Venous Disorder

Venous disorders affect the veins—the blood vessels responsible for carrying deoxygenated blood back to the heart. When veins become weakened, obstructed, or damaged, they may fail to function properly, resulting in a range of conditions that can impact mobility, circulation, and overall health. While many venous conditions are manageable with conservative care, others may require surgical or procedural intervention to prevent progression, alleviate symptoms, or avoid serious complications. Advances in minimally invasive venous procedures have made it possible to treat these issues with lower risk, shorter recovery times, and excellent long-term results.

Why Cuba

In Cuba, the management of venous disorders is driven by a patient-centered approach that emphasizes early intervention, minimally invasive solutions, and long-term vascular health. Whether treating varicose veins, chronic venous insufficiency, or deep vein obstructions, Cuban specialists focus on relieving symptoms, preventing complications, and restoring functional mobility. Each case is carefully evaluated to determine the most appropriate course of action, taking into account the extent of venous involvement, patient comorbidities, and overall goals of care.

Medical teams in Cuba are equipped with advanced imaging technology and procedural tools to accurately assess venous function and perform targeted interventions. When suitable, minimally invasive procedures—such as endovenous ablation, sclerotherapy, or venous stenting—are prioritized to reduce recovery time and procedural risk. For more complex conditions, open surgical techniques are employed with the same level of expertise and precision. Patients benefit from an integrated care model that combines post-procedural monitoring, compression therapy, and lifestyle counseling, ensuring not only effective healing but also reduced recurrence and sustained improvement in quality of life.

Types of Venous Conditions

Venous diseases may range from cosmetic concerns to life-threatening disorders. Common conditions include:

• Varicose Veins: Enlarged, twisted veins typically found in the legs due to valve dysfunction.

• Chronic Venous Insufficiency (CVI): Impaired blood return from the lower extremities, often leading to leg swelling, skin discoloration, and ulcers.

• Deep Vein Thrombosis (DVT): Formation of blood clots in deep veins, usually in the legs.

• Venous Ulcers: Chronic, non-healing wounds caused by long-standing venous hypertension.

• Pelvic Congestion Syndrome: Chronic pelvic pain in women caused by dilated pelvic veins.

• May-Thurner Syndrome: Compression of the left iliac vein, which can lead to swelling, pain, or DVT.

• Post-Thrombotic Syndrome (PTS): A complication of DVT characterized by long-term leg pain, swelling, and skin changes.

Causes of Venous Conditions

Venous disorders arise from a complex interplay of genetic predispositions, lifestyle habits, and environmental influences. Key contributing factors include:

Valve Dysfunction or Damage Within the Veins:
Weakened or damaged valves in the leg veins—often due to aging, genetics, or prior injuries—can lead to backward blood flow and pooling, increasing venous pressure and resulting in conditions like varicose veins and chronic venous insufficiency (CVI).

Prolonged Standing or Sitting:
Extended periods of immobility, common in certain professions, reduce muscle activity needed for blood return, causing blood to pool in the legs and raising the risk of venous hypertension and vein-related complications.

Obesity:
Excess body weight places additional pressure on lower limb veins, contributing to valve weakening and impaired blood flow; higher BMI is directly associated with increased severity of venous disease.

Pregnancy:
Hormonal shifts, increased blood volume, and pressure from the growing uterus during pregnancy strain the venous system, heightening the risk of varicose veins and CVI both during and after pregnancy.

History of DVT or Vascular Trauma:
Past deep vein thrombosis or vascular injuries can damage vein walls and valves, leading to post-thrombotic syndrome and chronic venous dysfunction marked by swelling, pain, and skin changes.

Age-Related Changes:
As people age, veins naturally lose elasticity and valves may weaken, making it more difficult for blood to return efficiently to the heart and increasing the likelihood of venous disorders.

Hormonal Influences:
Fluctuations in hormones like estrogen and progesterone can weaken vein walls and valves, particularly in women during pregnancy, menopause, or while using hormonal therapies, elevating the risk of venous insufficiency.

When Surgery Is Required

Surgical or minimally invasive intervention for venous disorders is usually recommended when conservative treatment approaches fail to adequately manage the condition or when complications pose a risk to the patient’s health and functionality. While early-stage venous conditions can often be managed with non-invasive strategies such as compression therapy, leg elevation, physical activity, and weight management, certain clinical scenarios demand more definitive intervention.

• When conservative measures are no longer effective.
• When symptoms become disabling or significantly impact quality of life.
• When complications arise, such as skin changes, ulcers, or recurrent DVT.
• When anatomical vein abnormalities require correction.

In all cases, the decision to proceed with intervention is based on a comprehensive vascular assessment and a personalized risk-benefit analysis, ensuring the treatment aligns with the patient’s clinical profile and long-term health goals.

Pre-Surgery Diagnosis and Evaluation

Before proceeding with venous surgery or intervention, patients undergo a detailed diagnostic workup, which may include:

• Duplex ultrasound: To assess blood flow and detect valve dysfunction or clots.

• Venography or CT/MR venography: Advanced imaging to visualize vein anatomy and blockages.

• D-dimer testing or coagulation studies: To rule out active clotting.

• Physical examination and symptom scoring: To assess severity and plan appropriate treatment.

• Comorbidity evaluation: Ensuring patients are suitable candidates for anesthesia or procedural intervention.

Types of Venous Procedures

Venous procedures are tailored to the severity and location of the condition. Common procedures include:

Endovenous Laser Therapy (EVLT) and Radiofrequency Ablation (RFA)

These minimally invasive procedures are designed to treat varicose veins by utilizing thermal energy to close off malfunctioning veins. A catheter is inserted into the affected vein, through which laser (in EVLT) or radiofrequency (in RFA) energy is delivered, causing the vein walls to heat, collapse, and eventually be reabsorbed by the body. Blood flow is naturally redirected to healthier veins. Both treatments are typically performed under local anesthesia, offering benefits such as reduced recovery times and minimal scarring.

Sclerotherapy

This minimally invasive technique involves injecting a sclerosing agent directly into small varicose or spider veins, leading to vein irritation, collapse, and eventual absorption by the body. Sclerotherapy is primarily used for cosmetic improvements and symptom relief in smaller veins. The procedure is quick, requires no anesthesia, and allows patients to resume normal activities immediately.

Phlebectomy

Also known as micro-phlebectomy or ambulatory phlebectomy, this minimally invasive surgical procedure involves removing superficial varicose veins through tiny skin incisions. Using specialized hooks, the surgeon extracts the problematic veins in segments. Performed under local anesthesia on an outpatient basis, phlebectomy results in minimal scarring and offers a swift recovery period.

Venous Stenting

This minimally invasive procedure addresses narrowed or compressed veins, such as in May-Thurner Syndrome. A catheter delivers a self-expanding stent to the affected vein, propping it open to restore proper blood flow. Venous stenting is often performed under local anesthesia and typically requires minimal recovery time, significantly improving symptoms like leg swelling and pain.

Catheter-Directed Thrombolysis

A minimally invasive intervention aimed at dissolving significant blood clots, particularly in cases of deep vein thrombosis (DVT). A catheter is navigated to the clot site, where thrombolytic agents are directly administered to break down the clot. This targeted approach enhances clot resolution while minimizing systemic bleeding risks. The procedure is conducted under imaging guidance, often with conscious sedation.

Inferior Vena Cava (IVC) Filter Placement

This minimally invasive procedure involves implanting a filter into the inferior vena cava to prevent blood clots from traveling to the lungs, thereby reducing the risk of pulmonary embolism. A catheter is used to position the filter via a small incision, typically in the neck or groin. The procedure is performed under local anesthesia, and patients can usually return to normal activities shortly thereafter.

Venous Bypass or Reconstruction

This is an open surgical procedure reserved for severe or complex venous obstructions where other treatments are ineffective. It involves creating a new pathway for blood flow by grafting a vein or synthetic conduit to bypass the blocked segment. Venous bypass surgery is more invasive, requires general anesthesia, and entails a longer recovery period. It’s typically considered when minimally invasive options are not viable.