What is Venous Reflux?

Healthy leg veins contain valves that open and close assisting in the return of blood from the legs to the heart:
  • When these valves no longer function, the blood begins to travel in both directions. This leads to the pooling of blood in the legs. ​
  • As a result of venous reflux, the veins in the legs begin to enlarge, lose form, protrude and become visible under the skin as varicose veins.

What are the Factors?
The following contribute to the development of venous reflux and varicose veins:
  • ​Age (>40 years)
  • Gender
  • Family history
  • Heavy lifting
  • Multiple pregnancies
  • Obesity
  • Prolonged standing

Is This a Cosmetic Issue?

Varicose veins are NOT a cosmetic issue as is commonly believed. If left untreated, they can progress over time to more serious problems such as:
  • Leg or ankle swelling
  • Leg heaviness and fatigue
  • Burning or itching of the skin
  • Restless legs
  • Skin changes/ pigmentation
  • Skin ulceration (ulcers/sores/open wounds)

​Venous Reflux Progression

​Venous reflux is a medical condition which progresses over time into a more serious medical condition called Chronic Venous Insufficiency (CVI). The increased pressure inside the veins, secondary to pooling of the blood in the legs, leads to varicose veins.

1 Normal  |  2 Spider Veins | 3 Varicose Veins | 4 Edema | 5 Venous Ulceration 

​Globally, more than 190 million people are diagnosed with varicose veins or Chronic Venous Insufficiency (CVI). More than 30 million people are affected in the United States. Many individuals remain untreated.

​Education and taking care of our health is ​critical for our well-being.
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What are Spider and Reticular Veins?

Spider veins and reticular veins are small, web-like, blood vessels that are easily visible on the surface of your skin. They can be red, blue, or purple and are commonly associated with varicose veins. Spider veins range in diameter from 0.1 to 1 mm. Reticular veins are dilated bluish sub-dermal veins measuring between 1 and 3 mm in diameter. When veins are more than 3mm in diameter, they are referred to as varicose veins. Varicose veins, although still visible through the skin, are usually larger, raised blood vessels that are swollen. 
Picture
Reticular Veins
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Spider Veins
Although spider and reticular veins are considered a cosmetic problem, they are often a result of underlying venous reflux in the larger veins. When reflux develops in the larger veins and results in the veins becoming bigger, the pressure is often transmitted to the nearby smaller veins under the skin and these manifest as spider veins and reticular veins. Therefore it is imperative that while seeing a patient with spider veins, the clinician also rules out underlying reflux in the larger veins which may be the cause of the problem. ​

H​ow are Conditions Diagnosed?

​Venous reflux and Chronic Venous Insufficiency (CVI) are diagnosed by Dr. Ramaswami in the office using non-invasive ultrasound examination. The test takes around 30 minutes and is the gold-standard for diagnosing the site and severity of venous reflux in the veins of the leg. 
Dr. Ramaswami will also take a detailed history and do a thorough physical examination to ensure problems are not caused by something else.
​It is therefore prudent to see a vein specialist to get varicose veins treated.​

Treatment

​ClosureFast™ Targeted Endovenous Treatment

The traditional treatment of varicose veins included surgery in the operating room with venous ligation and stripping. This was accompanied by significant patient discomfort, leg bruising, pain and delayed recovery. Surgery has, for the most part, been replaced by minimally invasive venous ablation procedures, which are performed in the office setting. Closure of refluxing superficial veins is achieved using Radio Frequency Ablation. Studies using the ClosureFast™ catheter have shown, less pain, fewer complications, better quality of life and nearly 95% reflux free rate at 5 years follow-up.
The ClosureFast™ catheter is inserted into the vein through a tiny incision below the knee. Guided by ultrasound imaging, the physician treats a 7 cm segment of vein with a 20-second burst of radiofrequency energy, causing the vessel to shrink around the catheter. The physician withdraws the catheter, treating each segment until the entire length of the vein has been sealed. Unlike painful vein stripping surgery, the catheter delivers uniform, consistent heat to each segment and temperatures do not exceed 120° C. As a result, the ClosureFast™ procedure causes less bruising and allows for rapid patient relief and recovery. The ClosureFast™ procedure is performed in our office.
Most patients report having limited to no scarring, bruising, or swelling following the procedure and many patients feel very little to no pain during the ClosureFast™ procedure. Our surgeon will give you a local anesthetic to numb the treatment area.
The ClosureFast™ procedure is a minimally invasive treatment for varicose veins and Chronic Venous Insufficiency (CVI) in which a vein specialist inserts a ClosureFast™ endovenous radiofrequency ablation (RFA) catheter to collapse and close enlarged leg veins. After the vein is sealed shut, blood then naturally re-routes to healthy veins.

Watch This Video to Learn More About our Procedure:

​Endovenous Radiofrequency Ablation (Thermal Ablation) 
  • Catheter (called ClosureFast™) that produces heat is used to close the vein that is incompetent
  • Have found the results to be very successful 
  • Our most popular form of thermal treatment 

​Endovenous Chemical Ablation (Venaseal) 
  • Uses cyanoacrylate to close large veins that are refluxing and uses single access and avoids the use of tumescent fluid which is needed for conventional thermal ablation ​

Endovenous Chemical Ablation (Varithena)
  • Particularly useful for treating patients with venous ulcers where the polidocanol foam (all the bubbles are the same size) can be injected directly into the ulcer bed to help facilitate closure of refluxing venous tributaries in the region of the ulcer and hasten ulcer healing
​We know this is a lot of information. At TVS, we believe it is important to customize a plan of action that is best for every individual. We are happy to talk with you and answer any questions you may have. 
Your health and happiness is important. Schedule your first appointment with us today. Just call ​(734) 287-1950 or click the button below.