Venous Disease

In normal circulation, blood rich in oxygen travels from the heart to other parts of the body through the arteries. It is returned to the heart and lungs through the veins to receive oxygen.

Veins
As the venous blood flows toward the heart, it travels from the superficial to the deep veins. Superficial veins are located close to the surface of the skin. Deep veins are located in the muscles of the arms and legs.

The walls of the veins are not as strong as the walls of an artery.  This is because the blood flow through a vein is under less pressure and does not flow as fast, therefore not requiring as strong of a wall.

Unlike arteries, veins in the extremities have valves along their length that open as blood flows toward the heart.  The valves then open to prevent blood from moving away (refluxing) from the heart.  Failure of these valves is common and is the source of most varicose veins and venous ulcers.

DIAGNOSTIC TESTS
If a problem with your vein is suspected, certain tests may be ordered.

Venous Ultrasound
This is a non-invasive test which uses ultrasound to send high frequency sound waves which reflects from moving red blood cells.  The test is used to diagnose blood clots, weak valves and incompetent perforator veins (the veins that connect the superficial and deep veins).

Venogram
This is a dye test used to diagnose abnormalities in your veins. This is done as an outpatient procedure when non-invasive tests are indeterminate.

Ascending Venogram
This is done to assess the patency of the deep veins and the presence of a blood clot in the deep veins. Dye is injected into a vein in your foot and x-ray pictures are taken.

Descending Venogram
This is used to assess the valves in the vein to see how they are working and if there is a problem with them. Dye is injected into a vein in your groin and x-ray pictures are taken.

VENOUS ABNORMALITIES

Weak (Incompetent) Valves
With weak valves the walls of the veins become weak and may stop working allowing the pooling of blood. This may cause leg swelling, pain, heaviness, and discomfort.  At worst, ulcers may form.

Varicose Veins
These are superficial veins located close to the surface of the skin that have become stretched and dilated (bulging in appearance). These are located predominately in the legs.

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