Talk:Varicose veins

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I would like to know if anybody has any feedback on the rate at which the veins grow back after going through childbirth? I am concidering getting my varicose veins stripped, and have been told to wait until after having children.--Hilarylberry 10:51, 30 April 2007 (UTC)

Are we sure it is not advocatory that we include a link to leech therapy on this page? Vivacissamamente 14:42, 23 October 2005 (UTC)

I ripped it out. I'm also worried about the barefoot mania. External links are still unregulated, and WP:NPOV does not seem to apply to them/ JFW | T@lk 17:26, 23 October 2005 (UTC)

I don't believe the condition is specific to the leg, at least not according to my GP. I'm not sure enough to make the edit myself but I do think it would be worth researching. 62.69.54.251 21:30, 18 September 2006 (UTC)

Contents

[edit] medical treatment

since when is ibprofen or other anti-inflamatory medication considered non-medical treatment?


Please could the title be changed from 'medical treatment' to 'treatment' as vein stripping is surgical!!! Cheers 81.129.221.26 18:10, 30 September 2006 (UTC)

They mean "surgical treatment" vs. "non-surgical treatment". That's the standard terms in the medical books. I changed it. But I haven't seen anything in the medical books or on the Internet that says ibuprofen does any good for varicose veins. There may be some people who take ibuprofen for everything. If we can't find a verifiable source we should delete it. Nbauman 17:52, 9 February 2007 (UTC)

[edit] Males and Females

In the introduction, it states that varicose veins affect men and women equally, but the Causes section states that women are more likely to suffer from them than men. I have no idea which statement is true. If anyone does, please fix whichever statement is wrong. Thanks. cnodell123 14:29, 28 November 2006

[edit] Surgical treatment, Paragraph 5 (endovenous treatment)

I´m interested in the source for the stated incidence rates regarding complications for radiofrequency and laser ablation. Sources I know state significantly different rates. Can you please give me a hint where these numbers come from. Thanks MickMedi 14:29, 5 March 2007 (UTC)MickMedi

These numbers come from individual studies that you can find indexed on PubMed. Different doctors publish studies with their own results. The results vary among doctors. The same doctors get fewer complications with time as they get more experienced. Nbauman 15:12, 5 March 2007 (UTC)

[edit] Spider veins

Veins2, this is a minor point but I want to put it on the record.

I don't have Derm Surg Onc at hand, but how do reticular veins (blue veins) and telangiectasias (spider veins) "involve" valvular insufficiency? The BMJ article by Campbell that I linked to says, "they are not the same as varicose veins, though they often occur in association with them." I think "association" is a good word.

The idea that spider veins are baby varicose veins is an intriguing concept, but I thought the defining concept of varicose veins was hypertension caused by vascular insufficiency -- although I can't find a good citation right now. Campbell just says that in varicose veins the valves are "usually incompetent" which leads to reflux with hypertension.

I like the idea of defining varicose veins as an entity that is caused by valvular insufficiency, and thus distinguished from all other entitites that are not caused by valvular insufficiency. I know that a lot of doctors like to take 2 diseases and say, "they are on a continuum," but then you never get precise definitions, and sometimes they turn out to have completely different mechanisms and completely different treatments.

It sounds plasuable that there is a common cause, plausably a genetic variation in the collagen, elastin, matrix metalloproteinase enzymes or something which causes many vascular conditions, but I don't know that and I can't document it.

The hereditary aneurysm defects like Marfan's were caused by a defect in the collagen, but now doctors tell me they think the aneurysms of aging are caused by a defect in the MMP enzymes. So you can't assume that just because they all look alike they're all aspects of the same disease. Or can you?

It's not acceptable for molecular biology purposes, but it may be acceptable for billing purposes. Nbauman 16:54, 9 March 2007 (UTC)


NBaumann.

Regarding valvular insufficiency in reticular (medium sized blue veins) and spider veins, this is a well established phenomenon. The quoted article was a significant step in proving its existence.(it was a lot harder to prove initially because of the size of these veins being not visible on early low frequency ultrasounds).Somjen et al in that same journal volume also had similar findings- " Anatomical Examination of Leg Telangiectasia with Duplex Scanning". With modern machines and 17MHz probes, reflux is easily identifiable.

The anatomy of the veins in the leg is a major determinant of why some veins are varicose and others produce spider veins, though of course there is a crossover between the two groups. Essentially spider veins are formed when venous hypertension is transferred to the tiny veins in the surface of the leg. This can originate from axial reflux via the SFJ, SPJ or perforating vein incompetence. Or it can originate from medium sized reticular veins and their (smaller, lower-pressure) perforators or other connections to the deep system. As you would be aware there are up to 100 (some authors say more) connections between superficial veins and the the deep veins of the leg. Veins down to 40 microns in diameter have venous valves.

So indeed in at least one respect there is a similarity between varicose veins and smaller reticular and telangiectatic vessels, with valvular insufficiency being the common factor, and the extent of disease being determined by the location of the source of reflux. What the cause of the valvular dysfunction is, that is something that may be different between the entities and i don't think that there has been a defined cause of either. (Vein2 04:37, 20 March 2007 (UTC))

[edit] Costs

Vein2, why eliminate references to costs? That's a significant difference, doctors tell me.Nbauman 20:15, 15 March 2007 (UTC)


NBaumann. With regard to costs, there is are couple of issues with the line as it was. Firstly, wherever it is performed, foam echosclerotherapy is likely to be less expensive that surgery or laser/RF, so the line needed to be corrected. Secondly, the costs of the procedures are going to be different between countries and even within different treatment centres. And thirdly, the cost to the patient is also likely to vary widely depending on the insurance/ health care system and its relative benefits for each of the procedures. So with all this variability, and with charges changing over time, i thought this line to be best left out. (Vein2 05:00, 20 March 2007 (UTC))


[edit] american college of phlebology link.

NBaumann. What was the problem with a link to the american college of phlebology website? I myself have no association with this college but I would consider it an important website. I just had a look and found some nice diagrams. See the anatomical images movies of reflux as well as the definition of terms. The information for patients section seemed pretty thorough and unbiased, and I would think that a link to this respected college would be logical especially for North Americans. The link I would be pointing at and wondering about its place hee is the one entitled "varicose vein overview"- a one page link with much less information.(Vein2 12:34, 20 March 2007 (UTC))

Veins2, I compared the American College of Phlebology's Phlebology.org to VascularWeb. VascularWeb has much more extensive patient and professional information. In particular, VascularWeb has free access to its newspaper, Vascular Specialist, which has thorough meeting reports and interviews with people who publish in journals like Lancet and NEJM. Phlebology.org didn't have anything that wasn't also in VascularWeb in greater detail, in my reading. If you read VascularWeb, you wouldn't find out anything new in Phlebology.org. In addition, VascularWeb seemed to be more promotional, of its doctors and also its industry sponsors. There are hundreds, maybe thousands of web sites on varicose veins, all of them with good illustrations, and most of them are essentially advertising for medical practices; you can't link to them all. One good one is veindirectory.org if you are looking for an unbiased source of information. My philosophy is that you should choose the ones that would be most useful to your readers, and if you already have one with extensive information, you don't need one that contains only a subset of that information.
I realize that this is subjective. It's a judgment call. If after reading the above you want to put it back in, I wouldn't object. Nbauman 14:45, 20 March 2007 (UTC)

Nbauman. I think you are right to say that not all of the thousands of site especially advertising sites for individual medical practises can or should be linked to. But i also think it is reasonable that a significant, internationally renowned, college like the American College of Phlebology be linked. True, this site has similar information to the vascular surgeons' site- VascularWeb, but in my subjective view the phlebology site is a little more accessible and specific to venous disease. Just my opinion. (Vein2 22:52, 20 March 2007 (UTC))

[edit] Diosmin 95

I would like to correct the article about Diosmin 95 and Nutratech. Diosmin 95 was filed through an NDI process in the US by the swiss company Stragen Pharma and not by Nutratech. Nutratech filed an NDI for Diosmin/hesperidin 90/10 with max daily dosage of 500mg. While Stragen filed an NDI for Diosmin 95 600mg per day.

[edit] Research Your Doctor - Choose a Specialist

When choosing a physicians, remember to do your homework. Read about their experience and research their specialty. The more experience they have, the better. Couple good resources to use is the American College of Phlebology site (phlebology.org) another good one is Vascularweb. Make sure the physician is trained if you go in for the more complicated procedures, such as the endovenous techniques including EVLT and VNUS. Another good resource to use is veindirectory.org; which lists the physician's background. However, don't trust just the websites, call the physician and ask questions such as: 1. How many procedures have you done, 2. How many years have you been practicing in the field of vein treatment and 3. Do you have extensive training for endovenous techniques.

These are just some resources and tips I think will help you get the best attention.