Venous seal procedure

A patient undergoes a venous seal procedure by Dr. Furlong at Physician’s Vascular Services.

Spider or varicose veins don’t usually top the list of health concerns. Swollen or visible veins are generally considered nothing more than an annoyance.

That’s just one of many myths surrounding venous disease.

Venous disease refers to chronic conditions related to or caused by veins that become weakened or damaged. These problems can include pain or swelling in the leg, chronic venous insufficiency when there’s not enough blood flowing through leg veins, discoloration of the skin, leg ulcers, inflammation of the veins called phlebitis, and swollen or dilated veins known as spider or varicose veins.

“If someone is young and they have a few spider veins, which are usually pencil thin, that’s usually just a cosmetic problem. But if they have anything larger than a spider vein it is indicative of venous insufficiency,” said Joseph B. Furlong, M.D., a doctor with Physician’s Vascular Services.

Furlong, who began working exclusively on veins 10 years ago, is certified by the American board of Radiology and is a Diplomat of the American Board of Venous and Lymphatic Medicine.

“Normally, when we speak about venous disease, we’re talking about superficial venous insufficiency – when the valves of the veins of the skin break, causing abnormal pressures that don’t just cause varicosity but also swelling, tiredness, itching, burning, pain, cramps at night, restless leg and numbness.”

Another myth about venous disease is that it’s a cosmetic issue. In turn, there is a widespread misconception that the cost of vascular treatment is not covered by insurance.

“The truth is that the vast majority of insurances do cover these medical procedures,” said Furlong. “There are purely cosmetic problems and those aren’t covered by insurance. But then there are cosmetic problems with medical symptoms. When we treat the medical symptoms there’s the added cosmetic benefit to that.”

So when is it cosmetic and when is it time to see the doctor?

“A lot of patients don’t really know what’s going on. They believe their legs are tired because they’re getting older when it’s really the venous insufficiency slowly getting worse,” Furlong explained. “Waiting too long to see a physician can result in some real damage being done.

“Veins run straight so if a person sees veins that are enlarged and twisted or running back and forth, they have varicose veins and should have that checked.”

Furlong believes it’s always better to err on the side of caution when it comes to venous concerns. On rare occasions, waiting too long can impact the vein’s ability to transport blood from the limbs to the heart efficiently.

“Venous stasis ulcers can open wounds that can become infected and very painful. I’ve seen some wounds where I was able to look through the skin and actually see tendon and muscle. It is not unheard of that this condition could advance to the point of amputation. But I’ve had over 20,000 patients and I’ve never seen it get to that.”

Treatment for venous disease has come a long way.

“It used to be that all major vein problems were dealt with by venous stripping – tearing the vein out of the leg. It was pretty gruesome,” said Furlong. “And although that procedure is still used in certain parts of the world, it is considered archaic and outdated in most modern countries.”

“I use anything from radiofrequency to treat long veins and I’m getting better than 99 percent success which means there’s about a 1 percent chance the vein will reappear.

Radiofrequency treatment is minimally invasive and applied with a local anesthetic. Patients will feel virtually no pain and can usually resume normal activities within a day.

“For shorter veins, laser is the best procedure. It’s about 85-87 percent effective. When people have these really large, twisted veins, we use micro-phlebectomy where we make a tiny incision and pull the vein out.”

According to the Society for Vascular Medicine, more than 30 million Americans suffer from venous disease, but only 10 percent seek treatment for it.

“One of the major misconceptions is that if you don’t see veins you must not have vein disease and that’s just not the case. Because some veins are located deeper inside the leg, they just can’t be seen,” said Furlong.

“That’s why it’s so important to have any noticeable changes in the leg checked out because you just never know.”