Understanding venous disease

Venous disease means conditions related to or caused by veins that become diseased or abnormal.

Venous disease is quite common and mild venous disease is usually not a problem. As venous disease worsens, it can become a crippling chronic problem.  

With normal circulation, arteries carry oxygen rich blood from your heart to the body, and veins return the blood to your heart. Veins have one-way valves along their length to keep the blood flowing to the heart. As muscles contract, the blood is squeezed forward in the veins. When muscles relax, the valves shut to prevent blood from flowing backward.

If the vein walls become weak or damaged, or if the valves are stretched or injured, the system stops working normally and the blood begins to flow backward when the muscles relax. This creates unusually high pressure in the veins, resulting in even more stretching, twisting and swelling of veins. The abnormal veins with their sluggish blood flow create disorders known as venous disease.

Venous disease includes:

  • Spider veins

  • Varicose veins

  • Leg swelling and pain

  • Chronic venous insufficiency

  • Leg skin changes

  • Leg ulcers

  • Phlebitis

  • Vascular Malformations

  • Venous Malformations

Meet our team

Experts who care

Our team is made up of:

  • Vascular surgeons

  • Physician assistants


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Symptoms and diagnosis

The symptoms of venous disease


  • Pain or aching discomfort in the legs

  • Heaviness or a tired feeling in the legs

  • Tenderness over the dilated veins

  • Itching

  • Swelling

  • Dermatitis over the lower leg (a red itchy rash)

  • Dark pigmentation of the skin

  • Ulceration (sores that don’t heal)

  • Bleeding from veins close to the skin

  • Phlebitis (hard, tender, reddened vein)

Symptoms usually become worse at the end of the day, or after standing or sitting for long periods. Some women notice that the symptoms are worse during the days before their menstrual cycle. The discomfort may be improved with elevation of the legs.


Varicose veins are easy to see on most people. When a better look is needed, a painless ultrasound is performed in the office. The ultrasound can detect direction of flow in the veins, evaluate valve function, examine the size of feeding veins under the skin too deep to see on inspection and find signs of blood clots. This will allow us to create a treatment plan.


The many treatment options we offer

There are many treatments available from UW Health.

Spider veins and small varicose veins may be treated by injection. Using a small needle, a chemical is injected directly into the vein causing it to close.

laser is a highly focused beam of light. A doctor can use a laser to treat varicose veins. Laser heat damages a vein, which makes scar tissue form. This scar tissue closes the vein. A closed vein loses its source of blood and dies. After a year or two, the vein is likely to disappear.

Endovenous laser treatment can treat larger varicose veins in the legs. A laser fiber is passed through a thin tube (catheter) into the vein. Laser is less painful than vein ligation and stripping, and it has a shorter recovery time. Only local anesthesia or a light sedative is needed for laser treatment. (For ligation and stripping, general anesthesia is used to put you to sleep.)

Vein ligation and stripping is a minor surgery used to remove a damaged vein and prevent complications. If the vein itself is heavily damaged, the vein (or the diseased part of the vein) is removed (stripped). An incision is made below the vein, a flexible instrument is threaded up the vein to the first incision, and the vein is grasped and removed.

During this surgery, one or more incisions are made over the damaged veins, and the vein is tied off (ligated). If the ligation cuts off a faulty valve and the vein and valves below the faulty valve are healthy, the vein may be left in place to continue circulating blood through other veins that still have valves that work well.

Microphlebectomy is a technique to remove varicose veins. Several tiny cuts are made in the skin through which the varicosed vein is removed. Stitches usually are not required.

This procedure typically does not require a stay in the hospital. It may be done in your doctor's office under light sedation with local anesthesia and may be done along with another treatment for varicose veins, including ligation and stripping, laser treatment, or radiofrequency treatment.

Radiofrequency ablation is a minimally invasive treatment for varicose veins. This technique uses radiofrequency energy to heat up and damage the wall inside a vein. This usually closes off a varicose vein in the leg.

To treat a varicose vein, radiofrequency energy is directed through a thin tube inserted through a small incision in the vein. It can be used on large veins in the leg and can be done in an office setting using local anesthesia or a mild sedative. You will be able to walk following the treatment and recovery is short.

After treatment, you will wear compression stockings for 1 week or more. To follow up, your doctor will use duplex ultrasound to make sure that the vein is closed.

TriVex® is a reliable and minimally invasive way to remove varicose veins. The TriVex system requires only a few small cuts, through which your surgeon passes a light that allows them to see the veins. A fiberoptic scope is passed through a second small incision, allowing the veins to be visualized and removed. 

It is performed under a light anesthetic, and patients go home about an hour after the procedure.


More ways we can help

Frequently asked questions

Yes. The foods you eat can either improve or make your varicose veins worse. Eating more colorful fruits and vegetables and high-fiber foods lead to a healthier body. Salty, fatty foods put more pressure on your veins by causing water retention.

While anyone can suffer from varicose veins, women are more likely to develop them than men. Pregnant women are at a very high risk. People with a family history of varicose veins are generally more likely to develop them.

The two are generally not related. Spider veins are caused by mild swelling and rarely stick out as much as varicose veins. They are also less painful.

Compression stockings put direct pressure onto your veins. This increases blood flow, reduces swelling and prevents blood from pooling. Before you begin wearing compression stockings, talk to your doctor about which stocking is best for you.

  • Increasing age

  • Family history

  • Pregnancy and hormonal changes

  • Obesity

  • Prolonged standing

  • Prior deep venous thrombosis

Most insurance companies cover treatments for varicose veins that are medically necessary. Any treatment for cosmetic reasons, including sclerotherapy, is not covered.