Have you ever had a favorite clothing item that you loved because it fit like a glove and made you feel confident?
Now, pretend that you have a child who has gone through puberty and is 5 times your size who thought it would be funny to fit into that article of clothing…yup, permanently stretched.
Well, that’s similar to what happens when you develop varicose veins.
Here to answer all of your questions about varicose veins is Dr. Joshua Tepper.
About Dr. Joshua Tepper
Dr. Joshua Tepper is a Board Certified Diagnostic Radiologist and fellowship trained Interventional Radiologist. He specializes in minimally invasive vascular procedures with a passion for lower extremity venous interventions including varicose vein ablation. He is proficient in a multitude of other procedures including uterine fibroid embolization, chemoembolization, dialysis intervention, and kyphoplasty.
Dr. Tepper earned his medical degree at the University of Chicago Pritzker School of Medicine where he also trained as a General Surgery Intern. He completed his Diagnostic Radiology Residency and Fellowship in Vascular and Interventional Radiology at Northwestern Memorial Hospital.
He has been on the medical staff at Presence Saint Joseph Medical Center in Joliet since July 2010. He is a member of the Internal Review Board (IRB), Cancer Committee, and is Director of the Vein Clinic. He is the principal investigator at Presence Saint Joseph Medical Center for the EVOLVE research trial on kyphoplasty.
What are varicose veins?
Your legs looked and felt great until… well, they didn’t anymore.
Superficial veins (veins that you can see as opposed to the more important deep veins which are surrounded by muscle) can dilate if the valves which keep the blood headed upwards against gravity back towards the heart become weak and leaky.
This is what forms what we know of as varicose veins.
Why do the valves fail and cause varicose veins?
Well, usually it’s multifactorial including genetic risk, pregnancy, or possible DVT or simply bad luck (you can usually try and blame it on a first degree relative though and assume it’s not your fault).
“Once a valved segment starts to fail there is a resultant increase in blood volume that stresses the vein segment below that valve which can dilate and keep that valved segment from working well.”
This cycle can repeat itself until the veins are ropey, redundant and bulging.
Symptoms of Varicose Veins
The dilated, and now varicose veins, can cause symptoms.
The classic symptoms form the acronym HASTI, Heaviness Achiness Swelling Throbbing and Itching that tends to worsen towards the end of the day and is relieved with rest/leg elevation.
If the varicose veins involve both legs and the symptoms are symmetric you may not have realized that you were suffering vein “disease” i.e. varicose vein disease or venous insufficiency or venous incompetence.
Who gets varicose veins?
We see an equal number of men and women with varicose veins all in various stages of “suffering”.
“Varicose veins typically originate along the inside of the leg and where the blood pools secondary to gravity at the inner ankle. While it is uncommon to progress from one stage of venous disease to the next stage of venous disease (there are 6 stages, stage 0 nonexistent, stage 1 spider veins, stage 2 symptomatic varicose veins, stage 3 leg swelling, stage 4 abnormal skin changes including eczema/discoloration, stage 5 a healed venous ulcer, and stage 6 being an open venous ulcer) the worst possible outcome is the development of a painful and debilitating venous ulcer.”
After initial consultation, and in the appropriate clinical setting and presentation, an ultrasound is performed to evaluate both the superficial veins and deep veins. Using the Doppler effect (when a sound such as a siren comes towards you and then passes by you the change in frequency can be observed) we can tell how long blood flow is going in the “wrong, i.e. towards your feet” direction in your veins.
How to Treat Varicose Veins
Great news… we can fix your varicose veins and “venous insufficiency” minimally invasively. Since we (medical professionals) often remove superficial veins to use as bypass grafts or even “destroy” them when we use them for venous access (IV fluid, blood draws, chemotherapy, etc) we can safely close your superficial varicose veins and reroute the venous blood to healthy veins that are equipped with working “competent” valves by using a state of the art laser fiber.
Many patients have heard advertisements for the laser treatment of varicose veins and are mistaken to believe that the laser beam is external to the leg/vein.
The laser fiber is inserted into the varicose vein through a tiny skin nick during real time ultrasound imaging guidance. Local anesthetic is administered and the vein is subsequently closed after the laser is activated.
We can completely remove your varicose veins in under an hour without stitches and with minimal down time, many patients return to work the same or next day.
Are you struggling with varicose veins? Book an appointment with us to learn about your treatment options!
