Venous Disease

What is venous disease?

Venous disease is any condition that affects the veins in your body. Veins are flexible, hollow tubes that are part of the circulatory system that moves blood through your body. Veins bring oxygen-poor blood back to your heart, which pumps your blood. Arteries carry oxygen-rich blood away from your heart.

Veins have flaps (valves) inside that open when your muscles contract. This allows blood to move through your veins. When your muscles relax, the valves close, keeping blood flowing in one direction.

If venous disease damages the valves inside your veins, the valves may not close completely. This lets blood leak backward or flow in both directions.

Types of venous disease

Venous diseases include:

• Blood clots: These can happen in your legs, arms, veins of your internal organs (kidney, spleen, intestines, liver and pelvic organs), in your brain (cerebral vein thrombosis), in your kidneys (renal vein thrombosis), or in your lungs (pulmonary embolism).
• Deep vein thrombosis (DVT): This is a blood clot that occurs in a deep vein (including arms and legs). Deep vein thrombosis itself isn’t life-threatening. However, the blood clot has the potential to break free and travel through the bloodstream, where it can stick in your lung’s blood vessels and become a pulmonary embolism. This can be a life-threatening condition.
• Superficial thrombophlebitis: This is a blood clot that develops in a vein close to the surface of your skin. These types of blood clots don’t usually travel to your lungs unless they move from your superficial system into your deep venous system first. Typically, however, they cause pain.
• Chronic venous insufficiency: This condition causes pooling of blood, chronic leg swelling, increased pressure, increased pigmentation or discoloration of your skin, and leg ulcers known as venous stasis ulcers.
• Varicose and spider veins: These are abnormal, dilated blood vessels that happen because of weakening in your blood vessel wall.
• Venous ulcers: Ulcers are wounds or open sores that won’t heal or keep returning. Venous stasis ulcers most commonly occur below your knee, on the inner part of your leg, just above your ankle.
• Arteriovenous fistulas: These are arteries and veins that connect to each other directly, with nothing in between. This is abnormal.

How common is venous disease?

Venous disease affects more than 30 million people in the United States. Researchers predict even more people will have it in the future. With people living longer and weighing more, they’re more likely to get venous disease.

About 1 million cases of venous thromboembolism happened in 2010 in the U.S. By 2050, that number may reach 1.8 million.

Roughly 33% of adults have varicose veins.

About 1% of adults have venous leg ulcers.

What are the symptoms?

Venous disease symptoms include these issues in your legs or arms:

• Pain, cramping or discomfort.
• Redness or warmth.
• Heaviness.
• Itching or burning feeling.
• Swelling.
• Bulging veins.

What causes venous disease?

Venous disease causes include:

• Issues with how your veins formed when you were born.
• Injury.
• Other venous diseases.
• Weak blood vessel walls because of pregnancy, aging, cysts or tumors.
• High blood pressure.

What are the risk factors for venous disease?

Risk factors for venous disease include:

• Family history of venous disease.
• Pregnancy.
• Having a BMI (body mass index) greater than 30.
• Being a woman or assigned female at birth (AFAB).
• Sitting or standing for long periods of time.
• Taking birth control pills or hormone replacement therapy.
• Using tobacco products.

What are the complications of venous disease?

Certain venous diseases can lead to other issues.

• Superficial thrombophlebitis: Deep vein thrombosis.
• Deep vein thrombosis: Chronic venous insufficiency or pulmonary embolism.
• Pulmonary embolism: Pulmonary hypertension.
• Varicose veins: Superficial thrombophlebitis or venous ulcers.
• Venous ulcers: Infections, like gangrene.

How is venous disease diagnosed?

A healthcare provider will review your medical history, including your family’s medical history. They’ll also do a physical exam and order any tests you may need.

What tests will be done to diagnose venous disease?

Tests to diagnose venous disease include:

• Ankle-brachial index (ABI).
• Ultrasound.
• Intravascular ultrasound (IVUS).
• Computed tomography (CT).
• Magnetic resonance imaging (MRI).
• Angiogram.

How is venous disease treated?

Venous disease treatments include:

• Medications.
• Compression stockings or bandages.
• Lifestyles changes, such as eating foods with less fat, exercising more and giving up tobacco products.
• Procedures or surgeries.

Several nonsurgical and surgical treatment options are available for each type of venous disease. The goals of treatment are to reduce symptoms and reduce the risk of complications. Your healthcare provider will recommend the treatment option that’s right for you.

Before choosing any treatment, it’s important to discuss the potential benefits, risks and side effects with your provider. You’ll receive specific guidelines to help you prepare for your procedure, as well as specific instructions to help your recovery.

Specific medicines/procedures used

Medicines and procedures vary, depending on the type of venous disease. Venous disease treatment may include:

• Anticoagulants.
• Thrombolytics.
• Endovenous ablation of varicose veins (with lasers, sclerotherapy or radiofrequency).
• Thrombectomy.
• Vena cava filter.
• Vein surgery.

Complications/side effects of the treatment

Side effects of treatment depend on the type of treatment you have. Your healthcare provider can explain which treatments make sense for the venous disease you have.

How soon after treatment will I feel better?

Your healthcare provider may be able to give you an estimate of how quickly you’ll feel better. Everyone is different, and various methods provide relief at different speeds.

How can I lower my risk of venous disease?

You can lower your risk of disease by improving the health of your veins and the rest of your cardiovascular (heart and blood vessels) system by:

• Managing high blood pressure, high cholesterol and Type 2 diabetes.
• Exercising 30 to 60 minutes or more a day on most days of the week.
• Moving around every hour if you’re sitting and/or traveling.
• Not using tobacco products.
• Staying at a weight that’s healthy for you.
• Eating foods with low salt and saturated fat.
• Managing your stress.

What can I expect if I have venous disease?

Without treatment, venous disease can get worse and impact your quality of life. Receiving treatment will improve these things. While superficial thrombophlebitis goes away in a few weeks, it can take more time to recover from other venous diseases. Some people have chronic venous disease. This means they deal with it long-term.

You may need frequent appointments with your provider to make sure you’re managing the venous disease. They may want to redo ultrasounds or retake other tests to compare with earlier test results.

Venous diseases like varicose and spider veins can come back after treatment. Venous ulcers can also happen again.

How do I take care of myself?

Whether you’re sitting or standing, walk around every hour. This encourages good blood flow through your body. Avoiding tobacco products is another way to take care of your blood vessels. Ask your healthcare provider for information about programs or products that can help you with this.

When should I see my healthcare provider?

Go to all of your scheduled appointments with your healthcare provider. Contact your provider if you experience changes in your usual symptoms or if they get worse.

When should I go to the ER?

Get immediate help if you’re bleeding too much while taking blood thinners. Also, call 911 or your local emergency number if you have symptoms of a pulmonary embolism, such as:

• Shortness of breath.
• Chest pain.
• Fast heartbeat.
• Cough.
• Bluish skin.

What questions should I ask my doctor?

Questions to ask your provider include:

• How advanced is my venous disease?
• What can I do at home to manage my venous disease?
• Do I need medication or a procedure for my venous disease?
• Are there treatments you can provide in your office?

A note from Cleveland Clinic

Many people have venous diseases, so you’re not alone. Talk with your provider about your condition and how you can manage it with their help. Learning as much as you can about your specific disease will help you make informed choices about your treatment and how to care for yourself.