Learn About Venous Disease

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Have you recently experienced skin problems or regularly feel pain, swelling, or heaviness in your legs? Although easy to overlook, these symptoms may not be as simple as you may think; they may be associated with chronic venous disease.

VENITI helps create awareness about venous disease by sharing up-to-date information about venous disease and helping patients achieve better outcomes. Our mission is to advance the treatment of venous disease, so those suffering from venous disease can live lives free from pain and discomfort.

 What You Need to Know

Venous disease is deeper than varicose veins. The venous system of the lower extremities includes the deep veins, superficial veins, and perforator veins1.

Doctors refer to venous diseases and disorders as instances where veins anywhere within the body become abnormal, blocked, defective, or damaged. These conditions may cause the walls of the vein to swell and interfere with the normal function of the vein. Venous disease is caused be either reflux and/or venous obstruction. Venous reflux occurs when a valve within a vein fails to prevent the blood from flowing backwards1.

normal-vein-return

Normal Vs. Malfunctioning Valves

The image to the right shows the difference between malfunctioning and vein-imagenormally functioning valves. Valves areresponsible for preventing the blood from flowing backwards. These are therefore important in maintaining normal blood circulation and reducing the risks of vein expansion, blood clotting, and venous disease. Incompetent valves, or valves that fail to perform this function, may cause the veins to expand and the deep vein system to malfunction.

Venous outflow obstruction is a blockage either caused by Post Thrombotic Syndrome (PTS) or a Nonthrombotic Iliac Vein Lesion (NIVL), which block the circulation of blood. This blockage increases pressure within the veins; too much pressure caused by poor blood circulation can create dangerous conditions for your veins2. Either of these two conditions can lead to the other. A patient with an underlying obstruction may have pressure build up causing blood to pool in the lower extremities damaging the valves. Reflux can result in stagnant blood and DVTs, which can create a blockage. It is important to evaluate both reflux and obstruction to understand the etiology of the disease.

When venous obstruction and/or reflux happens, a variety of problems may occur, which include:

  • Deep Vein Thrombosis (DVT)
  • Severe Varicose Veins
  • Swelling of the Leg
  • Leg Pain and Heaviness
  • Leg Ulcer
  • Skin Discoloration
  • Dermatitis, Eczema, and other Skin Problems

Post Thrombotic Syndrome (PTS)

PTS is a common health concern among patients with Deep Vein Thrombosis (DVT). DVT is when a blood clot forms in the deep veins of the legs, pelvis, or abdomen2. PTS is a long term complication that can develop after a DVT. PTS occurs in approximately 20 – 50% of the DVT patient population3,4.

PTS usually develops after a DVT, which is why it is important to detect and treat DVT as early as possible. When blood cannot flow freely, it tends to clot, even within a vein7. This clotting prevents blood from flowing normally through the veins. When blood does not move normally, fluid moves out of the blood vessels and into the tissues. This is why fluid tends to collect around the ankle in someone with a DVT in the leg. A DVT may cause leg pain and swelling, but it may present no symptoms in some cases. This condition can cause Pulmonary Embolism (PE) if the blood clot breaks loose and reaches the lungs8.

Main Causes of DVT

The three main causes of DVT are:

  • Damaged or inflamed walls of the vein
  • Tendency of a patient’s blood to clot quickly (may be hereditary)
  • Poor or slow blood flow through the leg vein

Are You at Risk of PTS?

You are at risk of developing PTS if you:

  • Are previously diagnosed with DVT
  • Sit or stand for long periods
  • Have a history of high blood pressure
  • Smoke
  • Are obese
  • Have varicose veins
  • Have an inactive lifestyle

Nonthrombotic Iliac Vein Lesion

A nonthrombotic iliac vein lesion (NIVL) is an obstruction in the deep vein system that is not caused by a clot. Patients are frequently diagnosed with iliac vein compression syndrome, commonly known as May-Thurner Syndrome or Cockett Syndrome5.

In order to properly diagnosis and treat venous disease, patients should be evaluated for the presence of venous outflow obstruction. This can be done through the use of a duplex ultrasound, venogram, CTV, MRI, and/or intravascular ultrasound (IVUS).

Venous disorders with an obstructive component can be safely and successfully treated with stenting6.

venous-disease-left

Venogram of an Occluded Left Iliac Vein due to PTS, Pre-Stenting

 

1. Obstructed Left Illiac Vein.
2. Collateral Vein Developed as a Return Pathway; collaterals such as this can cause congestion, pain, and discomfort.
venous-disease-right

Venogram of an Occluded Left Iliac Vein due to PTS, Post-Stenting – Collateral is Gone!

3. Stented – Left Iliac Vein.

VENITI’s Fight Against Venous Disease

Venous disease affects over a million Americans each year, leading to pain, disability, and in the case of pulmonary embolism, death. VENITI recognizes the need for improved screening, accurate methods of detection, and effective treatments. Our research team is devoted to identifying and reviewing important medical studies to help in our ongoing effort to develop more effective venous disease treatment solutions. We also work with other medical professionals and conduct clinical trials to test the efficacy of the treatment options we provide. By doing so, we make a significant contribution to ongoing medical research on venous disease.

Our organization focuses on providing information and treatment options to individuals who are at risk or have experienced the painful, unsightly effects of venous disease. Our goal is to improve the lives of patients by educating them about their condition and providing access to innovative treatment procedures. Everyone should have the opportunity to experience relief from venous disorders.

What are the Treatment Options?

Medical professionals use a variety of procedures to alleviate venous disease symptoms and treat the underlying conditions:

  • Sclerotherapy. A doctor injects a solution that causes the affected vein to close. Once the damaged vessel is closed, blood is forced to travel through healthier veins. Sclerotherapy is ideal for treating small and medium sized varicose veins, but may require multiple treatment sessions.
  • Microschlerotherapy. This treatment option is similar to sclerotherapy, but uses different injection techniques and solutions. Microsclerotherapy is used to treat spider veins.
  • Laser surgery. Doctors use the heat generated by a laser beam to destroy spider veins without damaging the skin.
  • Ambulatory Phlebectomy. This procedure involves making a series of tiny holes in the skin to remove large varicose veins. Doctors normally use local anesthesia to reduce pain and discomfort during the process. Ambulatory phlebectomy may cause minimal scarring in some cases.
  • Anticoagulation. The use of blood-thinning medications to minimize the risk of developing a blood clot. To ensure safety, anticoagulation requires close monitoring and supervision by a physician.
  • Angioplasty. This nonsurgical treatment procedure uses a small, inflated balloon that helps widen the affected vein to increase blood flow.
  • Stenting. A doctor places a specialized stent, such as the VICI VENOUS STENT® System, into the abnormal vein. The stent keeps the affected vessel open, increases blood flow, and restores the vein’s function. VENITI is proud to offer this innovative treatment solution to patients with chronic venous disease (CVD).

It all Starts with You

If you are experiencing any of the symptoms we mentioned, please contact your physician.

References

  1. Meissner MH. Lower extremity venous anatomy.Semin Intervent Radiol. 2005;22:147–156.
  2. Comerota A, Eklof B, Martinez J, Mclafferty R. Surgical/Interventional Treatment of Acute Deep Vein Thrombosis. In: Gloviczki P eds. The Layman’s Handbook of Venous Disorders. Provided by the American Venous Form: veinforum.org.
  3. Prandoni P, Lensing A, Cogo A, et al. The long-term clinical course of acute deep venous thrombosis. Ann Intern Med 1996;125(1):1-7
  4. Kahn SR, Shrier I, Julian JA, et al. Determinants and time course of the post-thrombotic syndrome after acute deep venous thrombosis. Ann Intern Med 2008;149:698-707
  5. Neglén P, Raju S. High prevalence of nonthrombotic iliac vein lessions in chronic venous disease: a permissive role in pathogenicity. J Vasc Surg. 2006 Jul;44(1)136-43.
  6. Neglén P, Hollis KC, Olivier J, Raju S. Stenting of the venous outflow in chronic venous disease: long-term stent-related outcome, clinical, and hemodynamic result. J Vasc Surg. 2007;46(5):979-990.

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