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Varicose Veins, Spider Veins and Venous Ulcers [Transcript]

Jennifer Heller is the Director of the Johns Hopkins Vein Centers.
Jennifer Heller, MD, FACS, is
the Director of the Johns
Hopkins Vein Centers.
Watch the video.

Watch the video.

Featuring Jennifer Heller, MD, FACS, Director of Johns Hopkins Vein Centers

What are varicose veins and what are their symptoms?

There are two types of tubes that carry blood in the body: arteries and veins. Arteries are responsible for bringing blood from the heart and lungs down to all parts of the body. Veins, in contradistinction, have a much harder job to do. They in fact have to bring blood from the feet back up to the heart and lungs, and they do that with little structures in them called “valves.” When these valves are not working, dilated veins - otherwise known as varicose veins - can form.

What are spider veins?

Spider veins are flat, thin little veins that can occur anywhere along your body, but they do occur most predominantly, in the lower legs. The good news, however, about spider veins is that their most unappealing aspect is how they look. They are not a sign of circulatory compromise.

What are venous ulcers and what causes them?

There are many different causes for ulcers in the lower extremities or legs, however, vein ulcers in particular have very unique characteristics. They tend to develop most commonly on the inside ankle or on the lower half of your leg. As well, there tends to be a history of either trauma, varicose veins, or deep vein thrombus before in the patient’s history.  

What are the causes or risk factors for varicose veins?

The definitive cause of varicose veins and venous insufficiency has yet to be elucidated. However, we do know that there are certain risk factors that predispose people to develop varicose veins. They include: female gender, increasing age, heredity, and trauma.

When should someone seek treatment for varicose veins?

Symptoms of varicose veins are due to excess blood pooling in the lower legs. And this excess blood causes heaviness, fatigue, aching, and sometimes even throbbing. Over time these symptoms can worsen and develop into causes such as superficial thrombophlebitis, deep vein thrombosis, or even venous stasis ulceration.

What tests will I need to determine my treatment?

I cannot overemphasize the importance of a comprehensive history and physical examination. And certainly that is performed on each and every new patient that is brought to the Johns Hopkins Vein Centers. I will never have a patient undergo an unnecessary test or examination prior to me or one of my colleagues meeting that patient, speaking with them, and understanding their true signs and problems. After a suspicion of venous insufficiency or varicose veins is entertained, we do make that appointment for the patient to undergo a venous reflux examination in one of our accredited vascular laboratories.

What is the importance of a certified vascular lab for testing?

Accreditation for vascular laboratories in the United States is extremely rigorous, and with that accreditation comes some very important findings. Registered vascular technologists are the only providers who perform these ultrasound examinations. And think about it: Inaccurate vascular laboratory examination would potentially develop into an inaccurate and unnecessary surgical intervention.

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