Venous Disease

Venous disease is part of the heart and vascular care medical specialty. UF Health’s team of vascular surgeons are board-certified and fellowship-trained in the diagnosis and treatment of vascular diseases. Our experts provide every patient with a comprehensive approach to care and use advanced technologies and innovative therapies to precisely diagnose and treat the most complex cases. UF Health’s vascular lab is accredited by the Intersocietal Accreditation Commission for its quality outcomes in vascular care, and our specialists are uniquely positioned to provide patients with the most advanced and effective treatments for venous disease.

Venous disease refers to medical conditions that affect the body’s veins – the vast system of blood vessels that defy gravity to transport deoxygenated blood back to the heart. There are several types of venous disease, including:

• Varicose veins
• Venous reflux or venous insufficiency
• Deep vein thrombosis (DVT)
• Post-thrombotic syndrome
• Pelvic congestion syndrome

Venous reflux occurs when the valves in the veins that help to keep blood flowing towards the heart become weakened or damaged, allowing blood to pool in the veins – usually in the legs. Symptoms include swelling, achiness, heaviness, tiredness, and sometimes a burning or itching in the affected area. Left untreated, reflux can progress to skin changes or even ulcers. Treatment for venous reflux includes leg elevation during rest, compression stockings, and lifestyle changes such as losing weight and increased physical activity. Surgical treatment can be an option, such as ablation of the vein with radiofrequency ablation or cyanoacrylate glue.

Varicose veins are visible, bulging veins beneath the skin of the legs. Varicose veins are closely related to reflux, but it is possible to have varicose veins without venous reflux. Varicose veins can cause symptoms of burning, tingling, aching or itching in the legs. Varicose veins can be caused by genetics, obesity, pregnancy and prolonged periods of standing or sitting. Treatments for varicose veins include leg elevation during rest, compression stockings, lifestyle changes such as losing weight and increased physical activity and surgical procedures such as sclerotherapy or ambulatory microphlebectomy.

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in one of the deep veins in the body, most commonly in the legs. DVT can be caused by immobility, surgery, injury, and certain medical conditions. Treatment options for DVT typically involve blood-thinning medications to prevent the clot from getting bigger and to reduce the risk of complications such as pulmonary embolism. In some cases, surgical intervention may be necessary to remove the clot.

Post-thrombotic syndrome describes the development of varicose veins and venous reflux in people with a history of deep vein thrombosis. While the symptoms are similar, they are usually more severe with more advanced swelling and skin changes. The treatment must address both refluxing veins and venous obstruction caused by scarring in the deep venous system.

Pelvic congestion syndrome is caused by venous reflux specifically in the gonadal veins of the pelvis – this causes symptoms of pain, pressure, and heaviness in the pelvis.

Treatment Options

The specific treatment plan for venous disease will depend on each patient’s unique condition and severity of the symptoms. Our board-certified vascular experts can help determine the best course of treatment, and these may include:

Compression stockings are elastic stockings that help improve blood flow and reduce swelling in the legs. They are often the first-line treatment for CVI and may also be used after a surgical procedure. Proper compression is more than just tight socks – your physician will recommend graded compression stockings, which are tighter at the bottom than at the top.

Sclerotherapy is a minimally invasive procedure that involves injecting a solution into the affected veins, which causes them to close off and eventually be absorbed by the body. It is often used to treat varicose veins known as “spider veins” or telangiectasias. While these small veins never cause symptoms, some people find them unsightly and choose treatment.

Ambulatory microphlebectomy uses multiple very small incisions to remove painful and bulging varicose veins. Excellent symptomatic relief and small incisions make this a good option for patients with more or larger varicosities than can be treated by sclerotherapy.

Cyanoacrylate venous ablation is a minimally invasive procedure than uses cyanoacrylate glue to close a refluxing vein – allowing the blood to find other, healthier routes through the circulation. Often done under minimal sedation with local numbing medication, cyanoacrylate ablation is very effective at resolving symptoms of venous insufficiency.

Radiofrequency ablation is a minimally invasive procedure that uses heat generated by a radiofrequency emitting catheter to cauterize and close a refluxing vein – allowing the blood to find other, healthier routes through the circulation and back to the heart.

Endovenous reconstruction is a minimally invasive medical procedure to treat damaged or narrowed veins in cases of deep vein thrombosis (DVT) or in post-thrombotic syndrome. Complex endovenous reconstructions are often used when prior interventions have failed or stopped working. During endovenous reconstruction, a catheter is inserted into the damaged vein through a small incision and delivers a balloon or stent to the diseased area. The balloon or stent is then expanded to open the narrowed or damaged area of the vein to restore normal blood flow and relieve symptoms.

Anticoagulant medications, commonly called blood thinners, may be prescribed to resolve and prevent the formation of new blood clots in people with DVT. Medications that improve blood flow and reduce inflammation may also be prescribed for CVI.

Vena cava filter placement is a minimally invasive procedure that involves placing a small filter in the vena cava – the large vein that carries blood from the lower body to the heart – to prevent blood clots from traveling to the lungs. It is often used in people who cannot take anticoagulant medications.

Risk Factor FAQ

Some people may be at higher risk of developing venous disease than others. These risk factors include the following:

• As people age, the risk of developing venous disease increases.
• Women are more likely than men to develop venous disease, especially during pregnancy and menopause.
• Having a family history of venous disease increases the risk of developing the condition.
• Being overweight or obese puts extra pressure on the veins, which can increase the risk of developing venous disease.
• Jobs or activities that require long periods of sitting or standing can increase the risk of venous disease.
• The extra weight and pressure on the veins during pregnancy can increase the risk of developing venous disease.
• Smoking can damage the veins and increase the risk of developing venous disease.
• Having experienced previous injury or surgery to the legs can increase the risk of developing venous disease.

Having one or more of these risk factors does not necessarily mean that a person will develop venous disease. However, being aware of the risk can people to take steps to reduce the risk of developing the condition.