Varicose veins on the feet have long been diagnosed but left untreated by vein specialists and phlebologists. Untreated varicosities in the feet contribute to discoloration of the skin and hemosiderosis. They can also cause significant disablity and place the patient at risk of devleoping phlebitis, also known as inflammation of the veins. These varicose veins can also be life threatening with risk of spontaneous bleeding.
Bleeding from varicose veins in the feet can occur without injury and typically occur while patients are in the shower where the skin is warm and the veins are most likely to be dilated. Immediate leg elevation and digital pressure on the vein can control the bleeding. Placing a towel on the bleeder is dangerous as the towel can absorb a lot of blood and not provide adequate direct pressure to stop the bleeding.
Once the bleeding is stopped, the patient should call 911 and go to the emergency room and seek emergency treatment from a vein specialist (phlebologist). Often, emergency room physicians find a vein which has stopped bleeding and discharge the patient from the emergency room. If the bleeding event occurs during the day, they call a phlebologist to place a suture on the bleeding vein site to prevent recurrent bleeding.
Diagnostic work-up
The diagnostic work-up of these patients in the elective setting is Duplex ultrasonography to exclude deep vein thrombosis and also to look for perforator veins feeding these varicosities and increasing venous pressure, which is the underlying cause which eventually leads to bleeding eppisodes.
Once the perforator veins are mapped, then a decision is made as to how to treat varicose veins of the foot. Sclerotherapy is an options and so is microphlebectomy using local anesthesia.
Concommitant truncal venous insufficiency of the saphenous veins should be treated prior to treating varicose veisn of the foot in order to make it successful and to reduce venous hypertension originating from these superficial veins. Following EVLT of the saphenous veins (or ClariVein), perforator veins are treated with EVLT laser and finally microphlebectomy of the foot veins.
If the problem is isolated to the foot, the foot varicosities can be treated with foam sclerotherapy or microphlebectomy.
Dr. Hratch Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 716-839-3638 or www.VeinsVeinsVeins.com
Dr. Hratch Karamanoukian welcomes patients from Ontario, Canada. Our offices are minutes away from the Peace Bridge and patients can be in and out of the office in less than 90 minutes and expect to return to work the same day in 99% of cases. Our offices will help make arrangements for those who want to spend the night in the U.S. - but 99% of our patients drive back home to Canada immediately after leaving the office.
Dr. Raffy Karamanoukian is a member of the American College of Phlebology AND a Diplomate of the American Board of Phlebology. He can be contacted by calling 310-998-5535 or www.SantaMonicaVeinCenter.com
Drs. Raffy and Hratch Karamanoukian have authored 6 books about venous disease. The books are available on Amazon Kindle and Nook books for download.