Monday 23 April 2012

What is Venous Insufficiency of the Legs

Introduction and How the Veins Work

Showing correct valve flow             
Venous Insufficiency occurs when the walls or valves in a vein do not work as efficiently which means that blood is unable to return to the heart and blood may pool in the lower limbs. 

There are three kinds of veins: superficial veins, which lie close to the skin; deep veins, which lie in groups of muscles; and perforating veins, which connect the superficial veins to the deeps veins.

When you are standing up the blood in your veins must fight against gravity to return to your heart. In order for the blood to return the leg muscles squeeze the deep veins of your legs and feet to move the blood back to the heart. The valves (as shown above) keep the blood flowing in one direction, when the vein is squeezed the valves open to allow the blood to flow through and when the muscle relaxes the vein the valves close to prevent the blood from flowing in reverse. This entire process is called the venous pump.

What can Cause  Damage

If you are susceptible or have existing conditions then even sitting for long periods of time can stretch the vein walls as the pressure builds causing them to weaken and damage the valves. Other risk factors include:
  • Aging
  • Reduced mobility
  • Blood clots known as deep vein thrombosis
  • Pelvic tumors
  • Vascular malformations
  • Being overweight
  • Pregnancy
  • Sedentary lifestyle
  • Smoking
  • There are also unknown reasons too

What are the Symptoms and Complications

  • Swelling and tightness
  • Heaviness, tired, restless or achy
  • Pain while walking or shortly after stopping
  • Rashes, redness and sores on the skin
  • Itchy and flaking skin on legs and feet
  • New varicose veins

Repairing the Damage and Treatments

Like most diseases it is most treatable in its early stages. Medical professionals will prescribe a combination of treatments to help restore proper blood flow to the vein. These treatments include:
  • Compression stockings
  • Regular exercise
  • Lose weight
  • Elevate your legs when sitting and at a 6 degree angle when sleeping
  • Antibiotics to treat skin infections
  • Take care of your skin - keep it moisturized so that it doesn't crack and become susceptible to infections.
  • Blood thinners if you have blood clots
  • Sclerotherapy - by injecting a solution in small varicose veins they will collapse and disappear which can eliminate pain and discomfort and prevent further complications such as ulcers.
  • Endovenous thermal ablation - a laser or high-frequency radio wave to create heat is used on a vein and by doing so causes the vessel to close up. It is non-invasive and has a quick recover time for the patient.
  • Ligation - a vein is cut and tied off but requires surgery
  • Stripping - the larger veins are remove through two small incisions and requires up to 10 days recovery after surgery.
  • Microincision/ambulatory phlebectomy - small incisions are made over the veins and a phlebectomy hook removes the vein.
  • Vein bypass - a healthy vein transplanted from another area of the body is used to reroute blood from the affected area. 
Ideally the problem will be caught in its early stages and surgery would not be necessary. However, if previous treatments have failed the opting for a surgical procedure can really improve the quality of life for a patient.

Have you ever suffered from, or are suffering from venous insufficiency? Leave me a comment with your experiences.

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