Problems affecting veins of the lower extremities are seen more and more often in New York, just like in the rest of the word. There are many factors responsible for such increasing. Some of them are related to demands of our life style, other are due to growing life expectancy.
For prevailing majority of people varicose veins represent one and only manifestation of abnormal venous circulation. The varicose veins, however, are not a disease by themselves, but rather is a symptom, coincidentally not the most common one, of a condition called \”superficial venous insufficiency.\” More specifically, people with venous insufficiency always have varicosities. Rarely, however, these varicosities are seen by naked eye. They always can be easily identified with a special duplex vascular ultrasound evaluation.
While above superficial venous insufficiency and cased by it varicose veins are the most common disease affecting superficial veins of the lower extremities. Deep vein thrombosis (DVT), as it is seen from its name, affects the deep venous circulation of our legs. In other words, presence of varicosities and risk of DVT are nearly unrelated to each other, with the rarest exception, when the old DVT can cause future superficial insufficiency.
Understanding process of DVT formation is important, because one of rare complications of DVT, pulmonary embolism (PE), on some occasions can be fatal.
On other hand, DVT is often being confused with thrombophlebitis, which is unpleasant, but harmless complication of superficial venous insufficiency. Presence of thrombophlebitis absolutely excludes possibility of DVT and vice versa.
Among different methods of medical management of venous insufficiency, there are modalities related to either its prevention, so-called conservative treatment, or definitive treatment for cure. The former ones are changes in life style, such as avoiding prolonged standing / habitual heavy lifting and etc. The conservative measures are also called \”symptomatic\” therapy: they improve certain symptoms of a disease without eliminating the disease responsible for development of these symptoms. These involves numerous methods, ranging from pain killers to so-called \”compression therapy,\” or wearing special compression stocking closing the diseased veins from outside. Obviously, the compression stockings normalize your circulation only while you are wearing them. As soon, as they are off, the circulation goes back to its abnormal state.
Finally, curating treatment, the one providing permanent results, revolves around the concept of identification of diseased veins, which is usually done entirely with vascular duplex ultrasound, and seizure of abnormal blood flow through these veins. That is way in old day, surgeons used to remove these veins in the operating room. Performed correctly, it does take of the disease, but the coast of it is a large scar, not counting all negative aspects related to open surgery and general anesthesia. That is way surgery over the last decade was nearly entirely replaced by so-called \”endovascular therapy.\” It includes a variety of procedures performed through a needle in the office, where a wire caring one or other type of physical energy, is being inserted into a diseased vein to seal it off.
Endovascular LASER therapy is one of the most common type of endovascular vein closure. The other ones include radio-frequency ablation, cry-ablation, Carivein® therapy and many others. While each of the above endovascular modalities have their pros and cons, what they have in common is the following: performed in the office, under local anesthesia, do not require time off before or after the procedure, do not require any limitation of physical activity before or after, done through the needle, safe, effective, painless and, the most importantly, they provide permanent results, since the treated vein not only being closed, but also goes through a process of so-called \”disintegration\” in the future. The last is important, since once the vein disintegrates, it can re-open in the future, making the disease, therefore, not only treatable, but also curable once forever.
The best way to find out which treatment is best for you is to talk to Dr. Lev Khitin, who specializes in varicose veins and other vein-related procedures in New York. Please contact us to make an appointment today!