Vein disease is extremely common in the U.S and world-wide. The spectrum of disease is classified on a CEAP scale of 0 to 6:
- C-0: No visible veins (but symptoms may be present)
- C-1: Spider veins
- C-2: Varicose veins
- C-3: Leg swelling
- C-4: Skin discoloration/thickening
- C-5 & 6: Healed or active skin ulcers
Generally speaking, spider veins are isolated nuisances at the surface of the skin. If symptoms are present and/or as a patient moves down the spectrum of disease, there is a higher likelihood that underlying problems in the superficial venous system…specifically the Saphenous Veins…may be present.
The superficial venous system in the lower extremities have 2 main jobs:
- Return flow back to the heart: It does so with the help of the calf muscles which act as a “peripheral heart”, pumping flow upwards with each contraction as we walk. What keeps flow going one-way…up & out…are a series of valves within the veins.
- Store extra flow while the body is at rest. Veins are naturally a bit stretchy and can accommodate holding extra flow when needed.
If either of these two jobs are impaired, problems may occur over time:
- Valve malfunction: This allows wrong-way, downward flow with gravity and leads to pooling of blood in leg veins. This is known as venous insufficiency or reflux.
- As veins are ordinarily stretchy, things that lead to increased stretchiness or increased pressure can lead to veins that become bulgy and twisty over time. Such factors include
- Genetic factors
- Jobs that require prolonged standing or sitting in place.
No matter the underlying cause of vein disease, the first step is assessing the extent of disease and planning a tailored approach to treatment. When appropriate, this is done by an ultrasound exam during your consultation visit.