Venous Disease Treatments

Overview

What are venous disease treatments?

Your veins are blood vessels that are one-way routes for blood to flow through your body, toward your heart. Healthy veins have valves, or flaps, that open and close to keep blood flowing in the correct direction. But if you have a form of venous disease called venous insufficiency, these valves usually aren’t working properly. When this happens, blood may pool in certain veins or flow backward. Healthcare providers may also refer to venous disease as peripheral venous disease (PVD).

Venous disease treatments restore proper blood flow and lower your risk of complications. These treatments include medications, catheter-based procedures and surgery. Your provider creates your treatment plan based on the type of venous disease you have.

Common types of venous disease include:

Who performs venous disease treatments?

Depending on the treatment you need, your provider may be a:

  • Vascular medicine physician: These providers specialize in diagnosing and treating venous diseases. They may perform minimally invasive procedures or prescribe medications.
  • Vascular surgeon: These providers specialize in diagnosing and treating venous diseases. They may also perform surgeries and minimally invasive procedures to treat these conditions.

Procedure Details

What are nonsurgical venous disease treatments?

Healthcare providers may use nonsurgical treatments alone or in combination with other procedures or surgery. These include:

  • Anticoagulation: These blood-thinning medications can treat many types of venous disease, including DVT and blood clots.
  • Compression stockings: These socks provide gentle pressure on your legs to help prevent blood from pooling in your veins. Compression stockings may be helpful for managing DVT, varicose veins and spider veins.
  • Lifestyle changes: Your provider may recommend regular exercise, such as walking, elevating your legs or losing weight to help treat certain types of venous disease.
  • Sclerotherapy: This is a treatment specifically for varicose veins. Your provider injects a concentrated salt solution directly into the varicose vein. The solution causes the vein to collapse, so you can no longer see it or feel it.

What are catheter-based peripheral venous disease treatments?

With catheter-based treatments, your provider uses a catheter (thin tube) to provide treatment. Catheter-based treatments use small incisions, so you usually have a short recovery time and a low risk of complications. These procedures include:

  • Angioplasty: Your provider inserts a catheter into your vein and inflates a small balloon at the tip. This balloon stretches the vein open and increases blood flow. Your provider may also place a stent (tube) in the vein to keep the vein open.
  • Catheter-directed thrombolytic therapy: Your provider uses a catheter to deliver thrombolytics (blood clot-dissolving medications) directly to a blood clot. The medication dissolves the clot in a few hours or days.
  • Endovenous thermal ablation: Your provider uses a laser or heat energy to close off a malfunctioning vein. The vein collapses, and healthy veins take over for blood flow. This is also called laser therapy.
  • Vena cava filter: This small, umbrella-shaped filter goes into your vena cava, which is a large vein in your torso. The filter catches blood clots before they can move to your lungs or heart. Your vena cava filter may be permanent or temporary, depending on your needs.

What surgeries are available to treat venous disease?

You may need surgery for venous disease if:

  • Less invasive options haven’t worked for you.
  • Venous disease interferes with your everyday activities.
  • You’re at risk of developing DVT or a pulmonary embolism.

Surgical treatment options include:

  • Ligation and stripping: Your provider removes or ties off a varicose vein. In some cases, your provider removes the vein using a minimally invasive procedure. This is also called endoscopic vein removal.
  • SEPS (subfascial endoscopic perforator surgery): This surgery treats chronic venous ulcers (sores) caused by damaged veins in your lower legs. Your provider uses a small balloon to separate the surrounding tissues from the damaged, perforating veins. Then, they clip the perforating veins, which allows blood to drain out of these faulty perforating veins and into healthy ones.
  • Surgical bypass: This procedure redirects blood flow around a blockage in a blood vessel. Your provider creates a new route for blood flow using a graft (tube). The graft may be a piece of one of your veins or a synthetic tube.

Is venous disease curable?

In some cases, it’s possible to cure or reverse venous disease. For example, procedures to close off a varicose vein and reroute blood flow can cure varicose veins. However, these procedures don’t prevent new varicose veins from forming.

Not all cases of venous disease are curable. Sometimes, treatment manages symptoms or prevents complications, like a pulmonary embolism. For example, a vena cava filter can stop a clot from moving to your lungs or heart, but it doesn’t get rid of the blood clot itself. Blood thinners can keep clots from getting worse and prevent new clots from forming. However, blood thinners don’t remove the existing blood clot.

Risks / Benefits

What are the advantages of venous disease treatments?

Treatments may reduce your risk of life-threatening complications of venous diseases, such as a pulmonary embolism. These treatments can also bring relief from symptoms like:

  • Abdominal or back pain.
  • Bulging veins.
  • Feeling of heaviness or achiness in your legs.
  • Itching or ulcers.
  • Swelling.

What are the risks or complications of these treatments?

Each type of treatment has its own risks and benefits. Blood-thinning medications can have side effects like bleeding. Procedures and surgeries carry a small risk of complications like infection. But in most cases, the benefits of venous disease treatments outweigh the risks. Your provider will discuss whether a treatment is right for you, based on your unique health needs.

Contact your healthcare provider if you’re experiencing side effects or problems after starting blood thinners or having a procedure. In many cases, they can modify your medication or help you manage post-procedure symptoms, like pain.

Recovery and Outlook

What is the recovery time?

After a catheter-based procedure, you can usually return to normal activities within a few days. Your recovery time will vary based on the type of procedure you had, your age and your overall health. If you had surgery, such as an SEPS procedure, full recovery may take two weeks or longer.

When to Call the Doctor

When should I see my healthcare provider?

See your provider if you recently had a procedure or surgery for venous disease and you experience:

A note from Cleveland Clinic

Venous disease is a group of conditions that interfere with proper blood flow. With the variety of treatments available today, many people can live full, active lives with venous disease. Your provider can discuss which options are best for you and what to expect.

Last reviewed by a Cleveland Clinic medical professional on 08/15/2022.

References

  • Davies AH. The Seriousness of Chronic Venous Disease: A Review of Real-World Evidence. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824448/) Adv Ther. 2019;36(Suppl 1):5-12. Accessed 8/15/2022.
  • Lin ZC, Loveland PM, Johnston RV, et al. Subfascial endoscopic perforator surgery (SEPS) for treating venous leg ulcers. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397791/) Cochrane Database Syst Rev. 2019;3(3):CD012164. Published 2019 Mar 3. Accessed 8/15/2022.
  • Stone J, Hangge P, Albadawi H, et al. Deep vein thrombosis: pathogenesis, diagnosis, and medical management. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778510/) Cardiovasc Diagn Ther. 2017;7(Suppl 3):S276-S284. Accessed 8/15/2022.
  • Youn YJ, Lee J. Chronic venous insufficiency and varicose veins of the lower extremities. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406103/) Korean J Intern Med. 2019;34(2):269-283. Accessed 8/15/2022.

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