Varicose and Spider Vein Terms

ablation
Process in which chemical bonds are broken by thermal energy (heat).
(See saphenous vein ablation)

ambulatory phlebectomy
Removal of portions of a vein through a small incision. Ambulatory phlebectomy is an office procedure done with local anesthetic.

causes of varicose veins
Varicose veins are caused by the development of weak or faulty valves inside veins. The blood in leg veins is supposed to flow back towards the right side of the heart. One-way valves located inside the veins prevent the blood from traveling backwards with the force of gravity. When these valves do not function properly, backward flow of blood causes increased pressure on the preceding section of vein, resulting in formation of varicose veins over time. (Also see risk factors for development of vein disease).

catheter
A thin tube. In the type of greater saphenous vein ablation done using radiofrequency energy (Closure), a catheter with a 1/8 inch diameter is threaded directly into the vein to be treated (i.e. the greater saphenous vein ablation or lesser saphenous vein).

chronic venous insufficiency
Condition resulting from on-going venous reflux disease. Can result in varicose veins, skin discoloration in the ankle areas (see stasis discoloration), swelling of legs, and the possibility of venous ulcer formation. (also see restless leg syndrome)

Closure
Trademarked name of saphenous vein ablation done using radiofrequency energy. Closure is usually done in the office and uses local anesthesia. The Closure procedure replaces the older surgical procedures of vein stripping and high ligation of the saphenous vein.

compression stockings
Stockings with a specific amount of compression, available only with a prescription, used to treat chronic venous insufficiency and/or to prevent the development of venous insufficiency or other vein diseases. (See also graduated compression stockings).

deep vein thrombosis (DVT)
Blood clot in a deep vein. These blood clots can cause pulmonary embolus wherein a blood clot in a deep vein breaks loose and travels to the lung where it blocks circulation.

deep venous system of the leg
One of the three major systems of veins in the leg (see also superficial veins, perforator veins). The deep venous system of leg veins is located deep in the leg and receive blood from more superficial veins. This system transports blood back to the heart. The deep venous system is under the highest pressure of any leg vein systems. (See also femoral vein and saphenofemoral junction. Contrast with greater saphenous vein and superficial venous system of the leg).

Duplex scan
Method of study using ultrasound technology used to show direction and velocity of blood flow.

effect of pregnancy on vein disease development
Pregnancy is one of the most common times women develop vein problems. During pregnancy the mother has an increased blood volume. In addition to increased blood volume, the growing baby puts pressure on the largest vein of the body located in the abdomen (the vena cava) which is transmitted to other veins down the legs. The hormonal changes that occur during pregnancy also affect veins. Pregnancy as a whole is a “set-up” for vein valve stress and damage. While it is true that by about three months after delivery, vein problems have improved, damage done to the vein valves does not repair itself and vein problems may become worse with subsequent pregnancies. Though repair is not done during pregnancy, it is certainly desirable between pregnancies. It is important for all the reasons just listed to ask a health care provider about the advisability of wearing compression stockings during pregnancy to help prevent development of vein disease.

EVLA
A method of saphenous vein ablation. EVLA uses heat created by a laser to cause changes to the greater saphenous vein that in turn cause the vein to become non-functional and symptoms of varicose veins and chronic venous insufficiency to improve. (See laser).

excision of varicose veins
Surgical procedure which employs multiple small incisions to remove varicosities. Drawbacks include multiple scars (and possible keloid). Other varicose veins may form because the problem is not being addressed at the source.

extravasation
Escape of fluids into surrounding tissues

feeder vein
Larger vein that frequently can be seen under the skin leading to a telangiectasia or spider vein complex. (See also reticular veins).

femoral vein
Leg vein of the deep venous system located in the groin area. The femoral vein joins the greater saphenous vein at the saphenofemoral junction, a site that is important in the development of reflux and subsequent varicose vein development.

general anesthesia
Anesthesia that is complete and affects the whole body with loss of consciousness occurring when the anesthetic acts on the brain.

graduated compression stockings
Compression stockings in which the pressure is greatest at the level of the foot and decreases gradually up the leg. These stockings are a useful part of conservative therapy to prevent the progression of vein disease (varicose veins, spider veins and chronic venous insufficiency)

greater saphenous vein
Largest superficial vein in the leg. The greater saphenous vein is often the site of reflux from the deep venous system of the leg. It is located on the inside of the ankle and runs all the way to the groin where it joins the deep venous system at the saphenofemoral junction.

greater saphenous vein (GSV) ablation
Term used to describe procedures that render the greater saphenous vein non-functional without surgery and/or general anesthesia. There are two main types of GSV ablation: radiofrequency (called Closure) and laser (EVLA).

high ligation of the saphenous vein
Surgical procedure in which an incision is made in the groin and tissue is dissected to the level of the saphenofemoral junction. The greater saphenous vein is then clamped, tied off, and severed. This procedure does not address perforator reflux.

interventional radiologist
Medical doctor whose subspecialty it is to do minimally invasive procedures (i.e. saphenousvein ablation). Interventional radiology procedures typically use some type of image guidance (i.e. ultrasound). Interventional radiologists are adept at accessing blood vessels and do so routinely to perform their minimally invasive procedures.

keloid
Excessive scar tissue formation that can be cosmetically objectionable. People with naturally darker skin are more susceptible to keloid.

laser
Device that emits intense heat by focusing various frequencies of light into a small powerful beam of one wavelength radiation. (See EVLA)

lesser saphenous vein
Leg vein belonging to the superficial venous system of the leg that can be a site of reflux from the deep venous system.

lidocaine
A local anesthetic

local anesthesia
Anesthesia used to affect a local area only. Contrast with general anesthesia

matting
(See telangectatic matting)

minimally invasive
Procedure that is carried out by entering the body through the skin with the smallest damage possible. (See interventional radiologist, saphenous vein ablation).

necrosis
Death of tissue

perforator veins
In the leg, perforator veins connect the deep venous system and the superficial venous system. Often the site of reflux occurrence.

phlebitis
Inflammation of the wall of a vein. This condition is usually treated with heat, elevation, compression stockings and non steroidal anti-inflammatory drugs (i.e. aspirin, ibuprofen). Very rarely, an antibiotic is used in treatment. (see related condition, superficial thrombophlebitis)

Polidocanol
Fluid (sclerosant) used in sclerotherapy. Although not approved by the FDA for the purpose of sclerotherapy, Polidocanol is reportedly the most commonly used sclerosant worldwide and the second most common sclerosant used in the United States.

pulmonary embolus (PE)
Condition in which lung blood circulation in the lung is blocked. ( PE is a potentially life-threatening complication of deep vein thrombosis (DVT).

radiofrequency
Form of energy composed of electromagnetic waves that are converted into heat used in the Closure type of saphenous vein ablation.

reticular veins
Medium-sized vein. These veins are larger than spider veins (telangiectasias), but smaller than the typical varicosities of the greater saphenous vein. Although reticular veins can become varicosed, the term usually refers to a medium-sized vein that is merley visible beneath the skin.

reflux
Backward flow. In the legs this term refers to backward flow of blood allowed when a one-way vein valve malfunctions. Reflux can result in varicose veins, chronic venous insufficiency and telangiectasias (spider veins) when the valves inside very tiny veins do not work properly.

Restless legs syndrome (RLS)
A disorder characterized by sensations in the legs which compel movement. The sensations most often described as “creepy-crawly”, itchy, achy, prickly or boring. Typically, RLS does not involve pain. This disorder is most common in middle and older ages and affects 10-15% of the US population. RLS is most annoying at night and can cause trouble falling asleep, and/or repeated awakenings. RLS sufferers describe symptoms that are made worse by relaxation and which are relieved by activity. There are numerous causes for RLS such as intake of stimulants (including caffeine), side effects of some medications (i.e. beta blockers and antidepressants), alcohol, pregnancy, drug withdrawal, anemia, and chronic liver or kidney failure. Chronic venous insufficiency also appears to be a secondary cause of RLS. Many patients report improvement in or disappearance of their RLS symptoms after having saphenous vein ablation. Medications are also available for treatment of RLS.

risk factors for development of vein disease
The big risk factor for vein disease is family history or heredity. If a close relative in your family has vein problems, chances are greater that you will develop vein problems, too. Pregnancy is the time when many women first have vein problems. This occurs because a og a larger blood volume and the weight of the developing baby can put weight on the large vein which runs through the abdomen (the vena cava), causing increased pressure to be generated down the legs. (for a greater consideration of the role of pregnancy in vein disease development, see effect of pregnancy on vein disease development). Obesity, hormonal changes (especially during puberty, pregnancy and menopause), a history of leg injury and prolonged standing may also play a role in the development of varicose veins, spider veins and vein disease in general.

saphenofemoral junction
A junction located high in the groin area where the femoral vein (deep system vein) is joined by the greater saphenous vein (large superficial system vein). The blood in this location is supposed to be moving from the greater saphenous vein into the femoral vein. It is a frequent site of venous valve malfunction, causing reflux or backward flow of blood from the deep system into the superficial system.

saphenous vein ablation
Procedure in which the saphenous vein (lesser or greater) is ablated (see ablation), causing it to become non-functional. This procedure uses thermal energy procuced either by radiofrequency waves or laser

sclerosant
Treatment method in which a fluid (a sclerosant) is injected into a vein in order to cause a reaction in the walls of the vein which in turn causes the vein to become non-functional and to gradually fade away. Examples of sclerosants include Polidocanol and Sotradecol. (See sclerotherapy)

sclerotherapy
Treatment method in which a fluid (a sclerosant) is injected into a vein in order to cause a reaction in the walls of the vein which in turn causes the vein to become non-functional and to gradually fade away. (see sclerosant, poly........)

Sotradecol
Fluid (sclerosant) used in sclerotherapy. Sotradecol has been used as a sclerosant for many years, but can be difficult to obtain. Extravasation may in rare cases cause necrosis.

spider veins
Also referred to as telangiectasia. Spider veins are very small veins (can be as small as a hair), red or blue in appearance, that can resemble the legs of a spider. Spider veins can occur singly or as a spider vein complex.

spider vein complex or web
Name given to a closely spaced collection of spider veins that are many times created by one feeder vein.

stasis discoloration
Discoloration of the skin in the ankle area caused by chronic venous insufficiency. Components of the blood leak out into the skin causing skin discoloration, skin breakdown and set the stage for possible venous ulcer formation.

superficial thrombophlebitis
Inflammation of a vein of the superficial venous system in conjunction with a thrombus (clot). This condition can be painful, but not life-threatening (contrast with deep vein thrombosis), and is usually treated with local heat, leg elevation and aspirin or other non-steroidal anti-inflammatory drug such as ibuprofen. (Also see phlebitis).

superficial veins of the leg
One of the three major systems of veins in the leg (see also deep venous system of the leg, perforator veins). Superficial veins collect blood from the skin and other superficial tissue and transport it to the deep venous system, sometimes through perforator veins. The largest superficial vein of the body is the greater saphenous vein.

support stockings
Stockings that are available “over the counter” which supply a small amount of compression to the legs when worn. Compression can be helpful to prevent or slow down the development of vein disease. The compression offered by support stockings, however, is frequently not enough to be truly helpful in preventing varicose veins, spider veins or vein disease in general. In the absence of arterial disease, graduated compression stockings are much more effective.

Ted hose
Compression stockings frequently used in hospitals to prevent deep venous thrombosis in the inactive or bedridden patient. Graduated compression stockings are much better to use for the long-term prevention of venous disease.

telangiectasia
Medical name for spider veins. Veins that are dilated, tiny or small, and frequently form branches that loosely resemble spider legs. All veins contain one-way valves and telangiectasias are a result of vein valve malfunction on a very tiny level.

telangectatic matting
Refers to the occasional appearance of tiny new spider veins (telangiectasias) after sclerotherapy or surgical removal of varicose veins. Matting can look like a blush of the skin.

thrombus
Clot. In the venous system, the location of the clot is important. If the clot or thrombus forms in the deep venous system it can create a deep venous thrombosis (DVT), and possibly a life-threatening condition of pulmonary embolus. If the clot and inflammation occur in the superficial venous system, it is not usually of grave concern and can be treated effectively with local measures. (See phlebitis and superficial thrombophlebitis)

tumescent anesthesia
Mixture of normal saline, lidocaine (a local anesthetic) and sodium bicarbonate injected into the leg during greater saphenous vein ablation. Tumescent anesthesia not only supplies pain relief but also provides protection for tissue surrounding the greater saphenous vein during its ablation.

ultrasound
A non-invasive type of study that uses inaudible sound waves to highlight tissues with varying densities. This mode of study can be used to outline various tissues and organs in the body. Often used along with a Doppler or duplex study, which can be used to show direction and velocity of blood flow.

ultrasound guided sclerotherapy
Technique in which ultrasound is employed to do a sclerotherapy injection.

valve
A small flap inside a vein which should only permit one-way flow. When valves malfunction, backward flow of blood (called reflux) is allowed, causing pressure elevation in the preceding area of the vein. This can lead to formation of varicose veins and telangiectasias (spider veins).

varicose veins
Enlarged, ropey, bulging and twisted superficial veins. Varicose veins are formed when the one-way valves inside veins do not work properly for various reasons (see risk factors for vein disease). If the vein valve becomes damaged or does not do its job, blood is allowed to leak backwards, causing increased pressure on the preceding area of the vein. Over time, the vein walls become thickened and enlarged. Varicose veins often produce aching and pain (see also varicose vein symptoms), and are many times present in the condition of chronic venous insufficiency. Once venous valves are damaged, they cannot be repaired. (See related varicose vein complications).

varicose vein complications
Varicose veins often signal the presence of a condition called chronic venous insufficiency. Leg swelling, pain, feelings of heaviness, aching, discomfort, restless legs, itching and possible venous ulcer formation are all possible complications of varicose vein disease. Some varicose veins are very superficial and may also bleed spontaneously or with very little trauma such as a bump.

varicose vein symptoms
Symptoms caused by varicose veins are many and may include swelling, (especially in the ankle area and especially after a long day of standing), sharp pain, aching, heaviness, itching, restless legs, congestion, pressure, throbbing and tiredness. Discoloration, called stasis discoloration, may be present in the ankle areas and above, and over time, venous ulcer formation may occur.

varicosities
Varicose veins

vein light
A special light which, when placed on the skin can transilluminate veins not seen on the skin’s surface. (The effect is similar to that of placing a flashlight directly on the skin, but more “illuminating”). Vein lights can be very helpful in locating the “feeder veins” that frequently supply spider vein complex.

vein stripping
Out-dated surgical procedure in which the greater saphenous vein is actually pulled out of the leg.

vein disease
(See venous disease)

venous disease
Disease of the veins such as: spider veins (telangiectasias), varicose veins, chronic venous insufficiency, and venous ulcers.

venous stasis leg ulcer
Possible consequence of chronic venous insufficiency. (About 10% of patients with chronic venous insufficiency will develop venous ulcers). Venous ulcers can be very difficult to heal and also tend to reoccur. Treatment must include some form of compression. Greater saphenous vein ablation is very helpful in the treatment and prevention of venous ulcers.

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