation involves the use of muscles and one-way valves to move blood in the right direction.

Different factors can affect returning blood flow from the lower body producing effects similar to a traffic jam.  Faulty valves can cause blood to travel in two directions causing congestion and stretching of venous tissue.  As we age, tissues in the veins are not as supple and elastic.

Sedentary lifestyles function as double-edged swords for people with varicose veins.  The pelvic angle has a constricting effect.  In addition, crossing the legs at the knees, and inactivity lessen the muscle contractions needed to keep the blood flowing.

Without treatment and lifestyle changes, varicose veins may lead to more severe illnesses and complications, potentially compromising other organs.

Swelling and Inflammation

As blood continues to pool in the legs, the resistance encountered against vein walls pushes water content into adjacent tissues.  This results in swelling, particularly around the lower legs, feet, and ankles.  Fluid consistency is felt upon pressing the skin around the affected area.  Indentations, known as pitting, are seen for seconds after release.  Fluid weight and pressure on surrounding tissues and nerve endings lead to pain, fatigue, and leg heaviness.  Swelling also occurs with circulatory disorders and heart failure.  Fluctuations in weight of more than a couple of pounds within a short period indicate additional fluid retention.

Sores, Ulcers, and Eczema

As fluid continues to build within the veins and tissues, pressure is exerted under the skin.  Fluid then begins seeping from the surface.  The continued moisture eventually leads to irritation or eczema.  The skin will become itchy, scaly, and red.  Blisters may also form and rupture leading to sores.  Excess moisture causes the tissues to breakdown forming ulcers.  Continued exposure and lack of circulation will eventually lead to skin death around the affected areas. Illnesses, which compromise circulation, such as Diabetes and vascular diseases, increase the speed at which tissue damage and infection occurs.

Bleeding and Bruising

Superficial varicose veins, termed spider veins, hold a fair amount of excess blood.  Small cuts, bumps, and scrapes lead to excessive bleeding and bruising.  The delicate skin surrounding these areas are also more prone to injuries.  Poor circulation can slow the time they take to heal and create a portal for infection. Dilated capillaries can also spontaneously burst and lead to bruising and blood pockets under the skin.

Hard Discolored Skin

Prolonged fluid build-up and swelling cause the skin to take on a drum-like appearance.  The area becomes hardened and dark discolorations occur.  Areas most commonly affected include the calves and ankles. The condition becomes painful and may impair walking. 

Blood Clots

Stagnated blood in the veins leads to blood clots, which can block oxygen and vital nutrients from reaching other cells and tissues.  This results in pain, loss of feeling, impaired function, and tissue death.  Surgery is required to restore circulation, and amputation is used as a last resort. Blood clots located in deep veins can become dislodged. Once this happens, they can become lodged in other areas of the body affecting major organs.  Clots lodging in the lungs, heart, and brain may lead to a heart attack, respiratory failure, stroke, and sudden death. Life-threatening complications are a rare occurrence. Painful enlarged calves are a telltale symptom, and the pain worsens when the foot is flexed.

Phlebitis

Inflammation within the vein, itself, is known as phlebitis. Varicose veins are a likely culprit of the condition.  Phlebitis is very painful and occurs with or without clotting.  Heat and streaking accompany the inflammatory response.  Untreated, infection can spread into the blood traveling to the kidneys and other organs.  Once the infection becomes widespread, the condition is known as sepsis.

Poor Circulation

More blood trapped in the veins means there is less blood available to carry life-giving nutrients to other tissues.  The heart works harder to feed hungry organs leading to fatigue. Leg heaviness contributes to feeling like you are in slow motion. Varicose veins are also associated with obesity and sedentary lifestyles, further contributing to sluggishness.  This creates a vicious cycle in which the symptoms feed the condition.

Varicose veins do not only affect your appearance. Complications can affect your quality of life, health, mobility, and vital functions.  Strategies to alleviate associated symptoms include modifications in diet, exercise, rest, clothing, and unhealthy lifestyle choices. Treatments range from minimally invasive laser surgery, radiologic intervention, and saline injections to surgical procedures, such as ligating and stripping the veins.  More invasive procedures are usually reserved for persons experiencing symptoms or complications.

Sep 14
0

What to Expect Before and After Venous Ligation and Stripping

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Venous ligation, as the name implies, essentially means tying off varicose veins through small incisions made in the skin at the affected areas.  Vein stripping refers to the removal of larger varicose veins in a similar manner.  Both procedures are usually done in outpatient surgery centers or in a hospital setting.  Many times, both procedures are included in one surgery. Venous ligation is often done in areas where blood pooling occurs due to the weakened veins, while stripping and removal are performed to eliminate more tortuous vessels. This type of surgical intervention is often performed to both treat and reduce the reoccurrence of varicose veins.  These procedures are considered surgical procedures, and will require you to follow guidelines to both prepare and recover from the surgery.

 

How do I prepare for Venous Ligation and Stripping?

The first step to preparing for venous surgery is to discuss all your options with your vein specialist.  He or she will more than likely perform a full history and physical, including a full medical and medication history.  Laboratory tests will also be performed to identify potential risks, such as hemorrhage, infection, and potential complications from the anesthetics used during the procedure.  Ultrasounds and other diagnostic testing will also be performed to pin point the affected areas and determine the proper course of surgery.  Often times the areas are marked with ink the day before the surgery.

Some medicines may need to be temporarily stopped before the procedure.  These may include blood thinners, such as coumadin, and non-steroidal pain medications, such as Motrin, Advil, and Aleve. Daily aspirin regimens will also be temporarily discontinued prior to the procedure and for a time period after. Heart, blood pressure, and diabetes medications are taken with a small amount of water before the procedure and continued immediately thereafter. Your vein specialist will discuss your presurgical plan with you during your consultations before the surgery.

 

What Happens After the Surgery?

Venous ligation and stripping are generally shorter and uncomplicated procedures, and patients are usually sent home the same day.  In more severe instances, a short hospital stay may be required.  A family member or friend will need to be available for transportation after the surgery and should remain with you for a period of 24 hours in case of complications immediately after.

Severe pain is unlikely, but you may experience burning and tingling after the surgery. If numbness and discolorations are noted to unaffected areas after the procedure, it is important to notify your vein surgeon.  For general discomfort, mild painkillers, such as ibuprofen are usually prescribed or recommended.

You will more than likely come home with dressings after the surgery.  Those should not be changed for 1 to 2 days after the procedure unless they become soiled.  Compression stockings should also be worn continuously after the procedure for at least three days.  The stockings should only be taken off when showering or sleeping during that time.

Avoid prolonged sitting or standing after the procedure and exercise regimens can be generally resumed one to two weeks after.  Walking short distances is generally indicted 24 to 48 hours after surgery, and the intensity and duration of your walks can be increased as swelling, pain, and stiffness are relieved.  You may usually resume driving 48 hours after surgery.

Aug 29
0
Treatment Procedures for Varicose Veins - The Vein Centre

Treatment Procedures for Varicose Veins

By | Uncategorized, Vein Health, Vein Surgery, Vein Treatments | No Comments

Treatment choices for varicose veins depend on several factors:

  • Whether you are seeking treatment for cosmetic benefits.
  • Whether your varicose veins are causing pain or discomfort.
  • The presence of skin changes, such as ulcers, or other signs of poor circulation.
  • Insurance coverage for treatment procedures.

While in many cases, treatment choices are a matter of personal preference, there are instances where certain invasive treatment options become necessary. Here is an overview of some of the most common procedures used to treat varicose veins:

Sclerotherapy

There are two types of sclerotherapy depending on the severity and size of the varicosities:

  • Standard sclerotherapy involves injecting a solution into the veins, which lead to scarring and closing of the specific area. Once closed, blood can no longer pool in the area, causing the veins to shrink and fade over a period of one month. In some cases, the vein must be injected more than one time for the procedure to be effective. Standard sclerotherapy can be performed in your vein specialist’s office without the need for anesthesia.
  • Foam Sclerotherapy is commonly reserved for large varicosities or veins not responding to standard sclerotherapy. The procedure is very similar; however, a foam solution is used as a sealant to close the affected veins.

Laser Surgery

Laser surgery for varicose veins is considered a newer technological advancement. This procedure involves the use for lasers to emit high frequency light pulses into the affected vein. Over time, treated veins will begin to fade and eventually disappear. Treatments may need to be repeated for the best outcome. Treatment can be performed in your vein specialist’s office without anesthesia.

Catheter Assisted Radio Frequency or Laser Energy Procedures (Ablation)

This procedure uses a catheter heated by radio frequencies of laser energy to heat seal the affected vein. A small catheter is introduced into the vein, which is heated; it is then removed, which cauterizes, or seals, the varicose vein. This treatment is usually reserved for large varicosities with associated skin changes or producing pain and discomfort. The procedure is usually performed by a vein specialist certified in interventional radiology or an interventional radiologist in an outpatient setting. Although it is minimally invasive, the affected area is prepped and draped to prevent infection. A topical anesthetic is used to minimize discomfort.

Ligation and Vein Stripping

The procedure uses a series of small incisions to access the affected vein and ligate, or tie off, and remove the affected vessel. Removal of the affected areas does not affect circulation, as larger veins in the legs will pick up the slack. Vascular surgeons perform the procedure in either an outpatient surgery suite or in an operating room depending on which veins are affected. Local, regional, and general anesthesia may be used depending on risk factors and size and severity of the affected veins.

Ambulatory Phlebectomy

Ambulatory phlebectomy is similar to vein stripping, except on a much smaller scale. The procedure is reserved for more superficial and smaller varicosities. Pieces of the affected vein are removed, utilizing small puncture sites in the skin. Local anesthesia specific to the puncture sites is used in the procedure. Minimal scarring is expected, and recovery time is generally shorter than in ligation and stripping procedures. Ambulatory phlebectomy may be performed in an outpatient surgery center or your vein specialist’s office, if equipped.

Endoscopic Vein Surgery

Endoscopic vein surgery is generally reserved for varicose veins with leg ulcers or associated circulatory symptoms. It is also used in cases unresponsive to other treatments. The procedure involves the insertion of a thin video camera in the affected area and then uses small incisions to close and remove the varicosities. The procedure is generally performed in endoscopic outpatient surgery centers under conscious sedation.

There are various options for the treatment of varicose veins depending on the severity, associated symptoms, and cosmetic benefits. Prior to discussing these options, it is important to review your health insurance options for coverage. Your vein specialist is the best person to discuss your individual cases and preference, and he or she can provide the most appropriate options for your case.

Aug 14
0
Peripheral Vascular Disease - Vein Center

What is Peripheral Vascular Disease? Am I at risk?

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Peripheral vascular disease, or PVD, occurs when circulation to areas outside the heart and brain is reduced. The term peripheral, in healthcare, refers to any structure or bodily function occurring away from the central source. The heart and lungs are the central source in our body, and our arms and legs are the peripheral. The most common causes of peripheral vascular disease are narrowing or hardening of the arteries and veins, which limit the blood flow to the outside areas of the body. If the narrowed areas occur at the knee, everything below it will also be affected and so forth.

Peripheral vascular disease can also affect circulation to organs besides the heart and brain, such as the stomach, intestines, and kidneys. When this happens, tissues are starved from oxygen and do not function properly. If the disease progresses and blood flow is cut off, the tissues will eventually die. The affected organs will fail, creating a medical emergency. PVD can also occur from vascular spasms.

Risk Factors for Peripheral Vascular Disease

According to the Center for Disease Control, 12% to 20% of people ages 60 and over get peripheral arterial disease (PAD), the most common type of PVD. This equates to roughly 8.5 million people. Risk factors for functional PAD without damage include:

  • Cold climate
  • Excessive and long exposures to vibration, such as tools and machinery
  • Prolonged stress
  • Certain drugs and medications

The organic form of PVD involves damage to the blood vessels by plaque deposits or thickening of the vessel walls. Risk Factors for this type of PVD include:

  • Smoking, causing chronic constriction of blood vessels
  • Uncontrolled Diabetes, causing sticky build up within the vessels for blood clots to adhere to
  • High cholesterol levels, causing fat deposits within the arteries and veins
  • Infections, leading to chronic inflammation of blood vessels
  • Major injuries involving blood vessels, leading to structural abnormalities

Increased risk factors for getting the disease also include

  • History of blood clots or strokes
  • Prior history of heart disease
  • Hypertension
  • Family history of the condition

Signs and Symptoms of PVD.

Symptoms of PVD happen as a result of the lack of oxygen and nutrients to tissues from decreased blood flow.  A good example is to describe how it feels when your hand or foot is asleep. Chances are there is pain, numbness, and tingling. The skin may also lose its pink and healthy appearance, and even turn blue from lack of oxygen. Over time you may lose feeling in the area and may not know if you have cut or injured yourself, leading to slow healing and infections. If PVD involves internal organs, you will experience signs and symptoms related to poor organ function.

Lifestyle Changes that Prevent PVD

If you fall into a risk category for PVD, there are several things you can do to help prevent or slow the process of developing the condition: quit smoking, adopt a low fat diet, limit foods high in cholesterol, and manage your blood sugar if you are diabetic. 

If you feel that you are at risk, or are developing signs and symptoms of the condition, your Tennessee vein specialists at The Vein Centre can help you find the most appropriate treatment for your situation.

Jul 25
0
Smoking and Varicose Veins

How Smoking Affects Varicose Veins

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According to an article featured in the American Heart Association’s Cardiology Patient circular in 2014, risk factors for varicose veins are grouped into four categories: hereditary, hormonal, acquired, and lifestyle. More specifically, hereditary risk factors include a family history of varicose veins. Pregnancy and menopause are the largest hormonal factors. Acquired risk factors include obesity, diabetes, blood clots, and venous insufficiency. And, lifestyle choices, such as smoking, also play a big role in developing varicose veins.

Smoking Affects the Veins in Two Ways

The immediate effects of smoking include vasoconstriction or narrowing of the veins. The effects are short-lived; however, over time, permanent changes occur inside the venous linings, which increase muscle tone within the veins. When veins become narrowed, this makes blood flow against gravity back to the heart more difficult. As the blood pools, the hardened veins distend and lead to varicosities.

Studies show that the carbon monoxide and tar present in cigarette smoke have damaging effects to the venous system. Carbon monoxide reduces the amount of oxygen found in the blood.  Because of lower oxygen levels, veins may become inflamed and injured. This response triggers the body to release infection-fighting white blood cells to remove the irritating substances, releasing free radicals. Free radicals have been linked to causing more inflammation and injury to the vein walls, leading to varicose changes.

Higher Stakes for Older Female Smokers

Females smoking over 19 cigarettes daily after the age of 45 with a family history of varicose veins and who are also entering menopause are most likely to develop varicose veins. Middle-aged male smokers with other risk factors are also more prone to develop them. Older female smokers, however, reported more associated symptoms than younger women or male smokers of the same age. These symptoms include, pain, heaviness, numbness, discoloration and ulceration.  Higher reports of associated symptoms are due to insufficient blood flow to the lower legs caused by continued effects of smoking.

Smoking is a Modifiable Risk Factor

Some risk factors, such as age, a family history of varicose veins and menopause cannot be changed. Lifestyle factors, such as smoking, and inactivity can be. In fact, by quitting smoking and beginning an exercise program—with your doctor’s approval—may reverse some damage to your veins. And, cardiovascular exercises using the calf muscles will also improve circulation through narrowed veins lessening associated symptoms and improving their appearance.

If you smoke and have varicose veins, it is important that you speak to your doctor or vein specialist regarding your treatment options, especially if you are experiencing symptoms, like pain, numbness, discoloration, or changes in the skin around the areas. There are many programs and several medications that may assist you to stop smoking. Your vein specialist is an important resource in determining the best course of action for your individual case.

Contact a specialist at The Vein Centre today to speak about your treatment options

Jul 11
0
menopause

What you need to know about Menopause and Varicose Veins

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Hormones During Menopause and Varicose Veins

Both physiologic and hormonal changes experienced during pregnancy increase the risk for varicose veins in women. Higher levels of progesterone and estrogen have a relaxing and thinning effect on the walls of the veins. In addition, higher abdominal pressure and higher blood volumes during pregnancy are also contributing factors leading to varicose veins. The other end of life’s spectrum, menopause, also has its effects on vein health. Whether you are approaching or are in this stage of life, there are some important things you need to know about managing and preventing varicose veins.

Hormonal Balance is a Major Player in Vein Health

Research shows that both estrogen and progesterone have beneficial effects on vein wall support. This phenomenon also occurs in men as both sexes have combinations of both masculine and feminine hormones in the body. The main difference between men and women are the amounts. Estrogen is also needed to make the male hormone, testosterone.

Hormonal balance in women occurs during childbearing years in a non-pregnant state. If increases in estrogen and progesterone weaken the blood vessels by thinning vein walls, then the sharp decreases in both hormones during menopause will have the opposite effect, excessive thickening and constricting of venous walls.

Decrease Hormone Levels in Menopause also Increase the Risk of Varicose Veins.

Hormonal fluctuations in pre-menopause, peri-menopause, and menopause can occur over many years. The rise and subsequent drop of estrogen and progesterone during these phases can create thickened and less flexible vein walls. The effects also occur along valves directing flow back to the heart. Thickened areas along these valves will prevent them from closing, allowing blood to flow freely in both directions. Blood will also pool in areas surrounding the valves, contributing to their swollen and knot-like appearance. The thickened vein walls create narrowed pathways for returning blood, causing congestion and further swelling.

What Actions can I take to Prevent and Lessen Their Appearance During Menopause?

Like pregnancy, varicose veins experienced during the transition to menopause in women, commonly fade. Most times, they are not painful, and their presence is mostly cosmetic. For some women, however, there are associated symptoms, such as pain, heaviness, skin problems, and blood clots. Women experiencing these symptoms should consult with their physician and vein specialist regarding hormone replacement therapy.

Unless other conditions are present, that prevent its use, HRT can be continued during treatment for varicose veins. Patients who are at higher risks for blood clots because of genetic or lifestyle factors may need to discuss other forms or treatment with their physician or specialist. Otherwise, adopting a healthy low-impact cardiac exercise program, which uses the lower body and leg muscles, will assist circulation and improve the condition. Other actions to take include frequent standing breaks during sedentary work and avoiding instances where long-term standing is necessary.

Your primary care doctor or vein specialist can help you determine which treatments give the best results for your individual case. Be sure to discuss options regarding HRT and venous procedures with your vein specialist during your consultation.

Jun 27
0
Pregnancy: A Leading Cause of Varicose Veins in Women

Pregnancy: A Leading Cause of Varicose Veins in Women

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Pregnancy is one of the leading causes of varicose veins in women.  The effects of pregnancy on the venous system increase the risk for developing varicosities in three ways:

  1. Both fetal weight and the growing uterus will compress the inferior vena cava, which transports blood from the legs back to the heart.
  2. Pregnant women have almost one and one-half times the normal blood volume to nourish both mother and baby.
  3. Hormonal changes in pregnancy cause venous walls to relax and dilate, accommodating the higher blood flow.

All three changes during gestation can place undue stress and tension on venous circulation causing veins in the lower body to stretch and swell. Venous blood flow, unlike arterial blood flow, does not occur in conjunction with the pumping action of the heart. Instead, the veins rely on one-way valves to keep blood from flowing backward due to the effect of gravity.

Fetal and Uterine Factors Contributing to Varicose Veins

Venous blood returning to the heart from the legs is already fighting gravity along its journey.  Picture a heavy object pressing on the large veins in the abdomen and thighs, which then creates restrictions on blood flow. Blood would pool below the compressed areas, and the veins in the legs would need to dilate and stretch to accommodate the congestion. This happens as both the fetus and uterus grow during pregnancy. The end results are varicose veins in the thighs and legs. Most times, superficial veins also dilate, resulting in superficial spider veins. These spider veins are common on the ankles, back of the knees, and even on the abdomen.

Increased Blood Volume

According to the American College of Obstetrics and Gynecology.  Blood volumes in pregnancy increase to over 50% more than non-pregnant women. This amounts to over one liter of extra fluid circulating within the veins. The largest part of the increase occurs in the last eight weeks of pregnancy, when both the fetus and uterus are growing in size rapidly. Increased blood volume takes an already compressed venous system below the abdomen. The increased plasma volume along with compression of the inferior vena cava can further dilate veins in the lower body, further contributing to the development of varicose veins.

Hormonal Effects on Venous Walls

Progesterone secreted during pregnancy makes veins more fragile. The weakened veins dilate and stretch more to accommodate both the increase in blood volume and pooling caused by compression of the inferior vena cava. The effects are like the thinning of a balloon when there is too much air blown into it. Superficial spider veins may rupture, creating bruising and superficial hemorrhages under the skin. This occurrence is also a contributing factor in the development of varicose veins during pregnancy.

How to Prevent or Treat Varicose Veins During Pregnancy

The good news is that in most cases, varicose veins disappear within three to four months after delivery of your newborn baby. Sometimes, such as multiple pregnancies and genetic predisposition, they may become permanent. Regardless, there are many treatments available to eliminate or diminish their appearance after pregnancy. There are also several methods you can use to prevent and lessen their appearance during pregnancy:

  • Regular low impact cardiac exercise during pregnancy will increase circulation and prevent blood from pooling in the lower legs.
  • Frequent rest periods, including elevating the legs above the level of your heart can also increase blood flow.
  • The use of compression stockings during daily activities can also deter blood from pooling in the extremities. Be sure to fit compression stockings when your legs are the least swollen to ensure the proper fit. Also, compression stockings should not be tight around the upper legs but should gradually tighten around the ankles.
  • Avoid prolonged sitting or standing and crossing your legs above at the knees to maintain open channels for venous return from the lower legs.

When to Notify your Doctor or Vein Specialist

Varicose veins during pregnancy are seldom harmful and usually resolve on their own after delivery. You should, however, notify your doctor or vein specialist if they do not resolve within several months after delivery. Seek immediate treatment if the skin around the area becomes discolored or hot to the touch. Also, notify your doctor if inflammation, redness, and fever occur. Contact us online or call The Vein Centre today 615-269-9007 for all your vein needs!

Jun 06
0
Pelvic-Venous-Insufficiency

Pelvic Venous Insufficiency (PVI): Affecting Millions of Women

By | Vein Health, Vein Therapy | No Comments

According to the American Journal of Radiology, pelvic pain is a common condition, which affects millions of women worldwide. It accounts for 25% of all hysterectomies and 33% of all investigative laparoscopic procedures performed for pelvic pain. Leading causes of pelvic pain in women include pelvic congestion syndrome or PCS and pelvic venous insufficiency or PVI. PVI often leads to PCS, which is a chronic condition causing severe pain and tenderness in the lower abdomen, back, hips, and thighs.

What Is Pelvic Venous Insufficiency?

Pelvic insufficiency results when circulation in the major pelvic veins is compromised. Blood pools within the venous system causing pressure on the walls of the veins. Over time, the veins swell and dilate to accommodate blood flow. The one-way valves in the veins weaken allowing blood to flow backwards and pool, causing further pressure on already weakened venous walls. The venous swelling and pressure on adjacent organs and tissues lead to pelvic congestion syndrome or PCS. If left untreated, damage to the veins may become permanent and surgical procedures are needed to correct the problem.

Am I at Risk for Pelvic Insufficiency?

Women of childbearing age, between 20 and 45 years of age are most at risk for PVI. Multiple pregnancies also increase the risk. PVI is also associated with obesity and rapid weight gain due to the increased weight of the fetus, uterus, and abdominal tissues pressing on pelvic veins. Other risk factors include blood clots and a history of varicose veins.

How do I know if I have Pelvic Venous Insufficiency?

Like varicose veins, pelvic venous insufficiency can have no symptoms. Most often, possible symptoms include severe, dull pain in the pelvic area, lower back, buttocks and thighs. Heaviness is often associated with the pain, and menstruation and prolonged standing tend to worsen the symptoms. Painful intercourse and urinary symptoms may also occur. Dilating venous tissues also release neuro-transmitting chemicals, leading to additional depression and anxiety in conjunction with the pain.

Tests for PVI include soft tissue imaging with and without dye. The most common include:

• Ultrasounds to visualize the venous structure around abdominal and reproductive organs. Doppler ultrasounds enable the physician to visualize venous circulation in real time.
• CT Scans provide the opportunity for measuring the diameters of affected veins in order to diagnose the potential severity of the condition.
• MRI’s with and without contrast provide an excellent diagnostic tool to examine the extent of blood pooling and congestion in affected areas.
• Venography is an invasive procedure performed when non-invasive imaging is not sufficient to provide a definite diagnosis. Contrast dye is injected via catheter directly into pelvic veins and measurements are taken to diagnose the severity of venous dilation.

How is PVI Treated?

Non-surgical treatment of PVI and PCS are aimed at treating ovarian dysfunction. Hormonal management with progesterone based birth control pills or treatments are used for their contracting effects on the veins. In some cases, estrogen-inhibiting implants are used in the management of PVI.

Interventional and surgical options are aimed at correcting pelvic vein engorgement and include ligating affected veins or blocking blood flow to the affected area by embolization. In severe and debilitating cases not responding to medical or less invasive surgical treatments, full or partial hysterectomies may be required to prevent irreversible tissue damage.

If you are experiencing any of the symptoms indicative of PVI, your primary doctor or OBGYN may refer you to a venous specialist for further testing and management of your symptoms. The vein specialists at The Vein Centre will assist you in making the best possible decisions specific to your case. Contact us or call The Vein Centre today at 615-269-9007!