Frequently Asked Questions
What are the functions of veins?
The human body is comprised of literally millions of veins, each of which plays a crucial role in helping the body function. While arteries push blood away from the heart, veins are actively working to push deoxygenated blood back to the heart. This is an incredibly difficult task as veins are actively working against the forces of gravity in order to deliver the blood back to the heart.
Veins are broken up into two classifications: deep and superficial. Superficial veins are the small veins located just beneath the surface of your skin. Deep veins, on the other hand, are located within the body's muscle tissue. Both types of veins feature specialized component parts that ensure blood can only flow towards the heart and cannot be reversed. However, certain health complications can cause these veins to begin to improperly function, which can lead to blood clots, blood pooling, and ulcers.
What are the signs and symptoms of venous disease?
Visible signs may include spider veins, varicose veins, venous ulcers, and leg swelling. Spider veins are small (1mm), red, blue, or purple veins on the surface of the skin. Varicose veins (3-4mm) are larger distended superficial veins
Common symptoms are leg pain, fatigue, restless leg, heaviness, aching, burning, throbbing, itching, and night cramps. As the disease progresses, symptoms of leg swelling, skin discoloration and skin ulceration may occur.
Who is at risk?
Predisposing factors include genetics, gender (females more common), age, obesity, trauma and occupation. Heredity is the number one factor in developing varicosities. Varicose veins are more common in women and is attributed to hormones including pregnancy, puberty, menopause and birth control. Varicosities after delivery may regress after the initial pregnancy, but often do not after subsequent pregnancies. The incidence of venous disease increases with age, and by 65 over 60% of women and 45% of men will have venous disease. Jobs that require prolonged standing or sitting are at a high risk for venous disease.
What preventative measures can be done?
Exercise your calf muscle to compress your veins and direct blood to flow to your heart.
Elevate your legs daily and avoid prolonged standing.
Maintain a healthy weight.
Avoid high heels, except on special occasions.
Avoid or minimize heavy weightlifting, pounding exercises, trauma, hot baths or the tanning bed.
How are ‘bad’ veins treated?
Corrective procedures are often indicated for venous disease. Treatment results are optimized when procedures are paired with the healthy leg principles above. Treatments include cosmetic and medically necessary procedures. An ultrasound will determine what veins have reflux. The results as well as symptoms and a physical exam will help your physician vein specialist make a tailored treatment plan. Though vein procedures are elective, delaying treatment allows your chronic condition to worsen over time. At VVC, cutting edge treatments allow a level of effectiveness and safety in treating varicose veins and spider veins.
What is phlebology?
Phlebology is the medical specialty devoted to the evaluation and treatment of patients with venous disease. This includes spider veins, varicose veins, venous ulcers, and leg swelling. Phlebology has been an established medical specialty in Europe for over 50 years. In the US, serious interest has developed over the last 20 years.
What is sclerotherapy?
Sclerotherapy is the gold standard in spider vein treatment. The treatment is an office based procedure where a micro needle is used to inject the vein with a medication that irritates the lining of the vein wall. After a series of treatments, the vein collapses and disappears. Normal activities can be resumed immediately and compression hose are worn after each treatment to aid in healing. Maintenance sclerotherapy may be needed every 6-12 months as new spider veins may occur.
What are the medical procedures for venous disease?
Procedures may be indicated to treat the underlying cause of your venous disease as well as the visual results of venous disease- the bulging varicose veins. Endovenous thermal ablation (RFA) is used to treat saphenous reflux. In this, a small catheter is inserted into the damaged veins and radiofrequeny (heat) is delivered to the vein wall. As the heat is introduced, the vein wall collapses and is sealed (scarred) shut, eliminating venous reflux.
The veins that connect the deep veins to the superficial veins are called perforator veins. If unhealthy perforator veins are detected, treatment with ultrasound guided sclerotherapy is generally recommended. Superficial varicosities close to the skin are removed via micro phlebectomy (incisions are 2-3mm in size). These micro incisions leave very little scarring.
Where will my procedure take place?
Your procedure will be an outpatient procedure in our office at 301 N Preston Rd Suite D in Prosper, TX 75078.
Will I have pain during or after the procedure?
We use a gentle numbing medication called lidocaine to keep you comfortable during the procedure. You may have mild discomfort when the numbing solution is administered and when the numbing medicine wears off in 4-6 hours. Aspirin is recommended to help with post-op discomfort. If needed to help with your nerves, Dr. Hart, Dr. Roberts or Dr. Rizzo may prescribe an oral relaxation medication for you to bring to the office on the day of your procedure.
Is there a problem with treating varicose veins in the leg if I may need heart bypass in the future?
No. We treat bad veins and leave the good veins. The veins that are treated are diseased and therefore are not good options for use in cardiac bypass. Other vessels that can be used include the internal mammary artery and the radial artery.
What kind of results can I expect?
Success is dependent on multiple factors- your initial assessment, accurate treatment recommendation, skill of the physician, and compliance to the treatment and maintenance plan. It is imperative that you and your physician vein specialist discuss your primary concerns and expectations prior to scheduling any procedures. When desiring improvement from physical symptoms it is important to know that your venous disease may not be the only cause of your symptoms. If you have symptoms from another etiology, it is likely that they will persist after treatment. If your main desire is for cosmetic improvement, it is important to know that until your underlying reflux is treated, you may not have acceptable cosmetic results.
If you are proactive and engage with your care, your outcomes will be better than a patient who is not compliant. Our hope is that after treatment of your reflux, you will have improvement in your pre-op symptoms and visual varicosities. If your venous disease is advanced, some of your symptoms (swelling, skin changes) may be chronic in nature.
Are treatments covered by insurance?
Insurance companies most often consider treatment of symptomatic varicose veins medically necessary. Over the years, insurance companies have become more restrictive in approval of vein treatments. Your insurance company may require that you meet certain standards prior to the approval of your procedure. The insurance pre-authorization process will be guided by our staff.
When you are ready for cosmetic spider vein treatment, a procedure appointment will be scheduled with a physician and financial arrangement will be made with our office manager.
What risks are involved?
The risks associated with these office based procedures are minimal. However, no treatment is completely risk free. After your procedure you may experience bruising, mild to moderate discomfort, skin discoloration, numbness, tingling, burning and increased swelling. The risk of infection and blood clots is low. If you have a history of blood clots, poor wound healing or a history of skin infections, these need to be discussed with your physician vein specialist.
After the procedure you may experience increased swelling related to the instillation of local numbing fluid. This post op swelling may last from 24 hours to a couple of weeks. If you have numbness, burning, or tingling post procedure, these symptoms may take longer to gradually improve. The risks of these post op complaints increase if work is done in your shin or ankle area, where there is less fat to separate nerves from the veins.
How can I let friends and family know that help is available?
One of the best compliments our practice can receive is you sharing your experience with your family and friends. Please tell your friends and family to contact our office for an appointment. Call 469-750-2277 or ask them to visit our website. It is helpful if you pass along conservative care guidelines so your friends or family may start managing symptoms prior to their initial visit.