Problems arising from varicose veins go well beyond any cosmetic discomfort the condition may cause people.
Dr. Craig Nachbauer, a Plattsburgh vascular surgeon, talked about prevention and treatment methods for varicose veins recently as part of CVPH Medical Center's monthly lecture series.
"Venous disease is a very common and frequently undiagnosed problem," Nachbauer told several dozen participants at the West Side Ballroom. "It's more common than coronary heart disease and more common than congestive heart failure."
The visual component of varicose veins is only one of many issues of concern with the disease, he added. It also disrupts the normal flow of blood racing through veins back to the heart and can cause changes in the skin.
The condition seems to be closely associated with heredity, Nachbauer noted. Statistics show an 89-percent likelihood of developing venous disease if both parents had it and a 47-percent chance if one parent did.
That potential drops to 20 percent if neither parent suffered from varicose veins, he added.
"Inactivity can also play a role," he said, citing research of factory workers showing that 64 percent of the workers who developed varicose veins had jobs standing in place, while 30 percent sat in one place.
Only 6.3 percent of the workers who developed the condition moved about regularly during work.
The disease is three times more prevalent in women than men and increases significantly with the number of pregnancies a woman has. The incidence also increases as both women and men age.
Veins carry de-oxygenated blood back to the heart. Smaller capillaries lead to the larger vessels, which have a system of valves preventing blood from flowing backward. Muscular activity in the legs assists the veins in pushing the blood upward toward the heart.
If those valves fail, blood will pool in the thicker veins and flow backward into the capillaries, creating varicose veins.
Symptoms beyond the blotchy and discolored skin can include aching and throbbing legs, fatigue, itching, burning, stabbing sensations, swelling and numbness.
Nachbauer will use a variety of steps to evaluate a patient's condition, including a thorough health history, physical exam and ultrasound images. Treatment plans will be developed based on those reports.
"Compression therapy can often take care of a lot of the symptoms," he said, referring to the use of a specially designed stockings that assists the leg's efforts to push blood upward.
Incorporating a physical-therapy program is another option that may help alleviate symptoms.
"When do we consider something else?" asked Nachbauer, who mentioned that improperly functioning valves cannot be corrected by surgery. "When we've done other things and still have symptoms, surgery might be the next option."
Endovenous laser ablation is the most obvious option. Using a minimally invasive procedure, the doctor uses a heat source to close off the blood vessels that are not functioning properly. Blood will then seek another vein en route to the heart.
"It works as well as vein stripping and can be done in the office with local anesthesia. It doesn't lay you up for days. The patient is typically up and active the next day.
"It's a very successful procedure. We've seen dramatic results."
Insurance companies will typically require a patient to try stocking therapy before moving onto the ablation technique, but people suffering from varicose veins should consult their health-care provider.
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