Varicose veins and venous insufficiency

Varicose veins and venous insufficiency

Varicose veins are a common medical condition and are estimated be present in up to 25% of women and 15% of men. Varicose veins are enlarged veins that are visible through the skin and may appear as blue or purple twisted, rope-like cords. Varicose veins can occur anywhere in the body, but are most commonly found on the legs.

What causes Varicose Veins?

In normal circulation to the legs your heart pumps blood into your legs and feet through your arteries. Your leg veins return the blood back to your heart against gravity. Your leg veins have one- way valves inside of them that open and close to promote the flow of blood back from your legs back to your heart. When the valves are weakened or damaged they don’t open and close properly allowing blood to flow backwards in the leg vein. This leads to an accumulation of excess blood and pressure in the leg veins. The excess pressure can cause the leg veins underneath the skin to stretch and become enlarged into varicose veins.

What are symptoms of Varicose Veins?

While many patients who have varicose veins may not have significant problems from them, there are many patients who have life altering symptoms from varicose veins. These symptoms may limit their ability to work, exercise, or carry out simple activities of daily living. They include:

• Leg swelling
• Leg pain, weakness, itching and/or fatigue
• Color changes to the skin
• Severe chronic varicose veins can be associated with the development of non-healing sores and ulcers to the legs.

What are risk factors for Varicose Veins?

• Inactivity
• Prolonged standing or sitting increases pressure in the veins.
• Gender
• Women are particularly susceptible to varicose veins because of the influence of progesterone (hormones) on the veins and the effects of pregnancy. Women are 2-3 times more likely to have varicose veins than men.
• Pregnancy
• Pregnant women have an increased risk of developing varicose veins due to the hormonal influences of pregnancy on the veins, but the veins often return to normal within one year of childbirth. Women who have multiple pregnancies may develop permanent varicose veins.
• Age

Varicose veins usually affect people between the ages of 30 and 70. With advancing age, the elastic wall of vein begins to weaken increasing the chance that the vein will dilate.

What tests are done to diagnose the cause of Varicose Veins?

Ultrasound is the best and most reliable test used to evaluate the cause of varicose veins. It is painless and non-invasive. Ultrasound allows us to image and identify improperly functioning deeper leg veins that are often the underlying cause of varicose veins. Ultrasound is also used to monitor the effectiveness of our treatments for varicose veins.

Treatment for Varicose Veins:

Specific treatment for varicose veins will be determined by your physician based on:

• Your age, overall health, and medical history
• Extent of the condition
• Your tolerance of specific medicines, procedures, or therapies
• Expectations for the course of the condition.
• Your opinion or preference

Medical treatment may not be necessary if there are no symptoms. However, varicose veins may sometimes worsen without treatment. Treatment for varicose veins involves both surgical and nonsurgical approaches.

Nonsurgical methods for treating varicose veins include:

Elevation of the legs You may be instructed to elevate your feet above the level of your heart three or four times a day for about 15 minutes at a time to help reduce leg swelling and relieve other symptoms. If you need to sit or stand for a long period of time, flexing (bending) your legs occasionally can help keep blood circulating. Compression Stockings These elastic stockings squeeze or compress the veins and prevent blood from flowing backward. Compression stockings are effective in treating varicose veins if worn daily and may prevent the need for more invasive treatment.

Minimally Invasive Methods

• Sclerotherapy
• This procedure involves a saline or chemical solution that is injected into the varicose veins that causes them to harden so that they no longer fill with blood. Blood that would normally return to the heart through these veins returns to the heart by way of other veins. The veins that received the injection will eventually shrivel and disappear. The scar tissue is absorbed by the body.
• Ablation involves the insertion of a thin, flexible tube called a catheter into a varicose vein. The tip of the catheter heats the walls of the varicose vein and destroys the vein tissue. Once destroyed, the vein is no longer able to carry blood and is absorbed by your body.
• Microphlebectomy
• This procedure involves passing hooks through small incisions to remove varicose veins.

Surgical approaches to the treatment of varicose veins include:

Vein Stripping

Steps to prevent varicose veins include maintaining a healthy weight, exercising regularly, and elevating the feet while sitting. While these measures may help prevent varicose veins in some people, they may only slow the onset of the condition in individuals who are susceptible

What are Spider Veins?

Spider veins are a form of varicose vein disease and could be the first sign of venous insufficiency. Spider veins are dilated small blood vessels visible as blue or red streaks, webs, or clumps located within the skin. They sometimes have a “sunburst” pattern. Spider veins are permanent unless treated. They usually do not a cause many symptoms, although in some cases they have been associated with itching, burning, heaviness, or fatigue in the legs. The treatment of spider veins is sclerotherapy. Spider veins become more frequent with age, especially around the foot and ankle, but can occur anywhere in the leg(s).