Venous disorders are exceedingly common, with more than 50 percent of the population showing some manifestions of these disorders, such as varicose or spider veins, by age 65. Venous disorders are often simply unsightly, but in many cases can cause leg pain, swelling, phlebitis, nonhealing ulcers of the skin and other serious problems. In the case of deep vein thrombosis, clots that break away can lead to death from pulmonary embolism.
Despite the very widespread and sometimes serious nature of venous disorders, patients are not aggressively diagnosed or treated and often do not get to treatment centers that have expertise in treating venous disorders. A key challenge is that venous reflux, the most common cause of venous problems, often goes unrecognized by health professionals, thus delaying the necessary treatment.
Venous reflux (also known as chronic venous insufficiency (CVI) occurs when venous valves don't function adequately, leading to reversal of blood flow through the valves during standing or sitting. Venous reflux most commonly occurs when vein valves weaken due to genetic influences or multiple pregnancies, among other factors.
Venous reflux is often self-perpetuating, as the pooling of blood in veins distends them, which pulls apart the valve leaflets of the next, lower valve and causes reflux farther down the leg. As blood pools in lower extremities, veins further swell, leading to pain, pigmentation of the skin and clots in the varicose veins (phlebitis). The high venous pressure in some cases can lead to nonhealing of simple breaks in the skin, which is seen as a chronic skin ulcer, usually around the ankle.
In simple cases, treatment for venous reflux can range from making lifestyle changes to use of compression stockings. In more complex cases, surgery may be required to correct the venous reflux and halt the progression of disease in the leg. Traditionally, one of the most common surgical procedures has been vein stripping, in which a vein-stripping tool is pulled through the great saphenous vein, removing the vein from the leg. More recently, vein stripping has largely been replaced by other vein ablation techniques.
Minimally Invasive Treatments
UCSF vascular surgeons offer the most advanced treatments for venous disorders, including minimally invasive approaches, such as radiofrequency (RF) vein ablation, a technique in which a catheter uses microwave radiation to seal veins that have reflux.
Radiofrequency vein ablation allows doctors to eliminate venous reflux with a needle puncture that is covered with a Band-Aid. Procedures traditionally used for the condition, such as vein stripping, require painful incisions and a long recovery time. Patients undergoing radiofrequency ablation are back to work in two days, rather than three to four weeks.
The Venous Center accommodates patients who can't make frequent trips to UCSF. Half of our patients are elderly with limited mobility, while the other half work full-time. We offer a one-stop appointment, in which patients have a thorough clinical evaluation, ultrasound to confirm findings, discussion with their doctor about their diagnosis and treatment plan.
For More Information
For more information or to request an appointment, call:
Fax: (415) 353-2669
The Venous Center is located at:
400 Parnassus Ave.
San Francisco, CA 94965