This article discusses frequently asked questions surrounding varicose veins including symptoms and risk factors. We believe that this article will be of great help to anyone who would like to know more about the treatment options for varicose veins, whether surgical or non-surgical.
- What are varicose veins?
- How do you get varicose veins?
- How common are varicose veins?
- What are the risk factors for varicose veins?
- How can you prevent yourself from developing varicose veins?
- What are the symptoms of varicose veins?
- How are varicose veins diagnosed?
- What are the non-surgical treatments for varicose veins?
- How does surgery remove varicose veins?
Varicose veins are enlarged superficial leg veins with a lumpy blue/purple appearance. These can appear as a result of venous insufficiencies (problems with pumping blood around the body) such as a deep vein obstruction, a valve failure or a pump failure.
Valves carry blood in only one direction; once a valve in a vein is damaged (through risk factors such as a fracture) or has failed through weak leg muscles this will allow the blood to flow back in both directions. This will cause the vein to stretch, pulling apart the next valve until enough valves are damaged to result in a prominent and visible varicose vein. When only small veins are affected this will lead to spider/thread veins.
Varicose veins are a significant health problem affecting approximately 30-40% of the population aged 18-64 years. Men and women have an equal likelihood of developing the condition.
- A past history of deep vein thrombosis (DVT)
- Old age
- Previous fracture or surgery on the lower limb
- Family history
- Being overweight
- Frequently standing for long periods of time
- Avoid sitting or standing still for long periods of time
- Exercise regularly
- Large, unsightly, dark purple or blue bulges on the legs
- Swollen feet and ankles
- Pain and cramp in leg muscles after standing for long periods
- Thread veins / spider veins
- Skin changes including eczema and ulcers
- Restless legs
By palpitating your legs or having an ultrasound scan your physician will be able to discover which areas have atypical veins and whether you have a deep venous insufficiency. In rare cases you may be sent for a venography or varicography.
Initial treatment for patients includes compression hosiery (socks/stockings) at a variety of compression levels. The pressure should be greatest at the ankle and decrease up the leg until the compression of the thigh is 50% of that at the ankle. For some patients the compression socks are sufficient to alleviate their symptoms and control changes in the skin; in which case surgery can be avoided.
Injection sclerotherapy involves the injection of a medicine into the veins making them empty and shrink. An anaesthetic will not be required but multiple treatment sessions will need to be carried out.
EndoVenous Laser Treatment (EVLT) is a technique in which a thin catheter and optical fibre are inserted into the vein to be treated; the faulty vein is closed off using laser energy. About 50% of patients will require additional cosmetic therapy after EVLT but there is no scarring involved and can prevent the problem from recurring in the same area, unlike sclerotherapy.
Ligation of the veins involves shutting off the difficult veins using a suture/tourniquet. It is typically a day case procedure and patients will require a week off work. This is usually carried out under general anaesthetic but it is possible to administer only a local anaesthetic. Major complications are rare but other complications such as haematoma, wound complications and DVT can occur in up to 20% of cases.