Fashionable...compression?

Graduated compression stockings are ugly, beige, and only for “old people,” right?

Wrong. In the past several years, compression companies, such as Juzo, SIGVARIS, Carolon and Jobst, have been developing stockings and socks in styles, patterns, finishes, and colors that look more like fashion accessories than medical devices (while still being clinically effective when purchased and put on correctly.)

Newer brands like REJUVA and ITEM m6 (a spin-off of compression manufactuer medi) are also taking compression trends to the streets. Both companies were mentioned in an article about compression in the NYTimes Style section!

Read more about how compression has evolved in Healthy Style: Compression Steps Up, the latest cover story in Vein Health News. Just click here to read the story.

Seeing is believing

Understandably, sometimes the easiest way for people to decide to get their vein problems treated is for them to see with their own eyes what is possible. We invite you to take a look at the results experienced by several patients of the VeinHealthcare Center in our new e-booklet Perspectives.

In addition to sharing the true stories of people with vein disease, you’ll see the treatment results of eight different patients—with before and after pictures, of course. Click here to see for yourself.

All in the family

Like the color of your eyes, varicose veins are a trait that runs in the family. Since venous disease does have a strong genetic component, it’s important for people to be aware of venous disease and its symptoms and, as with any illness, to know the family history.

If someone in your family has experienced vein disorders or has visible veins on their legs, your risk of the disease is much higher. For example, someone with first-degree family members with vein issues will find the risk is significantly increased.

But just because you watched your mother and your mother’s mother (and so on) suffer from painful and unsightly veins, that doesn’t mean you’re destined to the same fate. Even if you are not currently experiencing symptoms, an evaluation with an experienced phlebologist (vein specialist) can tell you the condition of your venous system, as well as possible interventions and prevention. Modern vein treatments, such as endovenous laser ablation and sclerotherapy, are minimally invasive and extremely effective.

True Stories

Have you thought about getting treatment for your varicose veins, leg ulcers, or other, less visible symptoms of vein disease? If you’re considering whether or not to seek treatment for your vein issues, it might help to hear about other people who have suffered from vein disease and found relief.

We’ve put together an e-booklet called Perspectives, in which we share the experiences of real patients of Dr. Cindy Asbjornsen. You’ll read about patients whose legs look and feel better as a result of having their vein problems diagnosed and treated. But it isn’t just their legs that have improved—so, too, have the quality of their lives. 

Click here to read their stories.

Preventing leg ulcers

It's not easy to live with leg ulcers. Open wounds can be painful, difficult to heal, and the likelihood of recurrence is significant. But prevention is possible.

One warning sign that you may be developing a venous ulcer is noticeable skin changes in the lower legs, such as dryness or thickening. Another sign of ulceration may be discoloration of the legs, typically dark red, purplish, or a brown, woody appearance. Other possible indications are aches or pains in the legs, especially when standing or sitting for prolonged periods.

Varicose veins are another possible warning sign. Varicose veins, as with any form of venous disease, are often hereditary. If you have varicose veins—or a family history of varicose veins— consider getting evaluated and treated for them before they lead to ulceration.

Risk factors for venous ulcers include older age, a history of deep vein thrombosis (DVT), venous insufficiency, and previous ulcers or leg injury. Though you can’t change your genetics, you can modify other things. If you have a job where you’re on your feet all day, wear graduated compression stockings.

There is often a misconception among patients and physicians alike that there is nothing you can do for venous ulcers. The fact is wound care specialists use a variety of modalities to heal patients’ wounds, including aggressive compression therapy, skin grafting and “low-tech” therapies like elevation.

It is important to remember that although wound care specialists can treat and even heal wounds, unless the underlying cause is addressed, it will only reoccur. If the wound is identified as a venous ulcer, then treating the incompetent vein valves that contribute to venous ulcers is key for lasting results.

Experts agree that the earlier the intervention and treatment, the better chance a wound has to heal and stay closed. And, of course, patients with venous ulcers are best managed by a multi-disciplinary team of primary care physicians, wound care centers, and professionals who specialize in venous care.

Leg ulcers, an advanced stage of vein disease

Leg ulcers can occur at any stage of life and, without treatment, can cause overwhelming problems. 

When blood pools in the lower leg over a long period of time, the condition is referred to as venous stasis. When blood leaks into the tissue of the skin it can cause swelling and damage to the tissue. Tissue damage can result in wounds, or ulcers, that are chronic and do not heal if the condition is left untreated. Ulcers may be painful or itchy and often require constant care and dressing.

There are three large classes of ulcers: diabetic, arterial, and venous. Of the three types, venous, or vein-related, is the most common. In fact, venous disease is thought to account for approximately 80% of chronic leg ulcers. Venous ulcers can be caused by venous insufficiency or by a wound that has been exacerbated by venous insufficiency. 

Leg ulcers are often an indication that vein disease has reached an advanced stage. However, the key to properly treating and managing them is to first get them diagnosed. Though ulcers may appear similar, each one has a different cause and thus, very different treatments.

Clinical appearance is the first clue to distinguishing between venous and arterial ulcers. Typically, venous ulcers can appear anywhere between the knee and the ankle, while arterial ulcers are usually found between, or on the tips of, toes.

Another sign is discoloration. Venous-related wounds tend to be ruddy, and the surrounding tissue may be red or hyper-pigmented due to hemosiderin (a pigment formed by the breakdown of hemoglobin). In contrast, the wound bed of an arterial ulcer tends to be black, grayish, or yellow.

The most effective way to diagnose a venous ulcer is with a duplex Doppler ultrasound, which reveals whether or not the blood is flowing in the proper direction, or if there is any pooling occurring.

Ulcers do not heal on their own, but even those who are already experiencing this late-stage symptom can have excellent success with treatment. If you have skin breakdown or infection due to ulceration, you should visit your doctor immediately.

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.