Simply put, your vascular system is made up of the blood vessels, or a series of tubes, that carry your blood. It has two major systems of vessels which are your arteries and your veins. Basically, the veins return oxygen-poor blood to your heart from all parts of the body and a problem in the veins is called venous disease.
Venous disease refers to all conditions related to or caused by veins that become diseased or abnormal. Venous disease is quite common occuring in about 15 percent of the adult population. Mild venous disease is usually not a problem for patients, but as venous disease worsens, it can become painful and even crippling,
In the normal circulation, arteries carry oxygen-rich blood from your heart to the body, and veins return deoxygenated blood to your heart. Veins are different from arteries in that they have one-way valves along their length that keep the blood flowing to the heart and not falling back down the leg. As muscles contract, the blood is squeezed forward to the heart. When muscles relax, the valves shut to prevent blood from flowing backward. Regular movement of the legs keeps blood from pooling and assists in vascular function. If you do 10 toe stands, you empty 65% of the venous blood out of your calf muscles. If you just lift your thighs up and down with your thigh muscles then you only empty 15% of the blood out of your leg.
If the vein walls become weak or damaged, or if the valves are stretched or injured, the system stops working normally and the blood begins to flow backward when the muscles relax. This creates unusually high pressure in the veins, resulting in even more stretching, twisting, and swelling of veins. The abnormal veins with their sluggish blood flow create disorders known as venous disease. (For specific normal and abnormal pressures of venous disease refer here.)
Most venous disorders are not life threatening, but they affect millions of people on a daily basis. Although venous disease in its mildest form is merely uncomfortable or cosmetically unappealing, a severe venous disease can produce pain, disability and become even life threatening.
Venous diseases include:
- Varicose veins
- Spider veins
- Leg ulcers
- Phlebitis (blood clots)
- Leg swelling and leg pain
- Leg skin changes (brown staining and scarring and also fatty subcutaneous tissue with injury to your small capillaries and veins)
More serious are enlarged varicose veins that can lead to the following complications and require treatment:
- Recurrent thrombophlebitis in the superficial veins
- Spontaneous bleeding from the superficial veins
- Nonhealing ulceration of the ankle
- Pain so severe that it interferes with activities of daily living
Fortunately, we now have the ability to treat nearly all affected patients with highly successful non-invasive or minimally invasive office-based procedures. The venous system of the legs is composed of deep and superficial veins. The deep system is responsbile for 98% of the blood that is returned to the heart. The superficial venous system returns only a small amount of blood. The superficial system can be surgically removed without any major consequences as long as the deep system is open (great saphenous vein, small saphenous vein, tributary veins). The great saphenous vein and small saphenous vein can be removed for heart bypasses if they are still good and without damage.
What Goes Wrong?
The most common form of venous disease is venous insufficiency caused by valve incompetence in the deep or superficial veins. As a person walks, the muscles contract around the vein forcing the blood upward. Multiple valves in veins in the deep and superficial system prevent blood from pooling in the lower legs. Superficial venous insufficiency occurs when the valves fail to close correctly causing increased pressure in the system. The vein branches then become enlarged and become visible under the skin (varicose veins) in most cases. The symptoms of venous insufficiency worsen after prolonged sitting or standing causing pain, heaviness, fatigue, aching, throbbing, cramping and even swelling of the legs. Large varicose veins can form clots and result in inflammation leading to local pain and tenderness. Spontaneous rupture of varicose veins may cause bleeding in some cases.
There are also perforating veins in each leg (approximately 60) under the skin that go straight into the depths of your leg to the deep system. They usually have one-way valves so flow can only go superficial to deep. If they lose these one-way valves, blood may blow back under the skin causing injury to the subcutaneous fat and to the capillaries that are blood supply to the skin. Perforators, too, can cause ulcers on the skin.
High venous pressure may lead to discoloration and ulcerations around the ankle which are difficult to heal with older conventional measures. These ulcers can enlarge becoming more painful and resulting in physical disability. The most common cause of ulcers at the ankle are the superficial veins and particularly the great saphenous vein. Should this occur, consultation with a venous specialist will determine if you are at increased risk for complications.
We hope the information on these pages is both informative and helpful, but it is intended for education only. Please do note that no web site, no matter how much information is shared, can replace a consultation with your doctor and a vascular specialist. Medical technology and treatment are continually improving and evolving so before making any decision on treatment, it is always advisable to see your doctor first for a comprehensive evaluation of your vascular disease and other medical conditions.
At the Vascular Center of Wichita Falls, we work closely with your other physicians. If you have concerns about your arteries or veins, contact us. A referral is not necessary to make an appointment.