Dr. Gregory K. Albaugh, D.O.

Generally, you have veins throughout your skin. When the pressure in the venous system increases over time the veins in the skin dilate  until they can be seen by the naked eye. They will gradually get bigger but the only symptom associated with this is usually itching. Spider veins are not treated by removing them surgically. They are treated with sclerotherapy. This is a procedure where a solution is injected into the spider vein. This causes the inside lining of the vein to scar down and eventually they will disappear. If you have underlying venous insufficiency you may develop more spider veins in other parts of your legs. If you have other symptoms like heaviness, swelling, fatigue or cramps in your legs at night, you more than likely have superficial venous insufficiency. If you just treat the spider veins, your legs will look better but they won't feel any better.

The general risks to vascular surgery are the same for other types of surgery. Every time you incise the skin, there is a risk of bleeding and infection. Antibiotics are given to prevent the infection and your vascular surgeon is responsible for the bleeding. Unfortunately, diabetics are slightly more at risk for infection. The risks of the surgery are specific to the surgery itself. Almost all vascular surgery patients have some evidence of heart disease. Some sort of cardiac workup is usually done to evaluate the risk of having a heart attack during surgery. Vascular surgery is usually done when there is some evidence of under perfusion of a part of the body and the risk of a cardiac complication needs to be balanced with the possibility of losing a limb or having a stroke.

I really depends on what kind of bypass surgery you are talking about. If it is coronary artery bypass surgery you should have relief of chest pain or other heart related symptoms. If it is lower extremity arterial bypass surgery you should have relief of pain in your leg. Generally, if your doctor recommended a vascular bypass and the endovascular option is not available I would not delay it asking for multiple opinions. If you don’t trust the surgeon to do what is best for you I would recommend another surgeon.

It really depends on what type of angioplasty we are talking about. If you have had some type of study of your heart that showed an abnormality, such as an abnormal nuclear medicine study for your heart, then you will be having a cardiac angiogram. When the cardiologist does the angiogram they can identify narrowing in the blood vessels that feed the heart. If your cardiologist is a “interventionalist,” then he will proceed with an angioplasty of the lesion if possible. If the cardiac disease is severe, he or she will take pictures and request a consultation with a cardiac surgeon.
If you are having leg pain from a vascular source and an area of disease has been identified with ultrasonography of some other modality, then the wires and catheters will be directed toward your legs. If I am treating the left leg, I usually enter from the right side. This allows me to evaluate the entire arterial tree from the aorta to the foot. A long sheath( to tube that I operate through) is fed I’ve a wire to the opposite leg. At that time angiography is done and if areas of blockage are identified it is best to address them at that time. There are multiple ways to treat blockages in the legs. Atherectomy is a device that cuts the plaque out of the vessel to improve flow. Balloons of different sizes can be used to open up the vessels and stents are metal mesh tubes that are inserted to hold the vessel open as the inner layer heals.
After the procedure, I prefer to put in some type of closure device. There are a few different types. This seals up the hole in the artery and reduces the amount of time you have to lay on your back with your leg straight.
When any type of angioplasty is done, it is usually followed with some oral medication, such as aspirin or plavix for a period of time. This keeps the platelets in the blood from sticking to the treated area. When they stick to the area, they secrete hormones to cause scarring of the area, which can reocclude the vessel.

Yes, but how bad they are is hard to predict. When you are pregnant your blood volume increase 40% and all the hormones that make it possible to squeeze a baby through your pelvis act on all the connective tissue. That and you have the baby sitting in your pelvis. Your body will go back to normal but the problem called superficial venous insufficiency will remain. It will usually get worst over the years as well.