Many patients with swollen legs believe their problem is due to varicose veins. However, there are many other causes of leg swelling, including inflammation, heart failure, kidney failure and insufficiency of the less well known lymphatic drainage system. The consequences and treatments of these conditions differ greatly and the expertise provided by a vascular surgeon's consultation can be invaluable. Often a simple examination by an expert can eliminate the need for costly tests frequently ordered by physicians with less experience managing patients with swollen legs.

   Lymphedema is a condition, unrelated to venous diseases, but is an insufficiency of the lymphatic drainage system in an extremity. The lymphatic system is made up of small channels carry a clear fluid called lymph, a protein rich fluid similar to plasma that flows through these small lymphatic channels and is taken back into the bloodstream in the upper part of the body. Any breakdown or mechanical obstruction of the lymphatic channels can lead to swelling of the extremity. This may eventually lead to infection or skin breakdown and ulceration.

Treatment: The treatment is multifaceted and involves elevation, the use of external compressive devices usually in the form of a fitted external support garment, either on the leg or on the arm. The use of sequential compression devices or a so called extremity pump can at times be useful as can massage therapy. Attention to excellent hygiene and the avoidance of skin breakdown, injury or infection in limbs affected with lymphedema is extremely important.