What are they? Can they be related? ` by Leanna L. Beaumont MSN, APNP with a duplex ultrasound evaluation of Leanna is a board certifi ed nurse practitioner. She is a member of the the veins. The duplex ultrasound is also American College of Phlebology and the American College of Nurse used to evaluate for the presence of a Practitioners. She works with Dr. Terry Gueldner MD, FACS, RPhS more dangerous deep vein blood clot. at The Wisconsin Vein Center in Manitowoc, (920) 686-7900. Are all blood clots in leg eins are blood vessels which Venous stasis ulcers are the most veins the same? return blood to the heart and common type of ulcers on the lower legs No. There are two systems of veins lungs so it can be re-oxygenated. affecting 500,000 to 600,000 Americans moving blood up and out of your legs: V annually. These ulcers are typically This means that blood in the veins a deep vein system and a superfi cial located below the knee in the ankle should move upward from the legs vein system. The deep system veins are area. Some venous stasis ulcers are toward the heart. Bulgy varicose of large diameter and situated close to quite painful while others are virtually veins are an indication that there is the bone, surrounded by muscle. They painless. The borders of the ulcer are blood fl owing backwards instead of are responsible for returning about 90 generally irregularly shaped and often up toward the heart. This backward percent of blood from your legs back surrounded by discolored and swollen fl ow of blood is called venous refl ux or to the heart and lungs. The superfi cial skin. Fluid drainage from the ulcer is venous insuffi ciency. Over time, venous system veins are located in the fat tissue also common and might or might not insuffi ciency leads to the pooling of under the skin, and at times are visible. indicate infection. blood in veins. This causes fl uid to They do not communicate directly with accumulate in the legs and excess What is phlebitis? the heart and lungs. pressure to develop in the veins, causing Deep vein thrombosis (DVT), or blood them to stretch and dilate. Varicose Phlebitis, or superfi cial clots which occur in the deep veins, can veins are an indication of venous thrombophlebitis (STP), is a condition in be a serious condition. The risk is that insuffi ciency. Open sores on the which a blood clot forms in one of the the blood clot breaks free of the leg legs and phlebitis of the veins are superfi cial veins of the body causing veins and travels to the lungs impairing complications which can develop infl ammation and tenderness of the the body’s ability to deliver oxygen. from advanced venous insuffi ciency. vein. This typically affects the veins in the legs, but can occasionally Blood clots which occur in the superfi cial What are venous stasis ulcers? occur in other areas. leg veins, or superfi cial thrombophlebitis Open sores which develop as a Symptoms of a STP (STP), can be quite uncomfortable, but result of venous refl ux are referred include warmth, redness and pose a much lower risk of breaking free to as venous stasis ulcers. Fluid tenderness over the affected and traveling to the lungs. accumulation in the legs makes vein. The vein might also However, in about 40 percent of STP it diffi cult for the cells in that area feel fi rm and cordlike cases, there is also a DVT present. For to obtain the necessary nutrients or because of the clotted this reason, it is extremely important effectively remove the waste products. blood inside of it. to contact your healthcare provider for Gradually the skin in the legs becomes The diagnosis a thorough evaluation if you think you malnourished and fragile. Left untreated, of STP can be might have developed a STP. open sores might ultimately develop. confi rmed Venous stasis ulcers are not a normal How are venous stasis ulcers, part of aging; STP and varicose veins related? they are the The presence of varicose veins result of a is a sign of a venous insuffi ciency treatable venous disorder which increases the risk insuffi ciency disorder. of developing STP or a venous SUMMER 2011 | 1 HEALTH | varicose veins stasis ulcer. Symptoms of venous insuffi ciency include aching, throbbing or burning of the legs especially with prolonged standing or sitting. Swelling of the legs or feet which worsen throughout the day, skin discoloration of the lower legs or the development of varicose veins are also symptoms of venous insuffi ciency. Venous stasis ulcers and STP are complications which can develop as a result of untreated, advanced venous insuffi ciency. How are these conditions treated? The short-term goals of venous insuffi ciency treatments are directed at reducing associated pain and infl ammation, WI VEIN CENTER improving leg swelling, healing venous stasis ulcers and limiting complications from venous insuffi ciency. Medical 1/4 PAGE grade prescription strength compression stockings, periodic leg elevation, walking and over-the-counter medications such as ibuprofen are all used for this purpose. Long-term management of these venous insuffi ciency disorders includes preventing a recurrence of the condition once it is treated. A thorough evaluation by a vein specialist is important. Identifying and treating any underlying vein disorders which contribute to the development of STP, venous stasis ulcers and varicose veins can prevent a recurrence. In individuals who have not suffered from STP or venous stasis ulcers, treatment of any underlying vein disorders including varicose veins might prevent these complications from occurring at all. Defi nitive venous insuffi ciency treatments have improved dramatically in recent years and typically include a combination of AFTER laser closure of veins, injection sclerotherapy and microphlebectomy (mini vein removal). All these treatments can be performed comfortably in 1/4 PAGE BEFORE an offi ce-based setting without the need for hospitalization, general anesthesia or sedation. Down time following these treatments is minimal with the ability to return to work and normal activities immediately. Venous insuffi ciency is treatable and the associated complications are preventable. Early identifi cation and treatment is essential. If you think you might be at risk for venous disease, ask your healthcare provider about it. Help is available! ADVERTISEMENT 2 | SUMMER 2011 .