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OH, THOSE ACHING LEGS

SUSAN M. WEEKS, MD
Vascular Radiologist

Varicose veins are a common medical disease, affecting up to 50% of Americans aged 50 and over. Unfortunately, their prevalence and association with cosmetic concerns often belittles their importance as a cause of significant medical morbidity.  While individuals with varicosities may be asymptomatic, many suffer from lower extremity tingling, heaviness, pain, itching, or throbbing. Over time, long-standing venous insufficiency and hypertension can result in severe medical problems, including superficial thrombophlebitis, spontaneous hemorrhage, and ulcer formation.

The evaluation and diagnosis of varicosities is straightforward.  In addition to simple inspection, when indicated, duplex ultrasonography of the affected limb will document the status of both the deep and superficial venous systems, including the presence or absence of venous dilatation, thrombosis, and reflux.

Conservative treatment is commonly employed as a first step for treating symptomatic varicosities, using compression stockings, elevation, and nonsteroidal anti-inflammatory agents. If more aggressive therapy is warranted, injection sclerotherapy, microphlebectomy, and endovenous vein ablation can be performed in an outpatient, office-based setting. 
Sclerotherapy is the direct injection of a sclerosant into a vein, which results in irritation of the vein walls and eventual obliteration of the vein. Microphlebectomy is the removal of enlarged varicosities via tiny incisions made alongside the vein. This is performed under local anesthetic. Endovenous ablation of varicosities is performed solely under ultrasound guidance. A small laser catheter is advanced along the length of the diseased vein, the tissues around the vein are anesthetized with dilute local anesthetic, and then the laser catheter is withdrawn slowly down the vein while administering energy to the vein wall to cause irritation and obliteration of the vein.

All of these procedures boast short (if any) recovery periods, a low complication profile, and excellent results, and thus in most instances have replaced open surgical therapies as the treatments of choice for lower extremity varicosities and chronic venous insufficiency. At the Wake Radiology Outpatient Interventional Suite, evaluation for and management of chronic venous insufficiency is performed by fellowship-trained vascular interventionalists with extensive experience in image-guided, catheter-based therapies.

Call Wake Radiology Interventional Services at 919-854-2180 or visit us at and click on the Vein Therapy Consultation to request a free consultation for men and women.

About Susan M. Weeks, MD
Dr. Weeks is a vascular and interventional radiologist, and vein specialist at Wake Radiology Interventional Services in Cary. She graduated from the University of North Carolina School of Medicine and completed a residency and fellowship in vascular/interventional radiology at the University of North Carolina Hospitals.