Chronic venous insufficiency (CVI)—the most common vascular disorder—affects more than 30 million Americans, and is the underlying cause of those painful, unsightly varicose and spider veins that develop in the legs. CVI can also lead to more worrisome conditions, such as venous wounds that are reluctant to heal. The good news is, this condition can often be treated effectively through state-of-the-art, non-invasive endovenous techniques coupled with simple preventive measures.
According to Mercy Health Network physician Zoe Deol, MD, FACS, of the Center for Vein Restoration, “Venous insufficiency is a chronic disease that, similar to diabetes, can be managed but not cured. It’s also progressive, so a leg vein that’s in good shape today may turn bad somewhere down the road.”
CVI occurs when the one-way valves in the leg veins become damaged or faulty, impeding the flow of blood back to the heart and allowing it to pool in the legs. In addition to varicose/spider veins and slow-to-heal venous wounds, symptoms of CVI might include (among others) swelling, heaviness, or a dull ache; an itching or tingling sensation; thickened and hardened skin; discolored skin; and cracked, “weepy” skin in the legs.
Risk factors for developing CVI include advancing age, female sex, pregnancy, inactivity, having a family history of the condition, and working a job that demands prolonged standing or sitting.
Practicing in both the Toledo and Detroit areas, Dr. Deol has extensive experience treating auto-industry workers, who spend a lot of time on their feet and are, therefore, vulnerable to CVI. In fact, she says that non-healing wounds due to CVI are among the biggest causes of early retirement in factory workers. With respect to the role of genetics, Dr. Deol notes, “If one of your parents has CVI, you have a 47 percent chance of getting it. And if both parents have it, your odds increase to 97 percent.”
The appropriate course of treatment for restoring vein health in patients with CVI is based on the type and severity of symptoms. Surgery is not the only option but is considered appropriate when symptoms begin to interfere with the patient’s quality of life.
“If surgery is determined to be the right course of action, we start by identifying the problem vein, which I describe as a ‘highway full of potholes and bumps.’ We then close down the vein using radiofrequency, laser, or a technique called MOCA, which stands for mechanochemical ablation. These treatments work by burning the inside wall of the vein so it closes down on its own, and the body then absorbs the closed vein naturally,” Dr. Deol says. These non-invasive techniques require no downtime and can often be performed over the patient’s lunch break.
Dr. Deol emphasizes that the advanced techniques used to treat CVI at the Center for Vein Restoration should not to be confused with the now largely obsolete surgical technique called “vein stripping,” which is less effective, causes more pain, requires longer recovery times, and puts patients at greater risk for a wide range of post-surgical complications. “Before the advent of non-invasive endovenous techniques, vein stripping was our only option, but it was pretty brutal and caused a lot of problems. The treatments we use now are 89 to 99 percent effective, and the more severe the disease, the more dramatic the outcome. Patients usually start to see results in a matter of days, with their legs feeling better and lighter. Within a month of treatment, they notice a big difference,” she says.
If advanced non-invasive surgical techniques are one half of the equation when it comes to restoring or maintaining the health of leg veins, then prevention is the other half. Though CVI is a chronic and progressive condition, those at increased risk of developing the disease—or those who already have it but would like to slow its progression—can help keep the disease or its symptoms in check through preventive measures such as performing simple leg exercises, wearing compression stockings, using cushioned flooring on jobs that require standing for long periods, and elevating the legs when sitting at a desk for prolonged periods.
“The bottom line is that people should be aware of their genetics or any other factors that put them at risk for developing CVI. They also need to educate themselves on any conditions in the workplace that might put them at risk, and take proper precautions to mitigate them,” states Dr. Deol. ❦