Today’s Vein Procedures – Interview with Sigvaris was able to ask Judith Brannan, Education/Medical Affairs Manager for SIGVARIS Inc., some questions about common vein procedures that people are getting. Judith was kind enough to share her knowledge and expertise with us. What are the most common vein symptoms that women experience on their legs today?

Judith Brannan: Vein disease isn’t just a women’s issue.Statistics indicate that 50% of adults have some level of venous insufficiency which result in symptoms such as tired, achy legs; swollen ankles at the end of their day and some vessel activity such as spider or reticular veins and varicose veins. Over 40 million people have varicose veins and these are the most common of the vein issues. Those with more chronic vein symptoms may have discoloration in their lower leg area near the ankle, or even an open wound known as a venous leg ulcer. Most vein issues are found in the superficial veins which are closer to the surface of the skin, not the deep veins.

LGS: Are these symptoms genetic? Or can anyone experience them?

JB: While some have a generic component, such as varicose veins, the real reason is that “life” is causing the vein walls to weaken. By life, I mean such things as aging, weight gain, pregnancy, disease or trauma, and certain professions which dictate prolonged standing or sitting. When the vein walls weaken, valves that are found in veins (normally opening and closing to aid in the blood flow) are pulling apart. This causes blood to reverse flow (known as reflux) which causes pressure to build in the vein. Remember, venous flow is taking blood back to the lungs and heart for recirculation and venous flow is fighting the pull of gravity. So when the valves become incompetent and blood flow reverses causing pressure, there is a cascade of damage from one set of valves to another. The weakened walls start to bulge with the pressure and a varicose vein begins.

LGS: What should individuals talk to their doctors about when discussing vascular health?

JB: The vascular system is comprised of both arteries and veins. Sometimes the pain or discomfort someone experiences could be peripheral arterial disease, or PAD. PAD is an early warning of possibly more serious symptoms related to heart and stroke. Other times leg discomfort is caused by venous insufficiency. One should tell their doctor if they are experiencing leg pain. He/She will then order diagnostic tests to determine whether it is arterial or venous related. Many of the vein symptoms are visual as well. Skin discoloration or vessel appearance and bulging being the most common of these symptoms.

LGS: What do doctors recommend for individuals with venous symptoms?

JB: Depending on the stage of insufficiency and also the cause, a doctor may prescribe graduated compression stockings, which provide a gentle squeeze to the outside of the leg, allowing the vein wall and valves to push together, moving the blood flow more normally which reduces the pressure build up within the vein. If the stage of insufficency is greater, there are several in-office procedures which can be recommended.

LGS: What are the most common procedures for treating these symptoms? Can you please describe these procedures for us?

JB: Procedures may vary depending on the size of the vessel and the cause of the insufficiency. Most are minimally invasive and done in the doctor’s office.

Sclerotherapy, for example, is used most commonly for small veins known as telangiectasias, or more commonly, spider/reticular veins. After identifying the vessel that is incompetent, the physician may decide to do sclerotherapy which is an injection of an FDA approved agent, foam or saline into the vein that causes the wall to inflame and collapse. The body then dissolves the damaged vessel and carries it through its waste system. Blood is rerouted into many other vessels. There is little discomfort and you can be active immediately following the procedure.

For larger vessels, an endovenous laser treatment (EVLT) or radio-frequency ablation (RFA) may be done. Many times, the saphenous vein suffers varicosities and these treatments would be used. The physician finds the source of the incompentency by using ultrasound. Then, because the vein is larger, he/she inserts a catheter, which holds a wire inside, into the vessel. The wire tip is then heated by radio-frequency or by laser. Drawing the catheter down the vessel causes the vessel wall to collapse and become dysfunctional. The blood then re-routes through other healthier vessels.

Other types of procedures are known as plebectomy or stripping. However, sclerotherapy, RFA and EVLT are the most common and least invasive.

LGS: What kinds of compression stockings do doctors normally recommend for patients after their vein procedure?

JB: Graduated compression is used following procedures to aid in the healing process. They reduce swelling and discomfort, as well as aid in the re-routing of blood flow. Following sclerotherapy, normally a 20-30mmHg thigh-high or pantyhose would be used. For the larger vessel procedures, such as EVLT or RFA, a 30-40mmHg would be prescribed.

Patients will be advised to wear the stockings for 24, 48 or as much as 72 hours following the procedure. Then, they should wear them daily for up to three weeks. For patients whose lifestyle or risk factors are high, wearing compression daily may help prevent additional damage to fragile veins.

If the procedure is covered by insurance, the insurance company may require a patient to wear graduated compression prior to authorizing the procedure.

LGS: What premium SIGVARIS compression stocking would you recommend for patients after their vein procedure?

JB: Well, I love all of SIGVARIS products! For those patients who have sensitive skin or allergies, our Cotton Series is a great solution. This product has 25% Supima® Cotton, of which 100% is against the skin. For a more fashion conscious woman, I highly recommend the EverSheer. You would never know by looking at it that it is a compression stocking as it is so sheer and soft! My other favorite is our Soft Opaque product. I find it easy to put on and remove and it is incredibly durable. SIGVARIS offers stockings, hosiery and socks that would please anyone’s style taste.

Special thanks to Judith Brannan and Sigvaris for allowing share these great leg health resources with our readers.

About Judith Brannan:
Judith Brannan is the Education/Medical Affairs Manager for SIGVARIS, Inc. With over 18 years experience as education manager for a major ultrasound company (ATL/Phillips) and then with Bristol Myers Squibb, Medical Imaging, she brings a wealth of experience in her role with SIGVARIS, Inc. She has developed and implemented numerous accredited educational programs for physicians, sonographers, nurses and participated in direct sales training for company sales representatives and dealers/distributors. Additionally, Judith is responsible for managing the medical efficacy studies for SIGVARIS. Judith attended the University of Minnesota at Mankato.