Symptoms and Warning Signs of Large Vein Disease

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In a previous post, we discuss the difference between large vein disease (LVD) and medium vein disease (MVD). Now we will focus on large vein disease signs (what you see), symptoms (what you feel), and disease progression, including what can happen if left untreated.

What is large vein disease (LVD)?

Large vein disease (LVD), also known as chronic venous insufficiency (CVI), happens when the valves in the veins in your legs stop functioning. Just like a broken public transit system, when the veins don’t work properly, normal traffic patterns come to a halt, creating a host of issues. When this occurs in your veins, these circulatory issues prevent the blood from flowing out of the leg, causing blood pooling. Since venous blood contains waste products, this creates inflammation and leads to a host of additional issues we will discuss later in this post.

Large vein disease (LVD) symptoms

Over time, the inflammation caused by blood pooling in the veins of the legs irritates and damages the tissues surrounding the broken veins in your legs. This tissue damage can cause you to experience the following symptoms in your legs:

Signs and symptoms of chronic venous insufficiency

You may look at this list and realize that, although you may not have skin changes, such as discoloration, open wounds, or visible veins, you may experience one or several of the listed symptoms. In fact, from a visual standpoint, many of our patients have healthy looking legs. In my case, my main symptom was leg cramping. For years, I attributed this symptom to not drinking enough water, not taking enough potassium (how many bananas can one person eat?), a particularly hard workout, or not stretching enough. In the end, the culprit was vein disease.

On the flip side, there are some people who have large, ropey varicose veins normally associated with chronic venous insufficiency and yet maintain they do not have symptoms. This is usually due to the progressive nature of vein disease. People who suffer from varicose vein disease and have visible, large bulging veins experience a progressive increase in symptoms over years, often 10 or more years. They see symptoms as their new normal and will often tell us “Doesn’t everyone have tired and swollen legs at the end of the day?”. Once we have them try graduated compression stockings, they realize what “healthy” blood flow feels like and return to the office realizing they indeed have symptoms associated with chronic venous insufficiency.

If any of this sounds familiar, schedule a consultation at one of our vein clinics today.

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Diagnosis of chronic venous insufficiency

While most people sit somewhere in the middle of these two extremes, meaning they have some visible signs of vein disease and some of the symptoms, the only way to obtain an accurate diagnosis is to visit a vein specialist. Also known as a phlebologist, these health care providers (MD, NP, PA), and their teams, are dedicated to the diagnosis and treatment of chronic venous insufficiency, or varicose vein disease. During your first visit, the team will carefully collect your medical history, inquire about your symptoms, assess your risk for developing chronic venous insufficiency, and as needed, will perform an ultrasound. Medical advances in the last 30 years have been amazing, and this is especially true for phlebology, the field specializing in the diagnosis and treatment of vein disease.

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Treatment of venous insufficiency

The biggest catalyst to this change has been ultrasound: training for sonographers, or those specializing in performing ultrasound exams and technological advances in the ultrasound machines available today. Gone are the days of vein stripping (surgical removal of saphenous veins) and ligation (surgical tying off top portion of saphenous vein) which could have negatively impacted patient quality of life. These old vein procedures had low success rates and poor outcomes, primarily due to recanalization (veins reopening), significant neovascularization (new vein growth in place of removed veins), infection (due to open surgical procedures), and required patients to be inactive (both poor for quality of life and can lead to blood clots).

Today’s minimally invasive vein treatment technology allows us to identify which veins are normal, which are abnormal, the extent of disease, and which procedures are best for each patient, quickly and accurately. Patients receive a customized treatment plan based on their disease process. Most procedures are performed under ultrasound guidance, leading to safer, more effective outcomes. Vein procedures offered today are minimally invasive, have a low risk of infection, excellent outcomes, and patients are encouraged to return to almost all normal activities immediately following treatments. Lunch date with your phlebology team? We’re in!

Read our interview with a VCA vein doctor to learn what to expect with your vein treatment.

Risks of not seeking treatment for large vein disease

Chronic venous insufficiency (CVI) is a progressive disease. There is no cure and without treatment, your symptoms will not improve. In fact, your symptoms, and the signs will only get worse! If left untreated, CVI will increase an inflammatory response which leads to tissue breakdown. This means eczema, discoloration at your ankles and calf, and eventually: ulcers. Venous ulcers occur when the skin in your lower calf breaks down, creating a wound. The wound does not heal on its own because pooled blood in your veins contains waste products rather than clean, oxygenated blood. These waste products go through the vein walls and deposit on the skin. At times, the ulcer may seem to heal, but then it opens again, and again, and again. This will happen until the source, i.e. the vein disease, is treated.

For years, varicose vein disease was believed to be cosmetic. However, with the advances of ultrasound, education, and awareness thanks to the pioneers in our field, we now know this disease is much more than cosmetic. Because of this, most insurances cover most procedures required to treat varicose vein disease. Chronic venous insufficiency is easily diagnosed and treated; in the right hands, patients have amazing outcomes – check out our before and after picture gallery.

If you think you may suffer from LVD, listen to your legs! Reach out to a vein specialist today.

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Medically Reviewed by

Tatiana Goclowski
Tatiana Goclowski is a board-certified family nurse practitioner at Vein Clinics of America. She received her Master's in Nursing Education from the University of Hartford and Master's in Family Nurse Practitioner from Simmons University. She now specializes in ultrasound-guided foam sclerotherapy and visually guided sclerotherapy to provide her patients with best-in-class vein treatment.

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