February 21,2012

Today's guest article is written by my friend and colleague, Dr. Stephen Rivard.  Dr. Stephen Rivard M.D., ACP, FACEP, is the Medical Director and owner of Illinois Vein Specialists, S.C., a dedicated vein treatment center located in Barrington. For many years, Dr. Rivard has offered the latest state-of-the-art technology and treatments available for varicose and spider veins. Dr. Rivard holds double board certifications in Emergency Medicine and Phlebology (the study of vein disease).

Varicose veins are not the problem! They are a sign of a more important circulatory problem inside the venous system. The real disease is “venous hypertension”, or high blood pressure inside the veins. The cause of this high pressure is the breaking of valves inside the veins in the legs and pelvis. The common reasons are genetics, years of prolonged standing without the use of support stockings, and in women, pregnancies. Obesity, age, and injury can also contribute.

All veins have many one way valves. They are the reason that blood can make its way up hill from our feet to our heart. When we are standing on our feet we flatten the veins in our feet forcing blood upward through these one way valves into our calf muscle. As we take a step our calf muscles flex flattening the veins inside and again propelling the blood upward and in time the blood climbs the “ladder” of these valves making its way back to the heart. This completes the circle of flow from the heart through the arteries and back through the veins.

In roughly 25-33% of the population, however, due to the factors listed above, these valves over time break. Typically this begins with the valves in the legs. When standing (and during pregnancy), gravity exerts its downward push on the blood inside the veins. One by one as the vein valves break the pressure on the next valve below it increases.  Eventually, with most or all of the valves breaking inside the veins, the pressure inside the veins rises to very high levels. This pressure is called “venous hypertension”, and when it occurs the pressure in branch veins connected to the larger veins begins to rise and their valves break in cascading fashion. These branches may bulge through the skin and are known as varicose veins. The more serious problem, however, is when venous hypertension begins in the leg; blood flow from the arteries to veins slows down. This causes the many symptoms that are associated with chronic venous hypertension, i.e. varicose veins, leg cramps, heaviness and fatigue, restless leg syndrome, skin rash and dermatitis, and even open sores, ulcerations and blood clots.

Prevention and Treatment:

Wearing compression hose while standing and maintaining an overall healthy lifestyle is helpful in slowing the progression of this medical condition. Because genetics plays such a significant role, I have seen patients as young as 15 years old with this disease. Those that already have this condition know that rest, elevation, and OTC pain medications help alleviate the symptoms temporarily.

The newest and most efficient treatment that is both safe and permanent in 97% of the patients is endovenous ablation and then sclerotherapy of the affected veins. This immediately reverses the venous hypertension and starts the healing process from the moment the patient stands up after the procedure.

In my office we have treated patients from ages 15 to 94 with little to no “down time” and a reoccurrence rate of less that 2%. As circulatory flow improves with these treatments recent studies also indicate an overall improvement in general health as well.

As a bonus… There is also a significant improvement in cosmetic appearance.