Stephen J. Dempsey MD, FACC, FSCAI
Dr. Dempsey graduated from the University of Notre Dame in 1989 and the University of Connecticut School of Medicine in 1994. He completed post graduate training in internal medicine at Harvard’s Beth Israel Hospital in Boston, MA. He then completed fellowships in cardiovascular disease and interventional cardiology at Emory University in Atlanta, GA graduating in 2001. He has been in practice at Saratoga Cardiology Associates since 2001, where he specializes in the minimally invasive treatment of heart and vascular diseases. He is board certified in cardiovascular disease and interventional cardiology, and is a Fellow in the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions. He has received advanced training in the latest techniques for minimally invasive treatment of venous disorders including varicose veins and venous insufficiency. He is a member of the American College of Phlebology.
Frequently Asked Questions
What is vein disease?
Veins are the blood vessels that return blood to the heart from the body. To overcome the force of gravity, inside the veins are one-way valves which open to allow blood flow to the heart, and close to prevent “reflux” of blood back to the body. When these valves fail to function, or if the vein is damaged so the valves do not completely close, blood can begin to pool in the vein and cause a variety of vein complications.
What are the different types of vein disease?
Spider veins are the small, thread-like colored veins that are most often seen on the surface of the skin. While many people seek treatment for spider veins for cosmetic reasons, spider veins also can result in substantial discomfort requiring therapy.
Varicose veins are the large, “rope-like” veins which are often ¼˝ or larger in diameter. Varicose veins generally grow in size over time and can result in substantial pain and complications if not treated.
What are the treatment options for vein disease?
Depending on the type and stage of vein disease, there are many different treatments. Your physician can explain all of the options. The following are common treatments performed for vein disease:
For minor pain from varicose veins, a compression stocking may be beneficial. The compression stocking will assist the leg in the pumping of blood back to the heart. While the vein disease symptoms may be relieved, compression stockings will not make the varicose veins go away.
Used commonly for spider veins and small varicose veins, sclerotherapy involves injecting a small volume of a liquid into the diseased vein. The sclerosing liquid acts upon the lining of the vein to cause it to seal shut, eliminating the vein completely. Sclerotherapy is quickly performed in a physician’s office and no anesthesia is required.
Historically, the only treatment for large varicose veins has been to surgically remove or ‘strip’ the vein from the body. Surgical stripping is done in an operating room under anesthesia and requires a considerable recovery period for the patient. More recently, a modified version of stripping known as ambulatory phlebectomy has grown in use. In this version of surgical stripping, multiple incisions are made to hook and remove the vein one portion at a time. More incisions are made than in standard vein stripping, but the damage to the leg and post-surgery recovery time are minimized.
Endovenous Laser Therapy
In the last few years, the use of lasers has become an accepted alternative to surgical stripping to treat varicose veins. In endovenous laser therapy, a thin laser fiber is inserted into the diseased vein, generally through a small puncture in the leg above where the visual symptoms appear. The physician then delivers laser energy through the fiber which causes the vein to close as the fiber is gradually removed. Endovenous laser therapy can be performed in a physician’s office in less than one hour, and the patient is encouraged to walk immediately following the procedure.
Who should not be treated?
Patients should wait at least three months after pregnancy or major surgery before being treated for vein disease. Persons with deep vein thrombosis or incompetence, and patients who cannot ambulate for other reasons are not good candidates for treatment. If the vein is closed by the treatment, where does the blood go? Because there are many veins in the leg, the blood that would have flowed through the closed vein simply flows through other healthy veins after the procedure. The loss of the diseased vein is not a problem for the circulatory system.
What can happen if varicose veins aren’t treated?
Varicose veins generally worsen over time. Initially, slight pain and restlessness in the diseased leg will be felt. If untreated, this pain will increase and result in limitations in walking and cramps during sleeping. Eventually, varicose veins can lead to open sores on the foot, blood clots and tissue loss.
What are the complications of vein treatment?
Fortunately, sclerotherapy and endovenous laser therapy have rarely been associated with any serious complications when properly performed. Common minor complications of these procedures include bruising, mild itching, tingling, tenderness and tightness in the treated leg for up to two weeks after the treatment.
Will insurance cover the treatment?
Many insurance companies cover the treatment of vein disease that is associated with substantial pain and other complications, but individual insurance companies may limit the types of therapy that are covered.
How do I know if I have vein disease?
Fortunately, most vein disease can be seen by looking at the size and color of the vein at the skin surface. In some cases, however, the diseased vein may be deeper in the body and not visible through the skin. As a result, paying close attention to other symptoms is important in diagnosing vein disease. Many patients with vein disease experience cramping, aching, burning, itching, soreness or “tired” or “restless” legs, especially in the calf muscles. If you experience these symptoms, your physician can quickly and easily perform a test to determine if you have vein disease. How common is vein disease?
Vein disease of the legs is one of the most common medical conditions. Approximately half of the population has some form of vein disease. Varicose veins affect between 15-25% of all adults, and approximately 50% of all people over age 50. Women have a higher incidence of vein disease than men.
How does vein disease occur?
The single most important cause of vein disease is heredity. Approximately 70% of all patients with varicose veins have parents with the same condition. Pregnancy, especially multiple pregnancies, is a contributing cause of vein disease. Other factors influencing vein disease are age, obesity and jobs which require long periods of standing.
Can vein disease be prevented?
Generally no. If you have a family history of vein disease, there is nothing you can do to change your genes. Being overweight can accelerate the progression of vein disease, and long periods of standing can also add to the problem. Diet and footwear are generally believed to be irrelevant in the formation of vein disease.
How can I get more information on varicose veins?
More information on varicose veins can be found at www.treatveins.com. As always, for information on your specific condition, ask your physician.