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| SUNDAY, MARCH 15, 2020
|
Don’t let
varicose veins
cramp your
style
By Anne-Gerard Flynn
don’t know how frequent the condition is - depending on Dr. K. Francis Lee, founder how you define venous insuffiand medical director of the ciency it is said between 20 to Advanced Vein Care Center, 50 percent of the population is a board-certified general has it - and how insidious it and laparoscopic surgeon who is and how much it affects specializes in the treatment of people’s lives,” Lee said. vein disease. “My patients have told His Springfield-based me they don’t wear skirts, practice, with the motto, “Feel shorts or sandals and wear Better, Look Better,” is where long pants when they go to he treats patients for such the beach in order to hide the conditions as venous insufficondition that is visible in 10 ciency that is most commonly to 30 percent of cases because seen in women through the they are embarrassed by it presence of varicose veins. and have been for decades.” These veins may be visiSurgery under general anble as raised and discolored esthesia was once needed to lines on legs and ankles, can address chronic venous insufbe painful and often prompt ficiency. The underlying vein women to wear clothing that hides the veins’ appearance from view. “Varicose veins are the very large, bumpy veins that pop out on some people’s skin as well as smaller ones called reticular veins,” said Lee, a graduate of Harvard Medical School and former chief of trauma services at Baystate Medical Center. “They are very common, and caused by an underlying condition called venous insufficiency and this, simply put, means insufficient vein circulation.” was removed, or stripped out, Developing varicose veins through incision. Today, these in most people is said to be an veins can be closed off and inherited condition and they taken out of circulation, using can appear in young as well as minimally-invasive options older women. Lee said they that employ heat delivered by often go unaddressed because laser or catheter into the vein patients have come to live to internally shut it down after with both their appearance it is initially numbed under and any related pain. local anesthesia. Newer meth“Most women, as well as ods use an adhesive or foam some health care providers, that can be administered to Special to The Republican
close off the vein without local anesthesia. The varicose veins on the surface are deactivated in separate procedures during which they are removed or closed off through injection. “You walk in and you walk out, everything is outpatient,” said Lee of options done in his office to treat varicose veins and venous insufficiency. “The condition is very treatable nowadays, and requires very little interruption to someone’s work. Twenty years ago, varicose veins were treated by vein stripping which was done in the hospital, in the operating room under general anesthesia.
overcome it can cause veins to stretch and bulge and blood to pool. “The role of the veins is to get the blood back to the heart after it has circulated oxygen and nutrients,” Lee said. “But sometimes that doesn’t happen in some of the veins in the leg where, because of gravity, the blood, instead of going back to the heart from the legs, starts going back toward the feet.” The body’s veins include what are called superficial ones in the fatty layer of skin tissue through which blood flows toward deep veins in muscles. These muscles help, through such actions as walk-
causes the varicose veins to pop out toward the skin from the underlying veins that are abnormal. You see the varicose veins, but the condition underneath is what we called venous insufficiency.” Lee lists on his website conservative treatment options such as walking, wearing compression stockings and weight loss, but said to “fully treat venous insufficiency you basically have to close that vein that is abnormal” and “most of the time you have to get rid of those varicose veins on the surface whether by removing them through tiny punctures or injecting them to make them close, with either
This is often use for spider veins, which are frequently regarded as a cosmetic issue and not covered by insurance but, Lee said, “can be related to venous insufficiency.” Options used to treat underlying abnormal veins include radiofrequency occlusion which involves the insertion of a catheter to deliver radiofrequency energy that causes the vein wall to heat and seal shut. Heat transmitted by lasers inside a catheter is also used to close off the abnormal vein. Lee added that the abnormal veins are expendable and their deactivation makes the work easier for the normal veins that have been trying to maintain proper blood flow. “The blood in these abnormal veins has been going in the opposite direction of the traffic,” Lee said. “Once we shut down these veins, all the other veins that have had to reroute the venous blood from the abnormal veins will be able to reroute it much easier for proper circulation.” Venous insufficiency can be one cause of night leg cramps, and Lee said one of the “most consistent improvements People were hospitalized for ing, to compress blood flow option appropriate depending symptom-wise from our treatment is improvement several days and laid up for a more efficiently toward the on the size of the varicose in cramps either to zero or couple of weeks to a month. heart. Short veins connect the veins.” every-night cramps to once a It was very painful and most superficial and deep veins. “You have to close the physicians then said it was not “Venous insufficiency insufficient vein underneath, week or two-or-three timesworth treating.” occurs in either the superficial and then remove or inject the a-week cramps to once a month.” Veins carry blood back to or the deep veins, though you veins on the skin,” Lee said. Valve failure that leads to the heart, and leg veins are can’t see it happening,” Lee Options used to treat variamong those that have onesaid. cose veins include sclerother- the chronic backward flow way valves to prevent back“But this insufficient circuapy, where a solution is inject- of venous blood in the legs is also associated with other ward flow, but sometimes lation causes high pressure ed into the vein to cause it to gravity and the pressure to inside those veins and that disappear over several weeks. SEE VARICOSE, PAGE D3
“The condition is very treatable nowadays, and requires very little interruption to someone’s work. Twenty years ago, varicose veins were treated by vein stripping which was done in the hospital, in the operating room under general anesthesia. People were hospitalized for several days and laid up for a couple of weeks to a month. It was very painful and most physicians then said it was not worth treating.”