At Heritage Valley VeinCare, we focus on the diagnosis and treatment of medically significant disorders of the venous and lymphatic systems of the lower extremities.
Chronic Venous Insufficiency (CVI) is a common health issue in the United States that can impact up to 40% of the population. It affects more women than men, and becomes more prevalent with age. The main causes are genetic, lifestyle, or injury related, with the disease commonly progressing over time. CVI is one of the main causes of lymphatic dysfunction, where the lymphatics are initially overwhelmed by the abnormal reverse flow and swelling caused by poorly functioning veins. The swelling can become chronic, and lead to permanent changes in the lymphatic circulation and the skin.
Signs and symptoms of venous dysfunction can range from the presence of visibly enlarged and abnormal veins (varicose, reticular and spider veins), easy bruising and bleeding, an increased susceptibility to blood clots, swelling, heavy and tired legs, aching, cramping, and even restless leg syndrome. Over time the skin can get discolored, exhibit poor healing and eventually lead to venous ulcers.
The VeinCare clinic at Heritage Valley Health System is run by Dr. Qurashia (Corrie) Manjoo. She is a Board Certified Internist with training in Venus and Lymphatic Medicine, the subspecialty that diagnoses and treats problems associated with poorly functioning veins and lymphatics. Every patient who comes to our office is seen by Dr. Manjoo, from initial consultation (including the ultrasound) and continuing through all follow-up care and treatment.
Initial Consultation
The initial in-depth consultation includes a thorough review of a patient’s symptoms and medical history, along with basic education regarding the role that arteries, veins and lymphatics play in circulation. Afterward, a focused physical exam of the legs and a Venous Duplex Ultrasound exam is performed by Dr. Manjoo. This generates a map of the main superficial and deep veins of the legs, and directs treatment.
The Duplex part of the Ultrasound picks up abnormal reverse flow in a vein, called reflux. Significantly refluxing superficial veins should be treated. From these findings, treatment options can immediately be reviewed and discussed with the patient at the time of the exam.
Procedures
At our office, we perform Endo Venous Laser Ablations (EVLA) to close large refluxing veins, using the heat of a laser. The body reabsorbs the vein over the next few months and the circulation reroutes naturally to normal surrounding veins. Veins that are not treated with the laser are closed using a medication made into a foam. This is called Sclerotherapy, and is usually performed over two to three sessions. All treated veins shrink and disappear over the next few months.
Dr. Jas Sandhu, our Interventional Cardiologist associated with the VeinCare clinic, performs the actual EVLA and is assisted by Dr. Manjoo, who does a simultaneous Ultrasound exam. All the follow-up Sclerotherapy is done by Dr. Manjoo to complete treatment. Some patients only require Sclerotherapy, while others need the EVLA, as well. No incisions are required for any of our procedures.
All medically significant and symptomatic venous conditions and concerns are addressed, and comprehensive patient education is provided. We also address other causes of swelling, including the diagnoses of Lymphedema and Lipedema, which can exist on their own, and discuss necessary and current guidelines for treatment. The combination of CVI resulting in Lymphedema is called Phlebolymphedema.
Most patients with lower extremity swelling should have a Venous Duplex Ultrasound exam to see what role their veins play in their swelling. What sets VeinCare apart from other clinics is that our treating physician performs the entire exam, from start to finish.