Everything you’ve always wanted
to know about Varicose Veins
Q and A with Dr. Ronald Lev of Advanced Varicose Vein Treatments of Manhattan
By Camille Sperrazza
Less than one percent of all
phlebology professionals in
the U.S. and Canada have
earned certification from
the American Board of
Venous and Lymphatic
Medicine, and Dr.
Ronald Lev of Advanced
Varicose Vein Treatments
of Manhattan is one of them.
His certification reflects his
expertise in the field of varicose
veins and the lengthy and intense education
he has pursued to master this specialty.
During these challenging days of
COVID-19, Dr. Lev and his family
made the conscious decision to stay in
Manhattan, and keep his two offices open,
safely treating patients who continue to
come to him. With one office in midtown
and one downtown, the doctor’s devotion
to the city was never in doubt, says
his wife, Melitza Lev, the company’s
Marketing Director. Although the couple
saw some of their colleagues opt to ride
the pandemic outside of Manhattan,
that was never a consideration for them.
“This is our city,” she says. “There’s new
construction going on, and it will get back
to where it was.” By staying put, they feel
they are supporting local businesses,
helping with the recovery efforts.
Advanced Varicose Veins of Manhattan has
been in business for more than a decade,
and patients know that there is always
someone who answers the phone, easing
their minds about concerns and questions.
If anyone cannot get to the office for an
in-person visit, virtual appointments can
One of the issues brought on by COVID
is that people are sitting home more often,
says Dr. Lev. This lack of exercise can lead to
blood clots, leg swelling, and pain. “It is good
for people to walk every day,” he says. “Get
some exercise. Wear compression socks.”
The subject of varicose veins can
be a complex one, so Dr. Lev
helps shed some insight:
What are varicose
They are swollen, twisted,
blue veins that are close
to the surface of the skin,
a condition that impacts
10-20 percent of adults. As
these valves are damaged,
Dr. Ronald Lev, MD
they hold more blood at higher pressure
than normal, which forces fluid into
the surrounding tissues. This causes the
impacted leg to swell and feel heavy.
Itching of the skin can also occur.
What causes varicose veins?
The function of leg veins is to carry blood
back to the heart. During walking, for
instance, the calf muscle acts as a pump,
contracting veins and forcing blood back to
the heart. To prevent blood from flowing in
the wrong direction, veins have numerous
valves. If the valves fail, blood flows back
into superficial veins and back down the
leg. This results in veins enlarging and
becoming varicose. The process is like
blowing air into a balloon without letting
the air flow out again – the balloon swells.
Who is at risk for varicose veins?
Conditions contributing to varicose veins
include genetics, obesity, pregnancy,
hormonal changes at menopause, work or
hobbies requiring extended standing, and
past vein diseases such as thrombophlebitis.
Women suffer from varicose veins more
than men, and the incidence increases to
50% of people over age 50.
What are the symptoms?
Varicose veins may ache, and feet and
ankles may swell. Varicose veins can get
sore and inflamed, causing redness of the
skin around them. In some cases, patients
may develop venous ulcerations.
What are venous leg ulcers?
Venous ulcers are areas of the lower leg
where the skin has died, and exposed the
flesh. These ulcers can range from the size
of a penny to completely encircling the leg.
They are painful, odorous open wounds
which weep fluid and can last for months
or even years. Most leg ulcers occur when
vein disease is left untreated. They are most
common among older people, but can also
affect individuals as young as 18.
What can people do to help avoid
pain associated with varicose veins?
We call it “ESES” - pronounced SS - an
easy way to remember the conservative
approach. It stands for Exercise, Stockings,
Elevation, and Still. Exercising, wearing
compression hose, elevating and resting
the legs will not make the veins go away
because of the underlying disease, but it
may provide some symptomatic relief.
Weight reduction is also helpful.
What treatment can Advanced
Varicose Vein Treatments of
It depends upon the severity of the
condition. There are anti-inflammatory
drugs and topical antibiotics that can be
prescribed. Injections can be given. There
are also potentially longer-term treatment
alternatives for visible varicose veins that
will be discussed with patients.
Anyone suffering from this condition
should make an appointment. Most major
medical insurances are accepted.
Advanced Varicose Vein Treatments of
Manhattan Downtown: 111 John St,
#1450, between Cliff and Pearl Streets,
and Midtown: 369 Lexington Ave.,
#18A, between 40th and 41st Streets
in Manhattan, (347) 658-5430, www.
Mondays – Fridays, 8 am – 5 pm.
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