Discover Your Clues of Venous Insufficiency

Outward signs or symptoms may not be visible.

Ever since William Olson was a child, he excelled at drawing, a talent he later parlayed into a career as an architect. The 79-year-old Chicago native owned a successful firm in the Windy City for more than 40 years until he retired and relocated 10 years ago to Florida.

Photo by Jordan Pysz.

William is impressed by how much better his legs feel since undergoing the ClosureFast procedure.

“I graduated from the University of Illinois with a master’s degree in architecture in 1962,” William recounts. “Illinois is one of the toughest universities around, so I consider that quite an accomplishment. After graduation, I completed three years of apprenticeship, and then took the licensing exam. I passed it the first time.

“I opened the firm in 1968 in partnership with an older gentleman. We did residential architecture and had 18 people working with us. At one point, I developed a website-based program where clients could choose their homes and confer with contractors. We all used that program and worked in concert.”

William worked hard and actively participated in sports his entire life. His legs got pretty beat up and were often stiff and sore. Seven years ago, he started experiencing discomfort in his right leg. His doctor told him there was a problem with the blood flow returning from his right leg.

“As time passed, my left leg was affected as well,” William recalls. “They told me there was a problem with that leg, but it wasn’t as severe as the one in my right leg. Both legs felt heavy and cramped up a lot at night, which was very painful. I had to get up and walk around.”

After William developed a red, bumpy rash on his legs, his cardiologist recommended a colleague who tested William’s legs. The specialist told William his blood flow was fine and no treatment was necessary. But William’s symptoms persisted and eventually worsened. Then, in the pages of Florida Health Care News, William learned about vein disease, the actual cause of his leg discomfort and a potentially treatable disease.

“Every time I got blood drawn or visited a doctor, I found the newspapers in the office and read about my problem and the latest techniques to treat it,” William relates. “I also learned that these techniques, which are proven and effective, are covered by Medicare, and that was very important to me.

“I held on to that information for about a year, but then I woke up one morning and had to put my legs up because of the pain. I was concerned that my problem was getting worse, so I called Dr. Magnant’s office and made an appointment.”

William had saved an article about Joseph G. Magnant, MD, of Vein Specialists in Fort Myers and Bonita Springs.

Dr. Magnant, a board-certified vascular surgeon, is dedicated to the modern and comprehensive evaluation of leg vein disorders and the most advanced minimally invasive treatment of those disorders.

“Since Dr. Magnant performed his ClosureFAST endovenous ablation procedure on me, my vein condition has improved and my legs feel great.” – William

Dr. Magnant began his evaluation by ordering an ultrasound examination of William’s legs. The noninvasive test is performed by registered vascular sonographers in Vein Specialists’ accredited vascular laboratory. The results of the ultrasound showed that William had a condition called venous insufficiency.

“Venous insufficiency exists when the one-way valves in leg veins that return blood from the lower legs to the heart do not close tightly,” Dr. Magnant explains. “When those valves close, they actually prolapse beyond the point of stopping blood flow, basically like a faulty check-valve.

“Essentially, those valves open and close, then flop open the other way, which allows blood to leak and then pool in the lower legs. That pooling creates high pressure in the veins, and that leads to the signs and symptoms of venous insufficiency.”

Photo by Jordan Pysz.

William Olson

Signs are indicators of disease that are visible. They include varicose veins, swelling, skin discoloration, bleeding veins and leg ulcerations. Symptoms are indicators that are felt but are not visible. They include heaviness, achiness or cramping, restless legs and frequent nighttime urination.

If left untreated, venous insufficiency can progress further and cause more serious complications such as bleeding veins, breakdown of the skin and venous ulcers.

The Nighttime Triad

“It’s a certainty that people with varicose veins have venous insufficiency,” Dr. Magnant states. But other patients may not have any obvious signs on the outside. They may only have the unseen symptoms such as the nighttime triad of leg cramps, restless legs and frequent urination.

“William was that type of patient,” Dr. Magnant recalls. “He did not have the obvious presentation of venous insufficiency: varicose veins. But he did have achiness, heaviness, leg cramps, skin rash and discoloration of both legs. And he had these symptoms for seven years. But he did not realize that they were related to venous disease.”

Over the years, William visited several physicians seeking answers to his symptoms, but they did not recognize the problem. Patients with less recognized symptoms of venous insufficiency are often overlooked or misdiagnosed by physicians unfamiliar with vein disorders and treatments.

“I have heard other physicians refer to the disease as varicose vein disease rather than venous insufficiency,” Dr. Magnant states. “Varicose veins are a sign of the underlying disease, which is venous insufficiency.

“It is important that physicians understand this and make the correct diagnosis so that patients with presentations other than varicose veins are not missed and have the opportunity to be treated appropriately.”

To treat William’s venous insufficiency, Dr. Magnant chose an endovenous ablation procedure called ClosureFAST, a thermal treatment that uses radiofrequency heat to seal damaged leaking leg veins. By sealing the diseased veins, blood flow is naturally redirected to healthier veins, which reduces pooling in the legs and improves symptoms and signs.

“We start the ClosureFAST procedure by inserting a small intravenous catheter into the abnormal vein, and through this IV the heating catheter is inserted and advanced into the vein,” Dr. Magnant explains. “We then inject liquid with local anesthesia around the vein to collapse it around the catheter and to absorb the heat from the vein wall during the heating process.

“The local anesthetic in the liquid helps prevent the patient from feeling pain. The vein is then heated with radiofrequency energy, which causes it to shrink into scar tissue and get absorbed by the body.”

“During the procedure, he and his staff explained everything that was going on,” William remembers. “Dr. Magnant took care of my right leg with this venous procedure, but he said my left leg wasn’t nearly as bad as my right leg and did not need to be treated just yet.”

Sound the Alarm

Canton, Ohio, native Tris Heestand, 58, feels lucky to be retired and living in Florida – again. Tris and her significant other moved to the Sunshine State the first time in 2006 seeking a better environment for their family.

Airport photo courtesy of Shutterstock ID: 25359169.

Tris was repeatedly singled out for scanning
at airport security checkpoints, much like this
woman at Seattle-Tacoma International Airport on February 5, 2009. The reason was that Tris’ high-energy varicose veins emitted enough heat to set off the alarms.

“We wanted to raise the kids in a little better area with a better lifestyle,” Tris elaborates. “Florida seemed like the greatest place to start anew. At that time, we lived in the Palm Harbor area north of Clearwater.

“After a while, the inevitable happened. We headed north again for the same reason a lot of people go back: some of our family members became ill. Years later, we looked at each other one day and said, It’s time to go back to Florida.

“We started new again,” Tris comments. “But this time, we moved into a 55-plus community in North Fort Myers, which we enjoy very much. There are many good people here. There are also friends we met up north who live in this area, and I have a sister who lives in Naples.”

Like several members of her extended family, Tris suffers with a condition called congestive heart failure. A common symptom is leg swelling, but Tris soon learned that her swelling had another cause. Her bulging varicose veins were a clue.

“My legs hurt and were weak, and my ankles swelled terribly,” Tris describes. “There was a cluster of ropey varicose veins at the top of my left thigh, and one vein ran down the outside of my leg and across the outside. If I was on my feet for a while, the veins would bulge out a good half-inch.

“The varicose veins were very sensitive. Sometimes, they would burst on their own and I’d get a bruise for no reason. I did not even have to hit them. This typically occurred around my knee, where the skin is thinner. I would be standing there and I’d feel it. Then, I would glance down and my leg would look like somebody kicked it.”

What’s more, Tris’ large varicose veins emitted a significant amount of heat energy, so much that she routinely set off alarms at airport security checkpoints.

“Every time I went through security at the airport, I got stopped,” she recounts. “When I went through the scanning machine, the alarms would go off. It was always from my groin area and the top of my left thigh, and there’d be nothing in my pockets and I’d be wearing shorts, so they had to search me.”

Over time, the swelling and achiness in Tris’ legs grew worse, and she decided to have them evaluated. She didn’t want the problems in her legs to complicate her heart condition. Tris had heard people talk about Dr. Magnant, and she liked what she heard, so she called and made an appointment.

“Dr. Magnant ordered an ultrasound and discovered that I had venous insufficiency,” Tris recalls. “He explained everything using charts, graphs and computers. He said that venous insufficiency is when the valves in the leg veins aren’t functioning the way they should so there isn’t proper blood venous flow.”

Under Pressure

Pooling of blood associated with venous insufficiency leads to high pressure in the veins in the lower leg, and branches connected to those veins can become dilated. It’s these dilated branches, not the main veins, that become ropey varicose veins.

“My varicose veins are gone! I’m truly thrilled with my entire experience at Vein Specialists and with my outcome.”- Tris

“Tris had a branch from her upper thigh that was being pressurized,” Dr. Magnant describes. “Over time, that vein unwound and progressed all the way down her leg to the front of her calf. But her problem was not that varicose vein. Rather, it was the leaking vein on the inside that was feeding that branch, which then became varicose.

“Our goal is always to treat the underlying venous insufficiency, but in Tris’ case, we also had to remove the bulging varicose veins. We chose two minimally invasive procedures for her treatment: endovenous laser ablation and microphlebectomy.”

During endovenous laser ablation, Dr. Magnant uses ultrasound imaging to place a small intravenous needle in the abnormal vein under local anesthesia. A catheter is advanced into the problem vein through the IV. Using laser energy, Dr. Magnant gently heat seals the walls of the diseased veins.

Before and after images courtesy of Vein Specialists

Tris Heestand’s Before and After

Over time, the sealed veins are absorbed by the body. Blood flow from the closed veins is rerouted through healthy veins, and venous pressure is reduced back to normal levels.

“Phleb is vein in Latin, and micro means small, so with microphlebectomy, we make small incisions through which we remove diseased varicose veins,” Dr. Magnant educates. “We use a technique in which we inject water around the vein to essentially squeeze all the blood out of the vein, making it easier to remove the actual varicose veins. This leads to less bruising and better postoperative results.”

“On my left leg, Dr. Magnant removed the cluster of veins at the top and the one that ran down the outside of my leg, and he sealed off the main feeder vein on the inside,” Tris recalls. “Two weeks later, I went back and had the other leg done, but all he had to do on that side was seal one vein.

“The next time I went through security at the airport, I didn’t get stopped. I went right through. It was the first time in probably a dozen flights.”

“Off-the-Charts Good”

Dr. Magnant used two different types of endovenous ablation to treat William and Tris. With William, he used radiofrequency ClosureFAST, and with Tris he used laser ablation. Both procedures seal diseased leaking leg veins with heat. The vascular surgeon also removed Tris’ varicose veins using microphlebectomy.

“My procedures were not painful at all,” Tris reports. “They use local anesthesia, so I just felt a little pin prick. I didn’t know what to expect, especially being awake, but Dr. Magnant made me feel very at ease and relaxed throughout the procedures.

I was very pleased.

“Up and moving around the second day was a little uncomfortable, but after that, with compression hose, it was wonderful. I wish I knew it was that easy. I would have had it done years ago.”

William agrees.

“The ClosureFAST procedure that I had was not difficult at all,” he says. “There’s hardly any pain, and that really impressed me. Since Dr. Magnant performed his ClosureFAST procedure on me, my vein condition has improved and my legs feel great.

“The staff at Vein Specialists who took care of me were fantastic. They were quick, efficient and calming. Dr. Magnant is off-the-charts good and very, very professional. The entire system he has is top notch. And they move you along quite quickly there, so you are not waiting a long time. It’s very impressive.”

After having her bulging varicose veins removed by Dr. Magnant, Tris is happy with the new appearance of her legs.

“My legs look pretty good for someone who is 58 years old,” she reports. “There’s no swelling in my ankles anymore, and I can’t even find the incisions Dr. Magnant made in my leg. I’m so pleased about that.

“I also have no idea where the cluster at the top and the main vein that ran down and wrapped around my leg were. My varicose veins are gone! I’m truly thrilled with my entire experience at Vein Specialists and with my outcome.”

William offers a word of advice to others who are experiencing symptoms similar to his own such as achiness, heaviness and nighttime leg cramps.

“I highly recommended Dr. Magnant and the ClosureFAST procedure to anybody who has venous insufficiency and aching legs and can’t sleep at night.”

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    • Vein Specialists

      Vein Specialists is 100 percent dedicated to identifying and treating vein disorders. Led by Dr. Joseph G. Magnant, they understand that the venous system varies between patients and consists of both deep and superficial venous systems and a net... Read More

    • Joseph G. Magnant, MD, FACS, RPVI

      Joseph G. Magnant, MD, FACS, RPVI, is a Fellow of the American College of Surgeons and is board certified by the American Board of Surgery in vascular surgery. He earned his medical degree from Medical College of Virginia. He completed a g... Read More