Meet your vein specialist
Dr. Syed Raza, MD
Vascular & Interventional Radiology · Founder, Premier Vein & Vascular Center
Fellowship-trained interventional radiologist, board certified in diagnostic and interventional radiology with a Certificate of Added Qualification (CAQ) in interventional radiology, and a Fellow of the Royal College of Radiologists (UK). Member of SIR and RSNA. Former Chief of Interventional Radiology at UTMB Galveston and Memorial Hermann Memorial City, with 15+ years treating varicose veins, venous reflux and peripheral arterial disease.
Dr. Raza on Great Day Houston: Why Vein Health Is a Hot Topic
Television medical panels tend to focus on problems that affect a lot of people but are often misunderstood. Vein disease fits that description well. Many adults have aching legs, ankle swelling or bulging veins and assume it is just part of getting older, standing at work or carrying a pregnancy. Others worry that every visible vein is a sign of a dangerous clot.
The truth sits in between. Most vein problems are not emergencies, but they are real medical conditions with a clear cause, and they tend to get worse slowly when left alone. Dr. Syed Raza is a fellowship-trained interventional radiologist board certified in diagnostic and interventional radiology by the American Board of Radiology and a Fellow of the Royal College of Radiologists (UK). He has served as Chief of Interventional Radiology at UTMB Galveston and at Memorial Hermann Memorial City, and has spent more than 15 years treating varicose veins, venous reflux and peripheral arterial disease. The sections below cover the vein questions patients bring to him most often.
What Causes Varicose and Spider Veins?
Leg veins have to move blood uphill, against gravity, back to the heart. They do this with help from the calf muscles, which squeeze the veins when you walk, and from small one-way valves inside the veins that stop blood falling back down. When those valves weaken and stop sealing, blood leaks backward and pools. Doctors call this reflux.
Pooled blood raises the pressure inside the vein. Over time the vein wall stretches, twists and bulges, and a varicose vein appears. The same higher pressure can open up tiny vessels close to the skin surface, producing the fine red, blue or purple lines known as spider veins.
Common contributors include family history, pregnancy, hormonal changes, jobs that keep you on your feet, excess weight and a previous blood clot. Age matters too, because valves and vein walls lose some elasticity over the decades.
Are Spider Veins and Varicose Veins the Same Thing?
They are related, but they are not the same, and the difference affects treatment. Patients are often surprised to learn that a cluster of spider veins around the ankle can be a sign of reflux in a larger vein that cannot be seen from the surface.
| Feature | Spider veins | Varicose veins |
|---|---|---|
| Size | Very fine, usually under 1 mm | Larger, often 3 mm or more |
| Appearance | Flat red, blue or purple lines or webs | Raised, rope-like or twisted bulges |
| Typical symptoms | Often none; sometimes mild itching or burning | Aching, heaviness, swelling, cramps, restless legs |
| Underlying reflux | Sometimes, especially near the ankle | Common in a feeding vein |
| Usual treatment | Sclerotherapy | Ablation, phlebectomy or foam sclerotherapy |
Symptoms That Deserve a Vein Evaluation
Visible veins are only one clue. The symptoms of venous insufficiency are often more telling than how the legs look, and many people live with them for years before connecting them to their veins. It is worth having your legs checked if you notice:
- Aching, heaviness or tiredness in the legs that builds through the day
- Ankle or lower-leg swelling that leaves a sock mark by evening
- Night cramps or an urge to move the legs when resting
- Itching, burning or throbbing over a vein
- Brown or purple skin discoloration around the ankles
- Skin that feels firm, dry or scaly on the lower leg
- A sore near the ankle that is slow to heal
A useful pattern to notice is timing. Vein symptoms usually feel worse after long periods of standing or sitting and better when you raise your legs or walk. Our page on vein disease symptoms explains these signs in more detail.
How We Evaluate Vein Problems at Premier Vein
A good vein visit is less about how the legs look and more about why the problem is happening. Our evaluation follows the same clear steps for every patient:
- Focused history. We ask about your symptoms, when they started, what makes them better or worse, pregnancies, prior clots, family history and the medications you take.
- Leg examination. We check swelling, skin changes, visible veins and pulses, standing and lying down, because veins behave differently in each position.
- Venous duplex ultrasound. This painless scan in our in-office vascular lab shows blood flow in real time, measures reflux in each vein and checks the deep veins for clot or blockage.
- A clear plan. We walk you through the images, explain which veins are responsible and lay out the options, from compression and lifestyle changes to minimally invasive treatment.
Modern Vein Treatments: What Has Changed
Many people still picture vein stripping, which involved general anesthesia, incisions and weeks of recovery. That operation is now rarely needed. Today, most vein procedures are done in the office under local anesthesia through a needle puncture, and patients walk out the same day.
Closing the faulty vein from inside
For a larger refluxing vein, endovenous thermal ablation uses laser or radiofrequency energy delivered through a thin catheter to seal the vein shut. Blood then reroutes through healthy veins. The procedure usually takes about an hour, and most patients return to light activity the next day.
Treating smaller veins
Sclerotherapy uses a fine needle to inject a medication that irritates the vein lining so the vein collapses and fades. It works well for spider veins and small varicose veins. Bulging surface veins can also be removed through tiny nicks with ambulatory phlebectomy.
What you can do at home
- Walk daily to keep the calf muscle pump working
- Raise your legs above heart level for short periods during the day
- Wear graduated compression stockings if recommended
- Break up long periods of sitting or standing with ankle pumps
- Keep a healthy weight to reduce pressure on the leg veins
Is Vein Treatment Cosmetic or Medical?
This is one of the most common questions patients ask us. When veins cause aching, swelling, skin changes or wounds, and an ultrasound shows reflux, treatment is considered medically necessary. Most insurance plans, including Medicare, cover evaluation and treatment of symptomatic venous insufficiency, though plans often ask for a period of compression first.
Spider veins treated purely for appearance are usually considered cosmetic. We explain which category your treatment falls into before anything is scheduled, so there are no surprises.
Call 911 or seek emergency care if you notice:
- Sudden swelling, pain and warmth in one calf or thigh, which may be a deep vein thrombosis
- Sudden shortness of breath, chest pain or coughing up blood
- A varicose vein that bleeds heavily and does not stop with firm pressure and leg elevation
- A leg or foot that turns cold, pale or numb
When to See a Vein Doctor in Houston
If leg symptoms are affecting your work, sleep or exercise, or if you see skin changes around your ankles, it is worth having a proper evaluation rather than waiting. Houston summers, long commutes and jobs that keep people on their feet can all make vein symptoms more noticeable. As a vein doctor in Houston with more than 20 years of vein care behind the practice, our team usually offers same-week appointments and serves patients from Katy and across Greater Houston. You can learn more about Dr. Syed Raza or call (832) 321-5355 to schedule.
Talk With a Specialist at Premier Vein
Have questions about your symptoms or treatment options? Dr. Syed Raza and the team at Premier Vein & Vascular Center can evaluate your concerns and explain your options clearly. Same-week appointments are usually available, and most insurance plans are accepted.
Frequently Asked Questions
Who is Dr. Syed Raza?
Dr. Syed Raza, MD, is the founder of Premier Vein & Vascular Center in Houston. He is a fellowship-trained interventional radiologist board certified in diagnostic and interventional radiology by the American Board of Radiology and a Fellow of the Royal College of Radiologists (UK), and a former Chief of Interventional Radiology at UTMB Galveston and Memorial Hermann Memorial City.
What is an interventional radiologist?
An interventional radiologist is a physician who uses imaging such as ultrasound and X-ray to guide minimally invasive treatments through needles and thin catheters. For vein disease, this means procedures like ablation and sclerotherapy can be done in the office without large incisions.
Do varicose veins go away on their own?
No. Once a vein’s valves have failed, the vein does not repair itself. Compression, exercise and elevation can ease symptoms, but the vein usually stays the same or slowly worsens without treatment.
Is vein treatment painful?
Most patients describe office vein procedures as mildly uncomfortable rather than painful. Local anesthesia numbs the treatment area, and the most common feeling afterward is tightness or mild soreness along the treated vein for a few days.
How long does a vein evaluation take?
A first visit with a venous duplex ultrasound typically takes about an hour, depending on how many veins need to be mapped. You usually leave with an explanation of the findings and a recommended plan.
Can men get varicose veins?
Yes. Varicose veins are more common in women, but many men develop them, particularly those with a family history or jobs that involve long hours of standing. Men also tend to wait longer before seeking care.
Trusted Health Resources
- Chronic Venous Insufficiency, Society for Vascular Surgery
- Venous Insufficiency, MedlinePlus Medical Encyclopedia (NIH)
- Varicose Veins and Spider Veins, MedlinePlus (NIH)
Quick Answer: In August 2014, Dr. Syed Raza, founder of Premier Vein & Vascular Center, joined the medical panel on KHOU’s Great Day Houston to talk about health topics viewers care about. Vein health questions come up constantly in conversations like this: why varicose veins form, whether spider veins are only cosmetic, when leg swelling is a warning sign, and what modern office-based treatment involves. This article collects the practical answers we give Houston patients every week.