Frequently Asked Questions

FAQ Sections

Q: How does venous circulation work?

A: Arteries are blood vessels that carry blood away from the heart to the peripheral tissues. Blood travels down the arteries to the capillaries, where it drops off oxygen and nutrients, and picks up waste products. The blood leaves the capillaries and collects in the veins. The blood returns up the legs to the heart through the veins. Blood in the veins has to fight gravity on its return trip back to the heart. It does this with the assistance of muscle pumps and delicate one-way valves. When the leg muscles contract, they squeeze the veins that run within them, forcing the blood upward. The valves open to allow the blood to go up, then snap shut to prevent the blood falling back down the leg. In this way, the blood returns to the heart.

Q: What is venous insufficiency?

A: Venous insufficiency is the impedance of flow back to the heart usually caused by malfunction of the delicate venous valves. Valvular dysfunction allows blood to reflux or flow the wrong way back down the leg due to the force of gravity, thus increasing venous pressure in the leg. Increased venous pressure from venous insufficiency causes pain, itching, restless legs syndrome, spider veins (telangiectasias), varicose veins, swelling (edema), venous stasis dermatitis, and eventually venous stasis ulcers. This is an unrelenting process that intensifies over time.

Q: Doesn’t my body need all of its veins for circulation?

A: The leg has three venous systems: The deep system, which is responsible for 90% of blood return, the superficial system, which is responsible for the remaining 10% of blood return, and the perforator veins, which connect the deep and superficial systems. Diseased, refluxing veins allow venous blood to actually flow in the wrong direction and pool in your legs and feet rather than returning to the heart and lungs. When the diseased veins are removed, the blood is naturally diverted to the remaining healthy veins and returns to the heart. Circulation is improved immediately.

Q: What if I need my veins for a heart bypass later on?

A: Dilated, refluxing saphenous veins and bulging varicosities make poor bypass conduits. As a rule, they are rejected as donor grafts by heart surgeons, as they have been shown to have a high incidence of early graft failure. Normal-sized, straight and healthy veins are required to construct a long-lasting Coronary Artery Bypass Graft (CABG). Should CABG be required, other conduit options are available that are superior to dilated, tortuous, or diseased leg veins.

Q: How do I know if I have venous disease?

A: Large, bulging varicosities or diffuse spider veins are the obvious result of advanced venous disease. Early in the course, however, more subtle symptoms such as ankle edema predominate. Many patients with venous disease develop aching, cramping, burning, soreness, or itching. Over time, these symptoms tend to worsen as the underlying disease progresses. Another less well-known but very common symptom of venous insufficiency is the Restless Legs Syndrome.

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