Angiology and Phlebology

What is Venous Insufficiency?

Venous insufficiency occurs when veins fail to properly return blood to the heart due to defective veins, known as varicose veins. A varicose vein is dilated, twisted, and has malfunctioning valves, which normally act as one-way gates to prevent blood from flowing backward.

As a result, blood pools in the lower part of the body when standing, increasing venous pressure. This elevated pressure can lead to symptoms such as pain, heaviness, fatigue, tingling, cramps, itching, and leg swelling, especially during prolonged standing or sitting positions. These symptoms can significantly impact quality of life, both personally and professionally.

How Are Varicose Veins Treated?

Treatment begins with a detailed consultation, clinical examination, and a venous duplex ultrasound (also called an echo-Doppler). This ultrasound provides a “map” of the affected veins, helping to design a personalized treatment plan.

A venous duplex ultrasound is essential and mandatory before any treatment.

Goals of Treatment

• Symptomatic Relief: Alleviating symptoms of venous insufficiency.
• Preventive Care: Slowing the progression of the disease and preventing complications such as superficial thrombophlebitis, hemorrhages, and venous ulcers that can occur in advanced stages.

Treatment Options for Varicose Veins

Lifestyle Modifications:

• • Regular physical activity, especially walking.
  • Staying hydrated and maintaining healthy habits.

Compression Therapy:

• • Compression stockings reduce venous pressure, relieve symptoms, and prevent complications.

Sclerotherapy:

• • A minimally invasive procedure where a sclerosing agent is injected into the vein, causing it to close and eventually disappear. The treatment can be performed in liquid or foam form during a routine clinic visit and requires no downtime.

Thermal Endovenous Treatments (Radiofrequency or Laser):

• • These techniques use thermal energy to seal the varicose vein, promoting its closure. Performed in an outpatient setting under local anesthesia, they allow patients to resume daily activities immediately. These methods are now covered by health insurance. It is the first line recommendation in the last European Society for Vascular Surgery’s guidlines.

VenaSeal™ Closure System

• Improves blood flow by sealing or closing the diseased vein.
• Delivers a small amount of a specially formulated medical adhesive to the diseased vein.
• Seals the vein with adhesive and blood is rerouted through nearby veins.

Surgical Stripping:

• • A more invasive procedure where the affected vein is surgically removed. This requires regional or general anesthesia and a recovery period of 2–3 weeks. Due to advancements in medical treatments such as foam sclerotherapy and thermal techniques, stripping is now less commonly used.

Dr. Chady Kallassy provides a patient-centered approach, offering the latest and most effective treatments to ensure optimal results with minimal downtime, tailored to each individual’s needs.