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Varicose veins are a part of a group of disorders called chronic venous disease. About 23% of adults in US are affected by this disease, if spider telengactesiaand spider veins are also considered them the prevalence rises to about 80%. The disease refers to the presence of gnarled and tortuous veins generally in the leg or feet. The dilated veins can be accompanied by small, thin, red capillaries called spider veins.

Causes of Varicose veins

This disease is caused due to multiple reasons, like weakening of the wall of the vein, incompetence of the valves between the deep and superficial vein, and venous hypertension. Weakening of the wall of the vein leads to dilation of the vein hence making the valves inside them incompetent leading to backflow of the blood from the deep veins to the superficial veins, which manifests in the form of gnarled and tortuous veins. Studies have shown there are multiple factors affecting the , prevalence of this disease, these are

  • Gender: women are more likely to have varicose veins than men.
  • Age: prevalence increases with age.
  • Body mass index: higher the BMI more are the chances that the individual will have varicose veins.
  • Pregnancy increases the risk of varicose veins
  • Occupational and lifestyle: there are some evidence to suggest that varicose veins are more prevalent in individuals with a sedentary life style and in individuals  whose jobs require them to stand for prolong interval.

Risk Factors for Varicose veins

Symptoms of Varicose veins

Varicose veins are often symptomatic. The signs that you might have varicose veins are:

  • Dilated purple colored veins visible on your leg
  • Feeling of heaviness and throbbing over the affected area or sometimes the whole leg
  • Pain in the leg that worsens with prolonged standing
  • Itching
  • Discoloration of skin
  • Painful cord like vein accompanied by redness
  • Slowly healing ulcers, this is a sign that the disease has progressed and you need medical attention.

Symptoms of varicose veins

Diagnostic Tests

To diagnose Varicose veins your doctor will want to examine your legs to look at the veins are ulcers if any. For confirmation your doctor might order and Ultrasonogram. During the sonography the sonographer will use the probe to look for the valve competency in the affected limb to identify the location of the defect. Other modalities that might be used are MR Venography or intravenous sonography. This will help in planning further treatment.

Treatment of Varicose veins

Depending upon the severity of the disease your doctor might suggest one of the following treatment plans:

  • Compression stockings: for uncomplicated varicose veins the doctor might advise you to wear compression hosiery, they increase the pressure on the limb and reduce the pooling of blood. They help reduce the symptoms of the disease but there is very little evidence to suggest that they prevent the occurrence or stop the progression of the disease.
  • Endothermal Ablation: this is an invasive procedure with high technical efficacy and rapid recovery time. For this procedure you will first be given local anaesthesia, a probe is then inserted into the affected vein and positioned near the incompetent valve. The probe produces thermal energy which leads to destruction of the vein and permanent occlusion. According to the source of heath the procedure is called Endovenous Laser Ablation (EVLA) or Radiofrequency Ablation (RFA).
  • Ultra sonography guided Sclerotherapy: using ultra sonography as a guide, a chemical is injected into the affected vein which leads to permanent occlusion.
  • Ligation and stripping: after administering local anaesthesia, a small incision is made and the junction between the superficial and deep vein is closed off and the superficial vein is removed.

Treatment of Varicose veins

Complications of Varicose veins

  • Untreated varicose veins may lead to the development of superficial thrombophlebitis, bleeding, discolouration of skin, non healing ulcers.

Prognosis of Varicose veins

  • After the treatment you will be required to take some precautions to ensure that there is no recurrence; these include mild exercise, keeping legs elevated during sleeping and when you need to stand for extended period of time, to take breaks at regular interval to make sure blood doesn’t pool in your legs.

 

Resources:

Varicose Veins, Vascular Surgery


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