What is PHLEBOLOGY?

Anatomy review Deep vein system vs. Superficial vein system

Why veins fail

Risk factors for venous insufficiency Genetics Gender Ethnicity Lifestyle Occupation Aging Ankle motility

What to look for and when to refer Spider veins Varicose veins Heaviness Aching Swelling Throbbing Fatigue Cramping Burning Restless legs Changes in the skin and/or wounds that won’t heal A B C D A) Swollen B) Varicosities C) Hemosiderin Staining D) Spider Veins

Questions to ask your patients

Common complaints I hear from patients

Brief overview of modalities to treat venous insufficiency Compression Therapy Endovenous Laser Ablation (EVLA) Sclerotherapy (ultrasound and light-assisted)

Compression Therapy

Endovenous Laser Ablation

Sclerotherapy

Ultrasound-Guided Sclerotherapy

Light-Assisted Sclerotherapy

Questions my vein patients always ask me

Why treat spider veins and varicose veins? 50-year-old woman with aching, cramping, throbbing, swelling, itching, heaviness in her legs bilaterally EVLA treatment and one session of sclerotherapy Relief from her symptoms

Why treat spider veins and varicose veins? Physically fit 59-year-old man was bothered by the appearance of his bulging varicosities Two sessions of sclerotherapy — Give your P.A. POV of why being aware of the symptoms of venous insufficiency is important. — Prevent problems down the line (skin breakdown and ulcers) — It makes a patient’s body feel better; it’s amazing how much your legs affect your health and wellbeing. — It makes your patient’s mind and spirit feel better; it can be a great relief to be able to “wear shorts again” without feeling self-conscious or embarrassed.

Why treat spider veins and varicose veins? 72-year-old woman presented with symptoms of venous disease, including aching and cramping EVLA procedure with follow-up appointments at two and six months Required no further treatment

Why treat spider veins and varicose veins? 45-year-old woman’s symptoms — aching, cramping, pain, heaviness, and numbness in her legs — started when she became pregnant more than two decades earlier Two EVLA treatments and multiple sessions of sclerotherapy All of her symptoms were alleviated

Why treat spider veins and varicose veins? 70-year-old man with a long history of swelling in all of his extremities, with more significant edema in his left leg Suffered with Milroy’s disease since birth EVLA treatment Swelling decreased — plus cramping and itching — and he is now walking comfortably

Why treat spider veins and varicose veins? 65-year-old woman sought help because of veins in her right leg Upon evaluation we saw that both legs were affected — and the disease was worse in her left leg EVLA treatment on both legs, followed by ultrasound-guided sclerotherapy

Why do I love treating veins?