Venous Disease Program

Our approach to venous disease treatment

Depending on your symptoms, we may use one or more of the following techniques to diagnose your venous condition:

• Physical examination
• Duplex ultrasound, which uses ultrasound to visualize a vein and determine its exact anatomy and blood flow direction, allowing us to assess for abnormal valves within a vein
• CT scan
• Magnetic resonance imaging (MRI)
• Specialized blood tests
• Vein light technology
• Venograms, where a contrast dye is injected into your veins (typically in the legs) so they show up on an X-ray or fluoroscopy, mapping your veins

Your veins are the tubes, or blood vessels, that carry oxygen-poor blood toward the heart. While arterial blood is pushed through the body by the pumping of your heart, venous blood is pushed back towards the lungs and heart by the muscles that surround the veins. Vein disease refers to a range of conditions that affect the veins and disrupt healthy blood flow.

Below are the main venous disease symptoms:

• Pain, throbbing, aching, or cramping
• A feeling of weight, heaviness, or fatigue in the legs
• Arm pain (Paget-Schröetter syndrome)
• Noticeable puffiness or swelling, typically in the legs, ankles, or feet
• Enlarged, twisted veins visible under the skin
• Skin irritation or inflammation around the affected area
• Skin changes, dermatitis, or leg ulcers
• Itching or burning feeling
• Abdominal or pelvic pain

Vein disease occurs when the veins are functioning poorly, often due to issues like weakened vein walls, damaged valves, or impaired blood flow.

Several factors can contribute to the development of venous disease, including:

• Age
• Chronic conditions like CVI and post-thrombotic syndrome
• Genetics/family history
• High venous pressure from chronic coughing, heavy lifting, constipation, or other conditions that raise venous pressure
• Hormonal factors
• Medical conditions or comorbidities, like congenital (in-born) vein malformations, heart failure, and tumors that obstruct blood flow
• Obesity
• Occupations that require prolonged standing or sitting
• Pregnancy
• Prolonged standing or sitting
• Sedentary lifestyle
• Smoking
• Thrombosis (blood clots)
• Trauma or surgery to the legs or pelvis
• Valve dysfunction

Addressing these underlying causes and risk factors of venous disease can significantly reduce its progression and improve outcomes. Early detection and intervention are essential for managing these conditions effectively.

As a care team, we evaluate each patient's vein condition and customize a treatment plan that addresses the underlying problem, not just the symptoms.

For vein diseases such as varicose veins, deep vein thrombosis, and chronic venous insufficiency, treatments typically focus on improving vein function and reducing blood pooling. Blood can pool or slow in the veins because they operate under lower pressure compared to arteries, which are pressurized by the heart’s pumping action.

To treat vein disease, we specialize in a range of procedures and therapies, from non-surgical medical interventions and minimally invasive procedures to more complex surgeries when needed.

Some of the treatment options we may recommend include:

Preventative and supportive care

• Compression therapy, including socks/stockings
• Lifestyle counseling and modifications

Cosmetic treatments

• Percutaneous laser treatments
• Radiofrequency thermocoagulation
• Sclerotherapy (guided by ultrasound or vein finder/light)

Minimally invasive procedures

• Cyanoacrylate (glue) ablation
• Endovenous laser therapy (EVLT)
• Endovenous mechanical chemical ablation
• Foam chemical ablation
• Microphlebectomy
• Radiofrequency ablation (RFA)

Other procedures (such as vein stripping and ligation)

• Blood clot treatments/procedures
• Inferior vena cava filters
• Medications for DVT or CVI, including anticoagulants and venoactive drugs
• Thrombectomy or thrombolysis (incl. mechanical thrombectomy)