Using ultrasound for vein treatment

Ultrasound is an essential tool in vein care, as well as non-invasive and comfortable for the patient. In addition to mapping a patient’s veins and diagnosing vein disorders, ultrasound is used throughout the treatment of veins, acting like the physician’s “eyes inside the leg.”

After a diagnostic ultrasound is performed and the doctor establishes a treatment plan to fix the problem, ultrasound may be used. In endovenous laser ablation for example, seeing where the healthy vein connects with the unhealthy vein is very important; ultrasound is the best modality to visualize this area.

Another example is ultrasound-guided sclerotherapy, which uses the guidance of ultrasound to find leaking veins that are not visible and can’t be seen with a hand-held light used to view veins near the surface (transcutaneous illumination). Ultrasound-guided sclerotherapy is often used to treat perforator veins, or veins that connect the superficial system (above the muscles in the leg) to the deep system (veins under and between the muscles of the leg).     

After the vein treatment and a designated amount of time for healing, the physician will use ultrasound again to assess the effectiveness of the treatment plan.

What is ultrasound mapping?

Vein disease, which often manifests as varicose veins, is defined as the impairment of blood flow towards your heart. Oxygenated blood is constantly being pumped from the heart to the rest of our bodies through arteries. It is the job of our veins to carry deoxygenated blood back up to the heart.

Healthy veins have valves that open and close to assist the return of blood to the heart. Vein disease occurs when these valves become damaged, allowing the backward flow of blood in the legs where it can pool, leading to a feeling of heaviness and fatigue and causing varicose veins or other skin changes.

Ultrasound is a tool used to diagnose if and where a vein valve (or multiple valves) in the legs is damaged. High-frequency sound waves are used to create images that allow the doctor to see which veins have flow going in which direction—like a road map for the venous system.

A healthy vein will only allow flow from the feet towards the heart. Faulty veins are often connected, so finding the “source” of the problem is a complicated, but critical, step in establishing where exactly treatment should start.

Ultrasound is the gold standard for evaluation of chronic venous disease, and it is important to have a qualified sonographer perform the mapping in order to have accurate diagnostic results. To learn more about what to expect at a vein evaluation, visit our previous post on the topic.

Are vein treatments permanent?

Have you ever wondered if vein treatments are permanent?

According to Dr. Cindy Asbjornsen, founder of the Vein Healthcare Center, the short answer is yes. However, that does not mean that a person who has one vein issue will never have another problematic vein.

What that means is once a vein is treated with a modern procedure, such as endovenous ablation, or “EVLA,” the success rates quoted in the supporting literature vary from the high 80th percentile to the high 90th percentile. In other words, less than 20 percent of patients will need to have the vein that was treated ever treated again.

Dr. Asbjornsen explains: “When I see most of my patients for a six or 12 month follow up, the problematic vein that underwent treatment is completely reabsorbed by the body. Because that vein no longer exists, it cannot cause problems in the future.”

Though the treated vein is taken care of, all the veins in the body have the same genetic makeup and have been exposed to the same environmental stresses (generally speaking) and thus, have the same risk of failing. Thus, if a patient has one bad vein, it is possible that at some point they will have other bad veins.

For this reason, Dr. Asbjornsen tries to spend time with patients at every visit counseling him or her on healthy tips for healthy veins. Small lifestyle changes can make a big difference in managing chronic venous issues and preventing additional problems.

Knowledge is Power

If you’ve thought about “doing something” about your varicose veins or heavy, achy legs but aren’t sure what exactly to do, here’s a suggestion: learn more vein disease and the available options for treatment. By reading this blog you’re on your way, and in this post we’re going to get more specific. After all, knowledge is power!

When researching on the Web, go to trusted sites that specialize in phlebology (the study of vein disease and vein healthcare), such as the American College of Phlebology (www.phlebology.org) and the American Venous Forum (www.veinforum.org). The Vein Healthcare Center website also provides reliable information for both patients and physicians (www.veinhealthcare.com).

If you prefer reading books to screens, then check out our previous post about vein health books.

Gathering information is important, but don’t worry yourself needlessly because of too many visits to WebMD! If you really want to understand the root of your vein problems—and possible treatments—then a visit to a Board-certified vein specialist is best.

A Patient Testimonial

We're ending the year on a positive note, with this testimonial of a patient whose health--and quality of life--has improved since seeking treatment for her vein problems.

“My legs were a mess. I had varicose veins on the front of my left leg that started in the back, upper part of my thigh and wound around toward my shin. My lower legs often felt heavy and sore. Dr. Asbjornsen evaluated my legs and recommended a treatment plan. Now my legs look great, and I don’t have any more achiness, throbbing, or tightness.  

I chose Dr. Asbjornsen because she listened to what I wanted and gave me other options like compression stockings and tips to alleviate my discomfort. I felt like she was looking out for me, not just pushing to have a procedure done. I thought everyone at Vein Healthcare Center was exceptional. Every time I called the office with a question, they knew who I was and made me feel like I was important.”– Christina J., 40, Lisbon Falls, ME

Read more patient testimonials. See if you may have symptoms of venous disease. Consider making an appointment with Dr. Cindy Asbjornsen, a board certified vein specialist.

And, of course, have a healthy, happy and peaceful holiday season!

Veins and Feet

When people think about varicose veins, they usually think about the veins in the leg— but that’s only part of the picture. Lots of patients experience aching, heaviness, or even bulging veins in their feet. Below is just one example of a patient who found great relief after visiting Dr. Cindy Asbjornsen at the Vein Healthcare Center.

 Here’s an explanation of the process in Dr. Asbjornsen’s own words:

This 45 year-old patient came to see me complaining of aching, cramping, pain, heaviness and numbness in her legs on both sides. All of her symptoms worsened with prolonged standing, and she felt self-conscious about wearing clothes that showed her legs. She would often have difficulty falling asleep because her legs bothered her so much.

The onset of her vein issues was about 23 years ago when she was pregnant with her son. After an initial exam, including ultrasound mapping, I diagnosed her with insufficiency of the great saphenous veins bilaterally (on both sides).

I treated her with several bilateral endovenous laser ablations (EVLA) to her great saphenous veins, as well as multiple sessions of sclerotherapy to clean up the surrounding veins.

           

As you can see by the picture, the outcome for this patient was a full resolution for all her symptoms, including the bulging veins. And she enjoyed wearing shorts and skirts this summer.

To learn more about the close connection between veins and feet, read the cover story about it in Vein Health News. Just click here to read the story.

What is Lymphedema?

In a previous post we discussed the problem of edema, as well as some tips for relief. Here we'll introduce the condition of lymphedema, a related--but different--condition.

To review briefly, edema is swelling that happens because of the accumulation of excess tissue fluid that had not yet returned to the circulatory system. The excess fluid eventually leaves the area as it heals and the swelling goes down.

Lymphedema, on the other hand, occurs when the lymphatic system is damaged or blocked and protein-rich fluid builds up in soft body tissues causing swelling. Primary lymphedema is caused by the abnormal development of the lymph system, before birth.

Secondary lymphedema, a more common condition, is caused by damage to the lymph system any time after birth, or by the removal of lymph nodes because of injury, trauma, infection of the lymphatics, or cancer biopsy. In fact, lymphedema is a common problem that may be caused by cancer and cancer treatment, although the patient may not notice any swelling until months or years after treatment.           

Lymphedema usually affects the arm or leg, but it can also affect other parts of the body. Swelling ranges from mild, hardly noticeable changes in the size of the arm or leg to extreme swelling that can make it impossible to use the affected limb.

Unfortunately, there is no cure for this chronic condition, only treatment and management. 

To learn more about lymphedema--and its close cousin phlebolymphedema--read the cover story in Vein Health News. Just click here to read "Mutually Interdependent: the Venous and Lymphatic Systems."