Fletcher Allen, a Vermont university hospital and medical center, serves all of
Vermont and the northern New York region. Located in Burlington, Fletcher Allen is a regional, academic healthcare center and teaching hospital in alliance with the University of Vermont.
Varicose Veins and Chronic Venous Insufficiency
- Vascular Surgery
- Medical Center Campus
- Main Pavilion, Level 5
- 111 Colchester Avenue
Burlington, VT, 05401 - Phone: 802-847-4548
- 1-877-817-5030
- Monday-Friday, 8 AM-5 PM
- Directions
Chronic venous insufficiency is a condition that occurs when the leg veins cannot pump enough blood back to the heart, and is the cause of varicose veins.
In healthy veins, blood flows from the limbs back to the heart. Valves are present in leg veins and help prevent blood from flowing backwards.
With venous insufficiency, those valves become damaged and no longer work properly. This results in blood pooling in the legs. The cause of venous insufficiency is not completely understood, but damage may result from varicose veins -- enlarged, twisted blue or purple veins -- a blood clot, or muscular problems.
As a result, patients may suffer from ankle and leg swelling; a heavy, tired or aching feeling in the legs; and pain while walking or after being on one’s feet all day. Other symptoms can include skin discoloration, varicose veins and skin ulcers.
Venous insufficiency is not usually considered a serious health risk. Treatments are directed at reducing pain and disability, prevention of venous ulcers and improving cosmetic appearance. The goal is to not only treat what is visible, but to address the underlying cause to prevent the condition from worsening.
Risk factors for developing venous insufficiency include:
- Older age
- Gender (women are more likely to develop the condition)
- Varicose veins
- Deep vein thrombosis (blood clot)
- Phlebitis (blood clots in superficial veins)
- Family history of varicose veins
- Obesity
- Inactivity
- Muscle weakness
- Pregnancy
- Smoking
Venous insufficiency treatment at Fletcher Allen
At Fletcher Allen, our highly skilled vascular surgeons provide expert care for patients with venous insufficiency and varicose veins. We are committed to providing the best possible care and service for patients and families.
Our philosophy is to make your visit as easy and convenient as possible. We provide multiple services in a single office visit -- minimizing the inconvenience of traveling for several appointments.
For example, our modern, state-of-the-art facility includes a nationally accredited non-invasive diagnostic laboratory, where imaging tests are done. We also provide assistance with insurance pre-approvals.
Patients are often able to meet with a surgeon, have an imaging test and get assistance with insurance approvals during the same visit.
Fletcher Allen’s vascular surgeons use the latest technology and minimally invasive procedures to treat venous insufficiency and varicose veins. In addition, we are committed to personalized, patient-centered care. Every patient who comes through our doors is seen and assessed by a vascular surgeon, who is personally involved throughout their care.
Because Fletcher Allen is a university hospital and health system in partnership with the University of Vermont, you can be assured that your care is informed by the latest scientific innovations and ground-breaking research. Your treatment is backed by a strong commitment to high-quality care and ongoing quality improvement. Fletcher Allen is also dedicated to patient education, making sure you have all the information you need to make informed choices about your care.
Diagnosis: Chronic Venous Insufficiency
Fletcher Allen’s vascular technologists and imaging specialists are specially trained in the latest techniques to diagnose venous insufficiency. Diagnostic tests are performed in our non-invasive diagnostic laboratory located within the Vascular Surgery offices. The process of diagnosis may involve the following:
- Physical exam -- Your vascular surgeon will conduct a full medical history and physical exam. He or she will examine your varicose veins and may measure blood pressure in your legs.
- Duplex ultrasound -- This test may be used to confirm your diagnosis. It can determine if your veins are working properly or if there’s any indication of a blood clot. The test involves using high-frequency sound waves which bounce off the blood cells and vessels. The sound waves create an image of blood flow and blood vessel structures in the legs.
Non-invasive vascular laboratory
Diagnosing vascular problems typically begins in our nationally accredited non-invasive diagnostic laboratory, conveniently located in the Vascular Surgery clinic at Fletcher Allen’s Ambulatory Care Center. Patients are often able to see a doctor and have a non-invasive test during a single visit.
The lab is staffed by registered vascular technologists -- highly skilled specialists with advanced training in non-invasive vascular imaging and testing. By focusing solely on vascular problems, these technologists bring an in-depth knowledge to the diagnosis of vascular patients.
The lab offers imaging and testing for the full range of vascular problems affecting all areas of the body. It provides two main types of testing -- physiological studies and ultrasound imaging. Both are non-invasive tests that are usually painless and relatively quick. They enable your physician to decide whether additional, more invasive tests are needed. These studies also can identify problems such as arterial atherosclerosis or vein disease.
- Physiological studies -- Studies that measure the amount of blood traveling through the vessels with and without exercise. They help determine if blockages exist.
- Ultrasound imaging -- An imaging study that uses sound waves to produce a video image of your blood vessels. Ultrasounds are used to check for a potential aneurysm, as well as blocked blood vessels in the neck, abdomen or extremities. In some cases, it may be the only test necessary to determine the need for an operation or stenting procedure.
Treatment: Chronic Venous Insufficiency
A key goal in treating chronic venous insufficiency is to decrease pain and disability, and prevent the development of venous ulcers. The type of treatment that is right for you will depend on the severity of your condition and your general health.
At Fletcher Allen, our vascular surgeons offer expert care in a personalized manner, working closely with you and your family. We offer the latest minimally invasive treatments for chronic venous insufficiency and help with lifestyle modifications.
We are committed to patient education through all stages of your treatment. We want to make sure you and your family have all the information you need to make the best decisions about your care.
Lifestyle Changes
Taking good care of yourself can make a difference in easing pain and preventing your condition from getting worse. The following lifestyle changes may be recommended:
- Exercise
- Losing weight
- Elevating your legs
- Avoiding long periods of standing or sitting
Our vascular team can help connect you with the resources you need to modify your lifestyle.
Compression Stockings
The use of compression stockings is a common treatment for mild cases of venous insufficiency. Compression stockings are elastic stockings that squeeze the veins and improve blood flow in the legs. They are usually worn daily.
Sclerotherapy
More serious cases of chronic venous insufficiency and varicose veins can be treated with injections or surgical procedures.
Sclerotherapy is a procedure used to treat small varicose veins. Fletcher Allen vascular surgeons perform the outpatient procedure at our Vascular Surgery offices. Your surgeon will inject a chemical into the affected veins, which scars and closes off those veins. The veins are eventually absorbed into the body. As a result, blood that would normally flow to the heart through those veins takes a different pathway through other veins.
Ablation (Closure)
Our highly trained vascular surgeons perform the latest minimally invasive techniques for venous insufficiency and varicose veins. Patients can be assured of working with experienced and knowledgeable surgeons, who are on the leading edge of new developments in vascular surgery.
We offer the Closure procedure for treating venous insufficiency -- a minimally invasive, radiofrequency ablation treatment done on an outpatient basis. Fletcher Allen was the first medical center in the region to offer this procedure for our patients.
The procedure is an alternative to vein stripping -- a more invasive surgical procedure that involves removing long veins through small incisions.
With Closure, your vascular surgeon will position a catheter into the damaged vein through a small opening in the skin. The catheter delivers radiofrequency energy to heat the vein wall. The vein wall shrinks and the vein is sealed closed. Blood flow is then re-routed to other, healthier veins.
The procedure relieves symptoms and results in a good cosmetic outcome, with minimal to no scarring, bruising or swelling. Patients are usually able to resume normal activities within one to two days.
