By Charles Hunt II, MD, FACS, RVT
As a Cardiothoracic Surgeon who has transitioned to the treatment of Venous Disorders, I have gained appreciation for the destructive nature of venous disease and become more aware of the misconception that saphenous vein reflux disorder and varicose veins are purely cosmetic. Tragically, the arterial system is synonymous with the vascular system. However this neglects the importance of the lymphatic and venous system. Dysfunction of either the lymphatics or venous system can be as equally devastating to a patient. A remarkable aspect of modern venous procedures is that it offers both curative and preventative measures.
In the absence of treatment, saphenous vein reflux disorder can advance to the end-stage symptoms or signs that consist of permanent edema, lipodermatosclerosis, destruction of the lymphatic system, and non-healing venous ulcers. Early intervention prevents these complications from developing.
Medical school and residency taught me that varicose veins were cosmetic. My experience as a vein specialist has demonstrated to me that varicose veins are a risk factor for spontaneous thrombus formation with potential for propagation into the deep system or pulmonic embolization. Removal of the varicose veins eliminates the risk of superficial thrombophlebitis and subsequent deep vein thrombosis secondary to propagation. The majority of spider veins are truly cosmetic but a subset of spider veins are a bleeding hazard. I have witnessed significant blood loss secondary to prominent spider veins. Two main factors contribute to the bleeding risk. Venous hypertension and lack of sufficient tissue to assist in tamponade of the offending vessel. The vein is designed to withstand approximately 8 to 12 mmHg. A patient with saphenous vein reflux disorder may have a venous pressure at the ankle of 120 mmHg. As one can imagine even a small puncture with a 120 mmHg of pressure and no overlying tissue can result in terrifying experience for an individual. Anecdotally, I have observed that the majority of cases of spontaneous hemorrhage occurs after a hot bath or shower secondary to vasodilation.
Modern treatment of saphenous vein reflux disorder provides patients with a safe and highly effective and definitive cure and the opportunity to prevent devastating complications.
Charles Hunt II, MD, FACS, RVT has over 20 years of experience in vascular medicine. He is the Physician-Owner of Alabama Vein & Restoration Medspa.