Varicose Vein Presention by Dr. Cardone

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Varicose Vein Disease Bruce W. Cardone , M.D. Medical Director

Varicose veins are enlarged, ropy, bulging veins that rise above the surface of the skin. They can be blue or purple in color and are frequently found on the back of the calf or the inside of the leg.: 

Varicose veins are enlarged , ropy , bulging veins that rise above the surface of the skin. They can be blue or purple in color and are frequently found on the back of the calf or the inside of the leg . What are varicose veins?

These abnormal veins affect 50% of women ages 40 to 50 years of age as well as 25% of men ages 30 to 40 years of age. With age, varicose veins become even more common. By 70 years of age, 75% of women and 50% of men show some sign of varicose vein disease.: 

These abnormal veins affect 50% of women ages 40 to 50 years of age as well as 25% of men ages 30 to 40 years of age. With age, varicose veins become even more common. By 70 years of age, 75% of women and 50% of men show some sign of varicose vein disease. Who is affected by varicose veins?

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Varicose Vein – Dilated, protruding , tortuous, saccular superficial veins in subcutaneous tissue Reticular Vein – Dilated, tortuous, non-protruding superficial veins in subcutaneous tissue Telangiectasia – Spider appearing, tortuous, non-protruding or dilated veins in dermis Different types of varicose veins

Primary Incompetence arises in the venous system from non-obstructive causes (hereditary, hormonal, etc) Secondary Incompetence arises in the deep venous system (usually due to prior thrombosis) - deep veins obstructed perforators dilate and become incompetent: 

Primary Incompetence arises in the venous system from non-obstructive causes (hereditary, hormonal, etc) Secondary Incompetence arises in the deep venous system (usually due to prior thrombosis) - deep veins obstructed perforators dilate and become incompetent Primary vs. Secondary

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Hereditary Valves may become stretched or weakened by: Obesity Pregnancy Age Trauma Standing for long periods of time Factors Causing V aricose Veins?

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Pathology " Valvular Incompetence "

Varicose Veins: 

Varicose Veins .

Venous Reflux: 

Venous Reflux

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Easily tired legs Pain Achiness in legs Leg heaviness Restless legs Numbness in legs Muscle cramping Itching and burning Throbbing Varicose Vein Symptoms

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Enlarged, unsightly bulging veins Networks of spider veins and blue reticular veins Skin discoloration/ hyperpigmentation Swelling Scaling of the skin Redness Signs of Varicose Veins

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Varicose vs. Spider Distribution-Greater, Lesser or Branches Size Stasis Changes Edema Varicose Vein Exam Using Doppler Ultrasound

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Blood clots/deep vein thrombosis Chronic and uncontrollable swelling (edema) Skin thickening and discoloration Leg ulcers Superficial V enous T hrombophlebitis V enous stasis/ulceration B leedin g S pider A ngiomas Possible Complications of Varicose Veins If Left Untreated

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Spider Angioma

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Swelling Skin thickening Skin discoloration

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Hyperpigmentation Skin thickening

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Skin ulceration

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Severe H yperpigmentation Swelling Skin Ulceration

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Compression Hose (20-30 mmHg, 30-40 mmHg) Endovascular Laser Vein Treatment Microphlebectomy Sclerotherapy Treatment of varicose veins

Endovascular Laser Vein Treatment: 

Endovascular Laser Vein Treatment

Laser Treatment of Varicosities vs. Surgery: 

Laser Treatment of V aricosities vs. S urgery In the past, treatment of varicose vein disease was primarily limited to vein ligation and stripping. This is an invasive , debilitating, painful procedure that often causes patients to lose up to 6 weeks or more of work or downtime from other activities. Note - this is still being performed today.

Laser treatment of varicosities vs. surgery: 

Laser treatment of varicosities vs. surgery Laser vein treatment of varicosities is a non-surgical alternative to traditional surgery. The procedure offers the following benefits: Minimally invasive N o significant recovery time L ow risk of infection M inimal discomfort Most patients are able to return to work and normal activities in a day or two at most.

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Guidewire

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Insertion Site

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Microphlebectomy In conjunction with your laser vein treatment procedure, there are often bulging, enlarged varicosities which need immediate treatment. A technique known as microphlebectomy is utilized. The skin is numbed with a local anesthetic. Several small 1-2 millimeter incisions are made in the skin over the bulging veins which are marked prior to beginning the procedure. Using a special instrument the varicosities are pulled to the skin surface and removed. This procedure is safe and generally painless.

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We look forward to meeting you and helping your legs look and feel better.