Information About Venous Disease

Understanding Superficial Venous Reflux

Chronic venous disease/venous reflux affects approximately 20% of the adult population and 50% of women over age 50. It is among the most common chronic conditions in North America with an estimated 20-25 million Americans suffering with varicose veins. The management of this disorder has undergone enormous advances in recent years.

Vein Valves Spider Veins

Your legs are made up of a network of veins. Healthy leg veins contain valves that open and close to assist the return of blood back to the heart. Venous reflux disease develops when the valves that keep blood flowing out of the legs and back to the heart become damaged or diseased. This can cause blood to pool in your legs and lead to symptoms such as pain, swelling, swollen limbs, leg heaviness and fatigue, skin changes and skin ulcers, and varicose veins.

Venous Reflux Disease Symptoms

Varicose Vein Symptoms

Spider Veins

Spider veins, medically known as telangiectases are dilated capillary veins less than 2mm. in diameter. They are small blue to red appearing blood vessels that lie close to the surface of the skin and occur either in lines or web-like patterns. They are usually visible on the legs but sometimes are visible around the nose and lips and are commonly referred to as "broken veins." While they can ache, burn or itch now and then, but they are usually not symptomatic. Spider veins are not harmful and are simply unsightly.

Varicose Veins

Varicose veins are ropy appearing blue vessels under the skin, usually ½ inch or larger in diameter. They are most often branches from the saphenous trunk veins, and have enlarged due to the excess pressure in the saphenous system. Varicose veins are unsightly and often painful. A clotted varicose vein causes the classic phlebitis, hot and red and painful skin at the site of the clot. Beside the visible symptoms, physical symptoms are tiredness, restless legs at night, heaviness in the leg, pain, aching, itching, throbbing & swelling, burning or a cramping sensation.

Click below to view a 30 second video-clip about venous reflux

Diagnosis and Personalized Treatment Plan

After a complete review of the patient’s history and symptoms, and if indicated, Dr. Coates will perform a diagnostic duplex ultrasound examination to visualize the venous anatomy and identify specific areas of venous reflux. Dr. Coates uses the award winning high performance Terason t3000 Ultrasound—a product trusted by thousands of clinicians worldwide for superior image quality.

He teaches the patient about the venous system and ultrasound techniques as he works. Dr. Coates believes that helping the patient understand about his/her condition is an important part of medical care. After the ultrasound and arriving at a diagnosis, the doctor discusses with the patient the specific treatment plan designed to best treat the patient’s venous disorder.

Dr. Coates may choose to incorporate one or more of the following into the treatment plan.

Vein Treatments/Procedures

After a comprehensive evaluation that includes an ultrasound examination of the veins, Dr. Coates will determine the optimal treatment for each patient's needs.

The Closure Procedure

Closure Procedure

The VNUS Closure Procedure, an alternative treatment option to traditional vein stripping surgery, brings state-of-the-art technology to an age-old disease.

Developed in 1999, it has helped over 300,000 people worldwide. The Closure procedure is performed on an outpatient basis and is usually completed within 45-60 minutes. Using ultrasound, Dr. Coates will position the Closure catheter into the diseased vein, through a small opening in the skin. The tiny catheter delivers radiofrequency (RF) energy to the vein wall. As the RF energy is delivered and the catheter is withdrawn, the vein wall is heated, causing the collagen in the wall to shrink and the vein to close. Once the diseased vein is closed, blood is re-routed to other healthy veins.

Following the procedure, you will be encouraged to walk once or twice that evening and take several 10 minute walks the following day. However, you will need to refrain from extended standing and strenuous activities for a period of time. Also, you will need to wear the compression stockings during the day for two weeks.

Patients who undergo the Closure procedure typically resume normal activities within the next day.

Highlights of the Closure procedure

  • Outpatient/Doctors office procedure
  • Local anesthesia
  • Resume normal activities within a day
  • Relief of symptoms
  • Good cosmetic outcome with minimal to no scarring, bruising or swelling
  • 98% would recommend the procedure to friends or family
VNUS Closure procedure video clip:

Ambulatory Microphlebectomy

Originally developed in Europe and now commonly performed in the United States, ambulatory microphlebectomy is the surgical removal of surface varicose veins. This procedure is minimally invasive, uses local anesthesia, and is done in the doctor’s office. Using specially designed instruments, the abnormal vein is removed through tiny punctures in the skin. These mini punctures do not require stitches to close and the discomfort is minimal. After the vein is removed by phlebectomy a bandage and/or compression stocking is worn for a short period of time. The patient is able to walk out and return to normal activities with 24 hours.

Sclerotherapy (Ultrasound guided and/or VeinLite assisted)

Sclerotherapy is a nonsurgical medical procedure used to treat varicose veins and spider veins. Sometimes referred to as injection therapy, a tiny needle is used to inject a solution (a sclerosing agent) directly into the vein. In order to achieve the best result Dr. Coates may choose to use either an ultrasound device or a Vein Lite in order to isolate the vessel targeted for the injection. At VTC we do not use saline as it is too painful and may cause damage to the skin. The sclerosing solution irritates the lining of the vessel, causing it to swell and stick together, and the blood to clot. Over time the body will absorb the treated vein. The number of veins injected in one session is variable, depending on the size and location of the veins, and the patient’s overall medical condition. Most patients find the treatment to have little or no pain. No incisions are made and no anesthesia is required. Anywhere from one to several sclerotherapy sessions may be needed to achieve the best results. Medically prescribed support hose and /or bandages may need to be worn for several days to several weeks to assist in resolution of the veins. In general, spider veins respond to treatment in 3 to 6 weeks, and larger veins respond in 3 to 4 months.

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Vein Therapies of Chattanooga, PLLC
6031 Shallowford Road, Suite 113
Chattanooga, TN 37421-168
Map and Directions

Phone: 423.648.4181
Fax: 423.648.4183

For more information about varicose veins or sclerotherapy, contact our practice by filling out the form below.

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