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VARICOSE VEINS

What Are Varicose Veins?

Varicose veins are enlarged veins near the surface of the skin which may be troubling both cosmetically and medically. They occur most frequently in the legs but may exist elsewhere in the body. Varicose veins can affect both men and women. According to The National Institute of Health, a quarter of patients who suffer from this condition are men. More women seek help for this disorder than men not only because more women suffer from them, but because in our culture women expose their legs more frequently to public view. Regardless of gender, however, varicose veins can be a serious problem requiring medical intervention.

Causes of Varicose Veins

Varicose veins are caused by a backflow of blood in the veins due to venous insufficiency. Venous insufficiency is when the veins are not functioning properly and fail to return blood to the heart efficiently and cause blood to pool. Sometimes, the cause of Venous insufficiency is due to deep vein thrombosis or high blood pressure inside the veins of the leg.

Damaged veins may also be the result of injury, disease or surgery. When damaged valves are unable to keep blood moving in the proper direction, a backflow results. We refer to this condition as venous reflux. Venous reflux can cause discoloration, skin breakdown, bleeding, and even ulceration. Once this happens, treatment may be more difficult. This is why it is important to intervene early in the disease process.

Varicose Veins Risk Factors

Many people are at a greater risk because of their occupations or habits. Individuals who work in professions that require a great deal of sitting or standing, like waiters, drivers, or nurses, or individuals who spend a great deal of time traveling in cars or airplanes, are at high risk. Varicose veins occur more commonly in women and individuals who smoke.

Risk factors for developing varicose veins may vary and some may relate to gender.

These risk factors include:

Pregnancy
Oral contraceptives
Aging
Congenital weakness in veins
Obesity
Family history of the vascular disease
Sedentary lifestyle

Symptoms Of Varicose Veins

Patients with varicose veins do not always experience pain from this condition, although some may develop aching, throbbing, cramping and other symptoms that may indicate a need for medical attention.

The symptoms of varicose veins may include:

Large swollen veins
Swelling, usually of the feet, ankle or leg
Pain, aching, throbbing or cramping in the legs
Heaviness in the legs
Itching in the lower leg or ankle
Discoloration of skin

Although varicose veins most frequently appear in the legs, they can also occur in other areas, such as the pelvis, vagina, uterus, esophagus or anus.

Best Treatments for Varicose Veins

There are many treatment options available for the treatment of varicose veins, depending on the severity of the individual case. These treatment possibilities may include:

Ambulatory Phlebectomy

Some varicose veins that sit near the surface of the skin are too large to treat with sclerotherapy. Ambulatory phlebectomy may be the ideal treatment for such veins. This minimally-invasive procedure is also sometimes called micro phlebectomy. Treatment is performed through small incisions that heal nicely without the need for stitches. Learn More..
Cutaneous Laser Therapy

Cutaneous laser therapy, or simply laser therapy, is a common treatment for spider veins, the small clusters of web-like vein structures that lie just beneath the surface of the skin. In our practice, we often recommend cutaneous laser therapy for the treatment of spider veins in the lower legs or around the ankles. This treatment is also suitable for facial spider veins. Facial skin is more delicate, and the laser is gentle enough to destroy veins without damaging surrounding tissue. The laser quickly and efficiently closes off these veins so the body can absorb them and send blood elsewhere. Learn More..
Deep Vein Thrombosis

A blood clot in a deep vein can be painful and concerning. Also referred to simply as DVT, deep vein thrombosis is a blood clot that sits far beneath the skin’s surface. This condition usually develops in the lower extremities, but could occur anywhere in the body. The concern regarding deep vein thrombosis is that the blood clot will dislodge from the peripheral vein and move to the lung, resulting in pulmonary embolism and the need for emergency care. Treatment for deep vein thrombosis focuses on the prevention of pulmonary embolism and additional blood clots. We also want to prevent the clot from getting bigger. DVT treatment options include blood-thinning medication, compression stockings, and surgery. A specialist develops the most appropriate treatment protocol based on each patient’s individual circumstances. Learn More..
Endovenous Laser Ablation Surgery (ELAS)

Endovenous Laser Ablation Surgery is a minimally-invasive outpatient treatment that closes a problem vein in which valves no longer push blood forward. It is referred to as a surgical procedure but does not require anesthesia or sedation. Patients experience minimal discomfort during the ultrasound-guided procedure and are able to drive themselves home after their appointment. Learn More..
Sclerotherapy

One of the most well-known vein treatments, sclerotherapy has achieved outstanding results for many years. It is known as one of the most effective treatments for varicose veins in the feet and hands. The minimally-invasive procedure can also successfully treat some leg veins. Treatment takes less than an hour in most cases and involves a number of injections into the problematic vein. Over time, the vein closes and circulation is rerouted to a healthy vein. Learn More..
Sclerotherapy For Leg Veins

Leg veins are not only cosmetically unpleasant but can also cause several uncomfortable symptoms. Sclerotherapy, which is a form of injection therapy, does not require incisions or anesthetic. The procedure is performed in the office and typically takes no more than half an hour. Patients can resume normal activities right away with few side effects. Learn More..
Ultrasound Guided Sclerotherapy

Problem veins are not always immediately noticeable. They don’t all exist in superficial tissue. That’s why we utilize ultrasound imaging to help guide sclerotherapy procedures when necessary. Ultrasound is painless imaging that shows the location of the dysfunctional vein so the doctor has an accurate map of the treatment area. Used discerningly, ultrasound guidance takes the guesswork out of vein treatments so our patients achieve the best outcomes via brief, effective sessions. Learn More..
Home Treatment

When varicose veins are mild, the patient may successfully treat them at home. Home treatment may include getting plenty of exercise, avoiding long periods of sitting or standing and elevating the legs when at rest.
Compression Stockings

The compression of these garments may provide symptomatic relief and slow disease progression. Compression stockings alone, however, will not remove varicose veins.
Sclerotherapy

In this procedure, a liquid called a sclerosant is injected into the affected vein to cause it to close and stop carrying blood. Sclerotherapy does not require an anesthetic and the doctor can perform it in about one hour with little or no discomfort.
Surgical Stripping Of Veins

Surgical stripping has been the traditional varicose vein treatment. It is usually performed under general or spinal anesthesia in the hospital. Incisions are made along the course of the vein and the vein is stripped out in pieces. The surgical incisions are closed by stitches. Recovery time after surgical stripping may be 2 to 3 weeks.
Endovenous Laser Ablation Surgery (ELAS)

During ELAS a laser fiber is threaded along the course of the diseased vein and the fiber is pulled out slowly, resulting in the closure of the vein. This is an outpatient procedure with topical or local anesthesia and takes about 45 minutes with minimal downtime. Immediately after the procedure, the patient can drive home, return to work, and resume a normal routine.
Endovenous Radiofrequency Ablation

During radiofrequency ablation, a small incision is made through which a catheter is inserted into the targeted vein. Once precisely placed, the catheter delivers radiofrequency energy to the wall of the vein, causing the vein to collapse and seal so that blood can no longer travel through it. After the radiofrequency procedure, patients may experience mild bruising and swelling in the treated area, but are usually able to return to your regular activities shortly after treatment.

What Causes Varicose Veins in Feet?

Varicose veins do not form only on the legs; they can develop in many other areas, with the feet being a common location. Pressure placed on the veins of the legs and feet during standing and walking can eventually damage veins, causing their valves to weaken. Weak valves can result in a backflow of blood, called venous reflux, that interferes with normal circulation. As blood pools, the walls of the veins are further stressed. Eventually, this causes them to distend and raise the surface of the skin. Varicose veins of the feet, like other varicose veins, are not simply a cosmetic problem. If left untreated, they can lead to potentially serious medical issues, including extensive bleeding and phlebitis.

What Causes Varicose Veins in Feet?

Once the vein collapses and becomes nonfunctional, the blood flow will be naturally redirected to healthy veins and circulation will continue uninterrupted.

Health Issues Caused By Varicose Veins

In patients of either gender, the biggest risk of having varicose veins is that the patient may develop a clot, or deep vein thrombosis (DVT), that may travel to another part of the body. We refer to this as an embolism and it is a life-threatening condition. If the clot travels to the lungs, it is called a pulmonary embolism. If it travels to the brain, it may result in a stroke, and if it travels to the heart it may precipitate a heart attack.

When a clot occurs in a milder way, we call this phlebitis or superficial thrombophlebitis. While less serious than DVT, we must treat phlebitis medically to assure that the condition doesn’t worsen. Usually, remedies include resting with the affected leg elevated, taking anticoagulants or clot-dissolving medications. In the most serious cases, surgical removal of the vein may be necessary.

How Can Varicose Veins be Prevented?

While some individuals may develop varicose veins regardless of maintaining a healthy lifestyle, there are steps that a patient can take to lower their risk. These preventative measures include maintaining a healthy weight, exercising regularly, taking frequent breaks from sitting or standing, and elevating the legs while at rest.