Definitive treatment for spider veins involves injections. Some will claim that superficial lasers or radiofrequency generators can do the job…but, in my opinion…based on experience…I would recommend starting with sclerotherapy first and use those other modalities as a last resort or to treat veins too small to enter with a needle. Sclerotherapy Centuries old, the concept of injecting solution into varicose veins in order to get them to scar down and shrink is still a mainstay in the armamentarium of phlebologists. Like thermal ablation, the goal is to achieve irreversible damage to the cells that line the walls of veins, causing local inflammation and ultimately scarring down and resorption of the vein itself. Too little, the body can ultimately heal the damage and allow blood to continue to flow through diseased veins. Too much can allow the sclerosing agent to flow into normal healthy veins and cause unwanted damage.
Venous Pathophysiology, Part 2 The whole of the Chicagoland area…including Northbrook where Rosen Vein Care is located…was once burdened by a sheet of glacial ice that oppressively flowed southward from Wisconsin. But hey…that’s just a theory. It’s not as if there was a video camera catching the evidence as it happened over hundreds of thousands of years. And that’s science: making best guesses based on facts as best we can gather them. Gather enough repeatable facts and you have yourself a theory. If it holds up long enough to the nerditudinous scrutiny of your peers… they’ll call it a Law. The lamp of scientific inquiry has flickered its way into nearly every crevice of uncertainty regarding the workings of our world…our bodies included. Over the years, a few theories have surfaced regarding the progression of superficial venous insufficiency and its effects on the lower extremities. Here’s where the trail of our discussion regarding the pathophysiology of venous disease picks back up again. The Old Theories: 1. Venous Stasis Theory: Attributed to Dr Homans and formulated during the early-mid 20th century: Valve/vein wall failure→reflux→stagnant blood→increased pressure→prevents nutrients from getting to skin→skin changes 2. Diffusion Block Theory (Fibrin Cuff): Venous Hypertension→capillaries become “leaky” (any docs reading this would rather I state it thusly: a widening of the endothelial gap junctions occurs)→fibrinogen leaks out and forms “cuffs” around capillaries→creates a barrier to oxygen/nutrient diffusion to tissues→ epidermal cells die. However, recent evidence suggests that the cuff is made up of multiple different proteins (fibrin,collagen,laminin…) and seems to serve as the body’s way of maintaining vascular architecture in the face of an increase in mechanical load due to venous hypertension. So the cuff could have protective benefits. But, it’s out with the old theories and in with… The New Theory: Inflammatory Model of Venous Disease A beautiful and compelling case which wraps it all up in a nice package: Venous Hypertension→shear stress on endothelial cells that line the inside of vessels→increased permeability of the lining→White Blood Cells (especially macrophages for those still awake) & Red Blood Cells leak out→ WBC’s become activated and release […]
Some people living in Chicago and the Chicagoland Suburbs who happen to suffer from varicose and spider veins take comfort in the fact that for 8-9 months out of the year it’s too cold to wear shorts…and therefore they can avoid wearing shorts along with everyone else around them. This just illustrates one of the more significant effects of venous disease: lifestyle limitations. Not to discount the fact that untreated disease can lead to things like blood clots and skin ulcers…but sometimes the emotional discomfort of having unsightly legs can be just as limiting and profound as the physical discomfort. Why should a completely fixable problem keep people from engaging in activities that they would otherwise love to do?! I want you to feel happy about parading your legs around town! They’re literally like walking billboards for Rosen Vein Care…show ’em off! That’s why I am on a mission to educate. As the Greek philosopher Epictetus said, “Only the educated are free”. I want to help free people from such limitations. Therefore I’m using the first postings of my blog to get you up to speed on the current understanding of venous disease. Once you understand the underlying problem and the state-of-the-art treatment options we provide at Rosen Vein Care, you’ll be better equipped to make a decision, to make a significant change. Enough preamble…let’s get down to business: How and What Leg Veins Do Arteries carry blood Away from the heart. The heart’s job is to keep on pumping and get the nutrient-rich blood to all the areas of the body. Arteries get all the press. “Hypertension” this….”Coronary artery disease” that…yadda-yadda “aortic dissection”. Most people, physicians included, rarely stop to think about how the body returns the blood back to the heart through the veins. The blood from the head is easy to get a handle on…gravity just drains it downward toward the heart. Fair enough. What about the legs? It’s not as if there is another heart in your lower extremities that pushes the blood upward against gravity. Well, actually there is! When the muscles in your calf […]