What are varicose veins?
Varicose veins is the term given to enlarged prominent veins in the lower limbs, caused due to abnormal blood flow.
What causes varicose veins?
Every persons veins has valves in them. These valves ensure that blood flows from the feet back to the heart against gravity. Without these valves, the effect of gravity would make the blood stagnate in the legs.
In some people these valves are weak. Pregnancy, weight gain, and the simple effects of aging can aggravate this weakness. Other factors–such as employment that requires long periods of standing or sitting – can also worsen varicose veins symptoms over time.
Healthy valves allow blood to flow in one direction only. When veins aren’t functioning properly, the blood flows backward, causing strain and damage, resulting in varicose veins.
What are the symptoms of varicose veins?
Varicose veins and spider veins are the two vein conditions caused by vein disease that affect the largest number of people. They bring visible signs and symptoms that can cause discomfort, pain, embarrassment, and fatigue. This not only makes sufferers feel self-conscious, but prevents them from living the healthy, active lives they want to live.
Varicose veins are large, bulging, and rope-like in appearance, are usually seen in the legs, and frequently accompanied by pain or discomfort.
Spider veins are smaller, thread-like, or tree-like in appearance, and are usually seen just under the surface of the skin in the legs and face. Similar to varicose veins, spider veins on the face, hands and limbs can be accompanied by pain.
What are the complications of varicose veins?
If varicose veins are left untreated, then they start causing complications such as:
- Dark coloration of skin
- Swelling of legs
It is easier to treat varicose veins before these complications arise. However many patients ignore this condition till they start seeing these problems and at stage the disease has often progressed
How are varicose veins treated?
Upon presentation, a doppler scan needs to be done. This determines the severity of the condition, based on which the treatment is done. The treatments include:
- Endovenous laser (for severe cases)
- Sclerotherapy (for minor cases)
Endovenous LASER for Large Veins
Endovenous Laser Ablation (EVLA) treatment is a safe, proven medical procedure that not only treats the symptoms of varicose veins, but also treats the underlying condition that causes them. The outpatient procedure time is usually less than an hour and does not require hospitalization. Most people do not find (EVLA) treatment to be overly uncomfortable, and recovery time is generally a matter of hours. In addition, some studies show that the EVLA procedure may be associated with lower rates of pain, bruising and complications when compared to other treatment modalities.
In EVLA, the doctor inserts a small catheter into the diseased vein through a small incision. Consistent and uniform heat is delivered to contract the collagen in the vein walls, causing them to collapse and close. After the vein is closed, blood is naturally redirected to healthy veins, and the treated vein is gradually absorbed into surrounding tissue. The procedure is always performed under ultrasound guidance, giving the doctor a live view of your veins, for accuracy and safety.
The procedure is done under local anesthesia, the patient goes home the same day with minimal discomfort.
Sclerotherapy is a safe, proven medical procedure that treats both the symptoms and the cause of varicose veins and spider veins. Treatment sessions usually take less than half an hour, with no hospitalization required. Most patients do not find sclerotherapy treatments to be particularly painful, and recovery time is generally very short—most people are back to their regular routine the same day.
For sclerotherapy treatments, a series of micro-injections of a solution (“sclerosant”) are administered directly into varicose veins or spider veins.
The injected solution acts to close off the vein with abnormal valves, sealing it off from your other, healthy veins. Over time, the treated veins shrink and are eventually absorbed by your body. Your blood flow, meanwhile, naturally reroutes itself into your healthy veins, improving your circulation and eliminating the root cause of your vein disease.
Your treatment may or may not involve ultrasound to either map your venous system for diagnosis or to guide the sclerotherapy process itself. For smaller spider veins closer to the skin’s surface, ultrasound guidance is usually not necessary and visual inspection is sufficient.
What is needed after treatment?
After any of the procedures listed above, it is important to continue preventive care to prevent the disease from recurring. One complain often heard is that varicose vein treatment is not useful because it comes back. The truth is that varicose veins rarely come back in the veins that have already been treated. They however can occus in other veins in the leg. To prevent this, it is important to wear compression stockings that prevent this
Know Your Surgeon
Dr. Aniketh did a dissertation on sclerotherapy during his training. He trained in endovenous laser under Dr. Hamid in Kentucky, USA.
He is a life member of the Venous Association of India.
He has published a chapter on Varicose Veins in the ACSI (Association of Cutaneous Surgeons of India) textbook: http://jaypeedigital.com/Chapter/ChapterDetail/51549
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