Conditions We Treat
As a comprehensive treatment location, the Venous Health Program encompasses all variations of venous disease. Our team of physicians will work closely with you to deliver the most appropriate therapy.
Venous Thromboembolism (VTE) affects nearly 1 million Americans every year, many of whom are hospitalized as a result. It is also the third most common vascular disease, after heart disease and stroke. VTE includes the following conditions:
- Deep vein thrombosis (DVT). Deep vein thrombosis is the abnormal clotting of the blood in a vein deep in the body, usually the lower leg or thigh. Our team will offer guidance for appropriate treatment and duration of therapy. We also have a number of efforts underway to help prevent DVT. One study involves risk-assessment for every patient admitted to the hospital, determining who may benefit from anti-clotting medications (known as anticoagulants or blood thinners) to reduce their risk for DVT.
- Pulmonary embolism (PE). PE is potentially life-threatening, but treatable and preventable in many cases. PE occurs when a clot breaks free from its original site in a vein and travels through the heart and into the lungs. About 200,000 Americans die of PE every year. Deaths from PE are several times more common than deaths from breast cancer, car crashes and AIDS combined.
Varicose Veins and Chronic Venous Insufficiency
- Varicose veins are swollen and raised just under the surface of the skin. They are dark purple or blue in color and can look like twisted, bulging cords. Varicose veins are often one-quarter inch or larger in diameter. They are generally found on the backs of the calves, the inside of the leg or anywhere from the groin to the ankle.
- Spider veins are similar to varicose veins, but they are substantially smaller. They are often red or blue in color and are generally closer to the surface of the skin than varicose veins. They can look like a tree branch or spider web with their short jagged lines. They can cover very small or very large areas of skin.
- Chronic venous insufficiency, or post-phlebitic syndrome, may be caused by a previous DVT, though they can happen without one. Signs or symptoms that may develop are:
- Itching and dryness of the skin of the lower leg
Complex Venous Management
Sometimes venous disease is caused by anatomical abnormalities rather than common risk factors. Management of these conditions in someone who is asymptomatic is most often risk reduction. For those individuals that are symptomatic with a history of venous thrombosis, long-term anticoagulation, as well as interventional therapy, may be appropriate.
- May-Thurner syndrome is not a disease, but an anatomical variation that can lead to the narrowing of the left iliac vein, due to pressure from the right iliac artery. This causes the vein to narrow, obstructing blood flow and causing swelling and pain in the left leg. Clots can also form in the narrowed vein. May-Thurner syndrome can lead to deep-vein problems, including clot formation. This condition is not uncommon in young women.
Treatment usually involves an aggressive approach with a combination of clot-dissolving medication and catheter-guided devices to mechanically remove clots. Sometimes a stent is inserted to widen the narrowed portion of the vein. Another surgical procedure can temporarily connect a branch of the vein to the side of an artery in order to push more blood through the vein and prevent re-clotting.
- IVC (Inferior Vena Cava) Abnormalities. These most often include IVC absence and IVC duplications. The most frequent non-operative complication of caval abnormalities is deep venous thrombosis of the iliac or femoral veins. IVC duplication is considered a congenital abnormality, while IVC absence is thought to be secondary to intrauterine thrombosis of the vena cava. Both can result in venous system symptoms.
Patients with arterial venous malformations are referred to the U-M AVM Plastic Surgery Center, while patients with lymphedema are referred to Occupational Therapy or Physical Therapy.