Venous Disorders

Veins are blood vessels that return blood from the tissues to the heart, and in the case of veins in the legs, this return occurs against gravity. Veins have valves that facilitate circulation of blood towards the heart but when these valves become insufficient, they allow blood to pool down and lead to dilatation of the veins. When veins become dilated and tortuous they are called varicose veins.

Varicose veins may not produce any symptoms at first, but as the disease progresses they can lead to significant discomfort, pain and heaviness. If left untreated, venous insufficiency can lead to irreversible skin discoloration and ulceration.  

Evaluation for venous disease and varicose veins is simple and can be completed in the office. We begin with a thorough physical evaluation and discussion of your symptoms and how they affect your health and your lifestyle. You may also benefit from an ultrasound test that will determine if the valves in your veins are insufficient. This ultrasound test is also performed in the comfort of our office by our experienced certified technologists.

There are conservative measures that are helpful in the early stages and may prevent progression to irreversible disease. Measures include:

• Exercise
• Leg elevation
• Use of compression stockings
• Weight loss
• Avoiding prolonged periods of sitting or standing

Fortunately, should you require treatment for your varicose veins, there are multiple alternatives that are simple and routinely performed in our office. We will have a discussion of all treatment options as well as insurance coverage. All of these procedures are very well tolerated and do not require anesthesia or prolonged recovery. In most cases, patients can return to their normal routine following any of these minimally invasive procedures that include:

• Endovenous laser ablation (EVLT)
• Sclerotherapy
• Microphlebectomy
• Newer non-thermal technologies

Spider Veins and Sclerotherapy

Spider veins (telangiectasias) are very fine superficial blood vessels that can become visible under the skin as red or blue lines in a branching pattern. They are the result of elevated pressure in these small veins as occurs with venous insufficiency but can also be primary or related to trauma or autoimmune disorders. They are usually painless but in rare occasions can cause discomfort, pain or a burning sensation. 

Treatment for spider veins is considered cosmetic and usually not covered by insurance. The injection of spider veins with a solution or foam that leads to scarring of these small abnormal veins is called sclerotherapy. This procedure is performed in the comfort of our office and patients return to their normal routines following sclerotherapy.     

Deep Venous Disease

Deep veins are vital blood vessels that return blood from extremities and organs to the heart and lungs to be oxygenated. There are a multitude of conditions that can affect these important structures and lead to significant discomfort and complications such as chronic edema, pain and even ulceration and wounds. Early symptoms can be minor but early diagnosis and treatment is of paramount importance to prevent progression to irreversible damage and significant disability.

Dr. Vargas has developed a special interest in venous disease which has been traditionally ignored and poorly understood as the focus has been placed on arterial disease. As the medical community has become aware of the importance of venous disease and recent research has shed light on these conditions, new technologies have become available and are offered by Dr. Vargas in her Windermere office.

• Deep Vein Thrombosis:

A condition where a blood clot forms in a vein and limits venous return leading to swelling, pain and discoloration. Blood clots can break off and travel to the lungs. The diagnosis is readily made by physical examination and ultrasound evaluation of the affected extremity and if confirmed, usually requires blood-thinning medication (anticoagulation) unless contraindications exist. In severe and extreme cases, an invasive procedure to remove the clot can be performed in the hospital setting but few patients require this.

Patients can present to our office and be evaluated and diagnosed in a calm and friendly environment while avoiding long wait times in busy emergency rooms as well as costly hospital bills. Primary care offices as well as specialty clinics such as orthopaedic surgery, gynecology and oncology among others will benefit from expedited evaluation of their patients. As well as peace of mind that communication of results and recommendations will be delivered without delays.

• Inferior vena cava filter placement and removal

In situations where anticoagulation is contraindicated due to intolerance or abnormal bleeding, and in situations where anticoagulation has to be stopped temporarily in preparation for surgery or a procedure, placement of an inferior vena cava filter may be indicated. Our office is equipped with a brand new procedure room where filters can be placed, and then removed when no longer needed. Patients and referring physicians will enjoy the world-class care of our board-certified physicians in a friendly environment that offers ease of scheduling and avoids the complexity of the hospital environment.

• Iliac vein and inferior vena cava obstructive disease

Patients who have suffered from deep vein thrombosis in the past are at risk of abnormal venous return if the clot does not completely recanalize. Other patients may have obstruction of the veins due to compression from other surrounding organs or structures such as neighboring arteries or scar tissue. This chronic deep venous obstructive pathology can go undiagnosed for years as these conditions are not in the main list of diagnoses for many physicians.

A thorough history and examination followed by ultrasound testing will facilitate the diagnosis. At our office and outpatient procedure room we have the capability of evaluating the inside of these veins with the use of intravascular ultrasound as well as stenting if indicated (placing a metal scaffold within the vein so it remains open). This procedure is done as outpatient in the comfort of our office and patients can return to their routine after a short recovery and bedrest.