Veins are a critical part of our circulatory system and return blood to the heart from all parts of the body. An estimated 25 to 30 million people suffer from venous disorders in the United States today. The most common disorders include varicose veins, spider veins and venous insufficiency, however, any defect in the circulatory system can result in stroke, the loss of a limb – and even death.
Georgetown University Hospital's Vein Center (with locations on the hospital campus and in Reston, Virginia) has a systematic and thorough process for evaluating and treating all vascular disorders.
 |
Vascular surgeons Dr. James Laredo and Division Chief Dr. Richard Neville treat all types of venous and lymphatic problems. |
"We approach venous problems from a completely medical standpoint and provide a comprehensive vascular evaluation," explains Dr. James Laredo, part of the vascular team at Georgetown. "We routinely treat patients with vascular problems who also have complex medical problems, including heart disease, diabetes, kidney disease and complex leg wounds. We work very closely with our cardiologists, diabetes doctors, kidney specialists and wound care doctors, and offer a multidisciplinary approach to the treatment of all of our patients," continues Dr. Laredo. In fact, the team at Georgetown boasts that it is able to assess and care for nearly every patient that enters the clinic due to this unique approach to venous problems.
Many existing clinics provide only cosmetic treatment for vascular disorders and never address the underlying medical causes associated with a patient's venous abnormalities. In addition, many of the other clinics only offer one type of therapy irregardless of a patient's vein disorder. "When choosing a center, it should offer all of the therapies available to treat vein problems because what is good for one person may not be good for another," explains Dr. Richard Neville, Chief of Georgetown's Vascular Surgery Division. Georgetown's vascular team offers the complete package of currently available treatments. They are experts at non-invasive diagnosis, medical therapy, vascular surgery and interventional procedures. Furthermore, this group of specialists prides itself on being especially skilled at avoiding invasive procedures wherever possible. Remarkably, most patients return to work the same day that they receive treatment.
"We treat all venous and lymphatic problems utilizing the most advanced treatments from injection sclerotherapy of spider veins and varicose veins, to laser ablation of the greater saphenous vein [the principal vein that runs up the leg and lies near the surface] to treat superficial venous insufficiency," explains Dr. Laredo. While spider veins appear as if threads run under the skin, varicose veins often look like ropes or grape clusters lying beneath the skin. These usually cause discomfort such as aching, swelling, tingling or numbness, night cramps and restlessness.
Sometimes varicose veins can rupture and bleed. Generally, spider veins and varicose veins are not harmful, but they may indicate potentially serious venous abnormalities such as chronic venous insufficiency (the poor return of blood to the heart from the feet and legs) and deep venous thrombosis (a blood clot in a deep vein associated with an artery, also known as DVT). Early evaluation of either spider veins or varicose veins in a patient with leg symptoms is the best way to prevent long-term complications. Georgetown's specialists use injection sclerotherapy to treat both spider veins and varicose veins. During this simple procedure, a doctor injects a sclerosing (or chemical) agent, such as saline, into the vein. The saline injures the lining of the vein which causes the vein to close. Over the next four to six weeks, the vein is re-absorbed by the body. Superficial venous insufficiency is a more complicated condition that is commonly treated at Georgetown's vein center. It occurs when leg vein valves do not function properly. If left untreated, this disorder can cause the skin to break down resulting in ulcers.
 |
Symptomatic Varicose Veins of the Leg |
That's exactly what happened to Elizabeth Radmard, 44, from Charleston, West Virginia. After suffering from varicose veins for years, Radmard developed an open sore on her leg. When it refused to heal, she sought help from Georgetown. "It was just amazing," Radmard says of the laser procedure she underwent with Dr. Laredo. "Here I was, walking around with an open wound for nine whole months. And only three weeks after my treatment at Georgetown, the wound was completely healed."
The Georgetown specialists often use ligation or laser ablation of the greater saphenous vein to treat patients with this disorder. Ligation of the greater saphenous vein involves the tying off of this vein through a small opening made at the groin. Laser ablation, on the other hand, is less invasive. A tiny laser ray is inserted into the vein which is able to shut down the vein and minimize the venous pressure in the leg.
"The days of vein stripping are long gone," reassures Dr. Neville. Stripping is an older and invasive procedure that involved the removal of a part of the diseased vein.
 |
|
Appearance 2 weeks after surgery |
Georgetown also offers specialized surgical procedures utilizing tiny or micro incisions such as phlebectomy [removal of large surface varicosities], sub-fascial endoscopic perforator surgery [or SEPS - malfunctioning veins cause venous pressure to be reversely directed toward the skin, resulting in venous hypertension and stasis ulceration] and deep vein surgery. Dr. Neville emphasizes though, "Even our surgical techniques are minimally invasive."
For more information about Georgetown's Vein Center or to make an appointment at the Georgetown or Reston location, contact Georgetown MD at 202.342.2400.
