Varicose Veins
Varicose veins are enlarged, swollen, and twisting veins, often appearing blue or dark purple.
Varicose veins are most common in older adults, particularly women, and occur especially on the legs. More than 23 percent of all adults are thought to be affected by varicose veins.
Causes of varicose veins
Arteries carry blood from your heart to the rest of your tissues. Veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity.
Varicose veins occur when veins aren’t functioning properly. Veins have one-way valves that prevent blood from flowing backward. When these valves fail, blood begins to collect in the veins rather than continuing toward your heart. The veins then enlarge. Varicose veins often affect the legs. These veins are the farthest from your heart, and gravity makes it harder for the blood to flow upward.
Less commonly, varicose veins are caused by such diseases as:
- phlebitis (inflammation of the veins),
- blood clots or any obstruction to blood flow in the veins, or
- congenital abnormalities of the veins.
Symptoms of varicose veins
The primary symptoms of varicose veins are highly visible, misshapen veins, usually on your legs. You may also have pain, swelling, heaviness, and achiness over or around the enlarged veins.
In some cases, you can develop swelling and discoloration. In severe cases, the veins can bleed significantly, and ulcers can form.
Diagnosis
Evaluation of varicose veins includes a thorough general physical examination by a doctor. This will include asking about any family history of varicose veins.
Duplex ultrasound visualization is very useful in evaluating of the venous system. Ultrasound can help in delineating the presence of any defective veins and pinpoint those that require intervention.
Doppler ultrasound (a device which can detect and measure blood flow) may also provide additional information such as the competency of and flow through the valves in the perforating and the deeper veins.
Treatment
If the patient has no symptoms or discomfort and is not bothered by the sight of the varicose veins, treatment might not be necessary. However, if there are symptoms, treatment may be required to reduce pain or discomfort, address complications, such as leg ulcers, skin discoloration, or swelling.
Some patients may also want treatment for cosmetic reasons – they want to get rid of the “ugly” varicose veins.
Surgery
Vein ligation and stripping is a surgical treatment that requires anesthesia. During the procedure, your surgeon makes cuts in your skin, cuts the varicose vein, and removes it through the incisions.
Other treatment options
Currently, a wide variety of minimally invasive treatment options for varicose veins are available. These include:
- sclerotherapy, using a liquid or foam chemical injection to block off a larger vein
- microsclerotherapy, using a liquid chemical injection to block off smaller veins
- laser surgery, using light energy to block off a vein
- endovenous ablation therapy, using heat and radiofrequency waves to block off a vein
- endoscopic vein surgery, using a small lighted scope inserted through a small incision to block off a vein