Case Number: RMVC-04-10-2007

Gender: Female              Age: 62

History: Both her father and grandmother suffered from varicose veins.

Occupation: School teacher

Symptoms: She has had signs and symptoms of varicose veins for over 20 years. Her symptoms continued to worsen, but were exacerbated by an auto accident several years ago. Her leg symptoms were; aching legs, swelling, cramping, and itching and progressively worsened until she developed lower leg ulcerations.

Treatment: We performed a lower extremity venous ultrasound to help understand the root cause and location of her disease.

Our findings prompted us to perform an endovenous ablation with Radio Frequency Ablation of the saphenous veins that were the major source of her venous insufficiency in both legs. Later she required injections to close the smaller incompetent perforator veins to complete her treatment.

Care Recommendations: We recommended the patient walk daily, and engage in light to moderate exercise.

Case Number: RMVC-05-15-2007

Gender: Female              Age: 29

History: Both her mother and grandparents had varicose vein problems.

Occupation: Waitress and mother of three

Symptoms: Her waitress job required extended periods of time standing. She complained of adverse lower extremity symptoms of bulging veins, legs aching, and feeling tired and heavy at the end of the day.

Treatment: We performed a lower extremity venous ultrasound to help understand he source of her symptoms.

Our findings prompted recommendation for Endovenous Laser Treatment (EVLT) of both greater saphenous veins (GSV), and the right accessory vein (ASV). After the closure of these veins she required 2 sessions of Ultrasound Guided Foam Sclerotherapy to complete her treatment plan.

Care Recommendations: Following the successful procedures, we recommend the patient begin a daily regimen of walking, light moderate exercise, and general physical activity. We also suggested that she wear compression stockings when standing or sitting for extended periods of time to reduce the recurring problems.

Case Number: RMVC-05-04-2010

Gender: Female              Age: 70

History: She is not aware of any family history of vein problems. Her leg pain had been so severe that she required narcotic pain medication to control the pain prior to her treatment plan.

Occupation: Mother and homemaker

Symptoms: She started noticing lower extremity swelling about four years ago, and then for two years has been plagued with progressive leg pain. Interestingly, she has never had visible bulging of her varicose veins.

Treatment: We recommended a lower extremity venous ultrasound to help understand the source and cause of her symptoms.

Our findings prompted recommendation for Endovenous Laser Treatment (EVLT) of both greater saphenous veins (GSV), and the right accessory vein (ASV). After the closure of these veins she required 3 sessions of Ultrasound Guided Foam Sclerotherapy to complete her comprehensive treatment plan.

Care Recommendations: Following our successful procedures she no longer required narcotic pain medications. She was encouraged to walk daily, and engage in light to moderate exercise.

Case Number: RMVC-02-27-2008

Gender: Male              Age: 37

History: Patients mother suffered from varicose veins. He was told that he would most likely become a candidate for vein stripping.

Occupation: School Teacher

Symptoms: He suffered from large visible bulging varicose veins in his right leg. In addition, to aching leg pain, frequent restlessness, and itching of the lower leg that became progressively more bothersome over a 10 year period.

Treatment: We performed a lower extremity venous ultrasound to identify the exact source of his condition.

Our findings prompted recommendation for Radiofrequency ablation (RFA) on his right greater saphenous vein, with Microphlebectomy of the large protruding varicose veins. Within the next few months following the RFA treatment we performed two sessions of Ultrasound Guided Foam Sclerotherapy to complete his comprehensive treatment plan.

Care Recommendations: Following our successful procedures we recommended that the patient walk daily, wear compression stockings when standing or sitting for long periods of time, engage in light to moderate exercise. He will follow up for evaluation with recurrent symptoms, or in 6-12 months monitoring for venous insufficiency, and early intervention if indicated.

Case Number: RMVC-08-24-2010

Gender: Female              Age: 56

Occupation: An acupuncture therapist works full time standing for extended periods of time in her practice. Her lower extremity symptoms of aching leg pain, swelling, cramping, and restlessness had bothered her for at least 16 years before coming to Rocky Mountain Vein Clinic in Billings Montana for evaluation, and treatment.

Symptoms: Her veins started bothering her in relation to pregnancy. Her father suffered a pulmonary embolism, and a sister had a deep vein thrombosis. Two of her sisters tested positive for a hypercoagulable condition (susceptible to blood clots). The patient’s symptoms had become progressively more bothersome over time, and were starting to limit her activities of daily living, and having an adverse affect on her quality of life.

Treatment: Her initial ultrasound findings prompted recommendation for Radiofrequency Ablation (RFA) of the left Greater Saphenous Vein (GSV), and Microphlebectomy in the left lower leg. She subsequently required three sessions of Ultrasound Guided Foam Sclerotherapy in the left leg. She later started to develop worsening symptoms in the right leg, and a repeat ultrasound identified more severe venous insufficiency in the right lower extremity, and it was recommended that she have RFA of the right GSV, SSV, and Accessory Saphenous Vein (ASV).

Care Recommendations: Prophylactic anticoagulation for 1 week post procedure to protect against blood clots (due to her family history). Following successful procedures her symptoms were alleviated, we recommended that she walk daily, wear compression stockings when standing for extended periods of time, engage in moderate exercise, and follow up in 6 months to a year for ultrasound and evaluation.

Case Number: RMVC-6-08-2010

Gender: Female              Age: 73

History: She is a mother of a 51 year old disabled daughter who she has cared for since birth. She has had leg pain, swelling, cramping, and restlessness for the past 10-15 years and now has progressed to the point of intolerable.

Occupation: Retired

Symptoms: Continued deterioration of the veins in her lower leg – causing severe swelling, cramping, and restlessness began to affect her most basic of daily activities. This is a typical case where, as we age our valves weaken and the symptoms continue to increase in severity.

Treatment: Treatment recommendation was for a lower extremity venous ultrasound to understand the exact source of her symptoms. Our findings prompted recommendation for Endovenous Laser Therapy (EVLT) of the left accessory saphenous vein (ASV), and a large incompetent perforator vein (IPV) in the lower leg, as well a Microphlebectomy (MP) of the large protruding vessels in the lower leg. After which she required 2 sessions of Ultrasound Guided Foam Sclerotherapy (USFS) to close IPV’s and complete her treatment.

Care Recommendations: Following our successful procedures we recommended the patient walk daily, and engage in light moderate exercise.

Case Number: RMVC-04-30-2010

Gender: Male              Age: 61

History: No family history was available.

Occupation: A mechanic at a manufacturing plant who works 12 hour shifts on concrete floors standing most of the time. About 20 years ago he fell through a floor grate, and required surgical venous repair right leg. He had vein stripping in the right thigh at that time. He ranches when he is not working at the manufacturing plant.

Symptoms: He first noticed varicose veins when he was in the army in 1969. He has had progressive leg pain, swelling, and bulging varicosities. He frequently works 4 consecutive 12 hour shifts, and at the end of those 4 days had suffered severe groin pain.

Treatment: His ultrasound findings prompted recommendation for Endovenous Laser Therapy (EVLT) of right greater saphenous vein (GSV), and 2 incompetent perforator veins (IP) in the right lower leg. EVLT of left accessory saphenous vein (ASV), and 3 IP in the left lower leg. Ligation of a medial accessory saphenous vein (MASV) with Microphlebectomy (MP) of a large varicosity in the left thigh. Re-evaluation in 1 month to assess need for MP of large varicosities in the lower leg. He required sessions of Ultrasound Guided Foam Sclerotherapy starting 1 month after his procedures were done.

Care Recommendations: Following our successful procedures we recommended the patient walk daily, wear compression stockings when standing for extended periods of time, and engage in moderate exercise.

Case Number: RMVC- 01-05-2010

Gender: Female              Age: 36

History: She is not certain of family history although her mother had leg problems and her physician told her she had venous insufficiency.

Occupation: She is a teacher, and a mother of 3.

Symptoms: Her lower extremity symptoms became noticeable after her second pregnancy with varicose veins visible in the right lower leg. She was experiencing nightly leg cramps, leg pain, end of day lower leg swelling, and restless leg type symptoms especially when she was tired.

Treatment: Treatment recommendation was to have an ultrasound of the lower extremities to understand the source of her symptoms. Our findings prompted recommendation for Radiofrequency Ablation (RFA) of the greater saphenous vein (GSV) on both legs, RFA of the accessory vein of the left leg, as well as a microphlebectomy in the left leg. After which she required a session of Ultrasound Guided Foam Sclerotherapy on each leg to close incompetent perforator veins (IP), and complete her treatment.

Care Recommendations: Following our successful procedures we recommended the patient walk daily, and engage in light to moderate exercise.