Varicose Veins


Your veins are responsible for returning blood to the heart from all the body’s organs. To reach the heart, the blood must flow upward from the leg veins. To keep the blood flowing up, the veins contain one-way valves.
Chronic venous insufficiency occurs when these valves become damaged and incompetent, allowing the blood to leak backward toward the foot. When the leg veins and valves are weakened to the point where it is difficult for the blood to flow up to the heart, blood pressure in the leg veins stays elevated for long periods of time, leading to chronic venous insufficiency. Chronic venous insufficiency is often associated with varicose veins, which are commonly leg veins that are twisted and enlarged veins close to the surface of the skin.


Risk Factors for Varicose Veins:

•    Genetic disposition (history of varicose veins in the family)
•    Gender (1 in 3 women and 1 in 5 men are affected)
•    Pregnancy (30 percent of women will develop varicose veins during the first
      pregnancy, and 55 percent will during their second and following pregnancies)
•    Age (older people are more susceptible to develop varicose veins)


•    Cramping
•    Aching/throbbing in leg
•    Restlessness/tiredness
•    Bulging
•    Itching/burning
•    Vein pain in leg
•    Leg heaviness
•    Fatigue
•    Swelling
•    Tenderness
•    Ulcers or chronic wounds in lower legs


Frequently Asked Questions About Varicose Veins:

What Is Chronic Venous Insufficiency?

In the human body a leaky valve is called an “insufficient valve.” It doesn’t matter if the valve is in your heart, your legs, or anywhere else in your body. So, venous insufficiency means leaky valves in your veins. Our leg veins have many one-way valves, which allow blood to travel up toward the heart. Upon standing, the valves close in order to keep the blood from traveling backwards down the leg. When valves don’t close properly, blood travels backwards in the direction of gravity. This valve problem is known as venous reflux or chronic venous insufficiency.


What Are Varicose Veins?

Varicose veins are simply a potential sign of venous insufficiency. Since your leg veins are supposed to transport blood uphill against gravity, when the valves become leaky the whole system backs up. This backed up blood causes your leg veins to distend, resulting in varicosities and symptoms. Symptoms of chronic venous insufficiency are due to the high pressure that develops in the leg veins as the blood travels backward. Over time, the leg veins below the bad valves can become dilated and varicose. This condition always progresses and often leads to complications such as skin damage, chronic leg swelling, blood clots, ulceration and even spontaneous bleeding. The exact location of the abnormal valves is determined with an ultrasound examination that is performed in the vein clinic.


Will Insurance Cover Varicose Veins Treatment?

Insurance plans cover some or all of the varicose veins treatment cost if it is determined that the varicose veins treatment is considered medically necessary due to chronic venous insufficiency. If a varicose veins treatment is purely cosmetic, insurance will not cover the cost.


How Is Medical Necessity Determined?

Medical necessity is based upon the severity of the chronic venous insufficiency as measured with an ultrasound exam; the presence or absence of symptoms; and the presence or absence of complications such as bleeding or non-healing ulcers.


What Are Venous Stasis Ulcers?

Patients who have chronic venous insufficiency will have such congested leg veins that the high pressure inside the leg veins will eventually cause the surrounding tissue to die. The tissue death causes an ulcer to form. In conjunction with a certified wound center, Dr. Nellestein has the expertise to diagnose and treat the underlying venous problems, leading to improved healing rates and lower recurrence rates of these ulcers.


Nellestein Vein Institute
1341 Village Drive
Saint Joseph, MO 64506
Phone: 816-323-4451
Fax: 816-897-3969

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