Understanding Venous Disease: A Q&A with Dr. Walkes

In this Q&A, we sit down with Dr. Walkes, a board-certified cardiothoracic surgeon and the owner of Texas Heart and Vein Multispecialty Group, which has four locations across Houston, Texas. Dr. Walkes shares his expertise on venous disease—its causes, symptoms, and the latest advancements in treatment. Despite affecting millions of Americans, venous disease remains widely underrecognized. Dr. Walkes is dedicated to raising awareness and offering guidance on available treatment options. For more information, visit our website here.

Q: Can you tell us a bit about your background and how you became interested in venous disease?

Dr. Walkes: I am a board-certified cardiothoracic surgeon specializing in heart and vascular surgery. My interest in venous disease grew over years of observing how underrecognized and undertreated it is. Severe cases can lead to venous stasis ulcers—chronic, non-healing wounds in the leg and ankle area. These ulcers are challenging to heal and can significantly impact a patient’s quality of life.

Q: How many Americans are currently affected by venous disease, and what are some common conditions under this category?

Dr. Walkes: Venous disease is a broad term covering various vein-related issues. In the U.S., it’s estimated that millions are affected by venous reflux disease, which occurs when blood flows backward due to malfunctioning valves in the veins. Chronic venous insufficiency (CVI), a common form of venous reflux, affects up to 40% of Americans, especially those over age 50, and is more common in women. This condition often leads to symptoms like varicose veins, leg swelling, and skin changes, and can progress to venous stasis ulcers if untreated. Learn More Here:.

​Q: What are the primary symptoms of venous disease that people should look out for? Are there any early warning signs?

Dr. Walkes: The main symptoms of venous disease are pain, cramping, itching, burning, heaviness, and swelling in the lower legs and ankles. Early signs may be subtle, like a feeling of heaviness or occasional swelling, but as the disease progresses, symptoms can worsen.

Q: Could you explain the main causes of venous disease? Are genetics, lifestyle, or other factors major contributors?

Dr. Walkes: Venous reflux disease in the lower extremities often has a genetic component. If your mother, grandmother, or sister has varicose veins or venous reflux disease, you are more likely to develop it. Multiple pregnancies and occupations requiring prolonged standing are also associated with the disease. The underlying cause is when the valves in the leg veins don’t close properly, leading to blood pooling in the lower legs.

Q: Who is most at risk for developing venous disease? Are there specific demographics or age groups that are more vulnerable?

Dr. Walkes: Venous disease risk increases with age, and those with a family history of venous issues are more susceptible. Women, especially after multiple pregnancies, are more likely to develop the disease. Jobs that require prolonged standing also elevate risk.

Q: What impact does venous disease have on a person’s daily life and overall health if left untreated?

Dr. Walkes: Symptoms can make it challenging to stand for extended periods or complete daily tasks comfortably. In advanced cases, people may develop venous stasis ulcers—wounds on the legs that are hard to heal. These ulcers often “weep,” causing clothing to become wet and sometimes emit an unpleasant odor, further impacting the individual's quality of life.

Q: How has awareness around venous disease changed over the years? Are more people now aware of the risks and treatments available?

Dr. Walkes: Yes, awareness has increased significantly. More people are now informed about the risks and available treatments for venous disease, thanks to improved outreach and education within the medical community and beyond.

Q: What are the latest advancements in the treatment and management of venous disease?

Dr. Walkes: Recent advancements include catheter-based treatments that target the small perforator veins responsible for feeding venous stasis ulcers. These treatments help ulcers heal faster and improve patients' quality of life.

Q: Can lifestyle changes make a significant difference in prevention or treatment? What advice would you give to someone wanting to lower their risk?

Dr. Walkes: Unfortunately, lifestyle changes alone may not have a substantial impact on venous reflux symptoms. However, the disease can limit physical activity, like exercise and dancing, as symptoms can worsen with prolonged standing.

Q: What message do you have for Americans who might be concerned about venous disease or for those who might be unknowingly affected by it?

Dr. Walkes: I encourage anyone concerned about venous disease to seek out a specialist and consider getting a venous reflux ultrasound. This diagnostic tool can help identify underlying issues early, providing a pathway to treatment and better quality of life.

Venous disease can have a profound impact on health and daily living, but advancements in treatment options mean that relief is possible. By raising awareness and seeking early diagnosis, individuals can take proactive steps toward managing this common, yet often misunderstood, condition.