What are varicose veins
Veins are blood vessels that return blood back to the heart from the periphery (arteries take the blood to the periphery). Varicose veins occur when the small valves inside the veins malfunction resulting in a reversal of blood flow. The veins will then dilate and become tortuous resulting in symptoms such as aching, burning, restless legs and cramps. More advanced vein disease can lead to leg discoloration, rashes and ulcers. Spider veins, also known as telangiectasias, are very small varicose veins.
What causes varicose veins?
Aging and heredity are the largest contributing factors. Women are two to three times more likely to develop varicose veins than men. Hormonal changes that occur during puberty, pregnancy, menopause, and sometimes by the use of birth control pills and estrogen, promote the development of varicose vein disease. Many pregnant women develop varicosities during the first trimester of pregnancy. Fortunately, varicose veins due to pregnancy will often improve within a few months following delivery. Other predisposing factors include obesity, excessive heat, disorders of the lower limbs (such as flat feet) and prolonged standing as in occupations such as sales, nursing, teaching, hairdressing, waitressing, etc. Uncommonly, varicose veins can result from an injury to the leg or a clot in the deep veins (deep vein thrombosis).
How can varicose veins be treated?
There are several methods of treatment:
Sclerotherapy is the elimination of unwanted veins using injections of special medications (sclerosants) which irritate and collapse the offending veins. The majority of varicose veins can be treated by sclerotherapy, including larger veins, though several treatment sessions may be required to achieve this. Sclerotherapy can be subdivided into surface sclerotherapy, for treating smaller spider veins and ultrasound-guided sclerotherapy, which is required to access larger, deeper veins. Sclerotherapy is performed in the doctors office and does not require loss of time from work or other activities. It does not entail anesthesia and there is no scarring. Modern lasers work well for facial veins but have inconsistent results for small leg veins. Experts agree that sclerotherapy remains the gold standard for leg vein treatment.
ENDOVENOUS LASER THERAPY (EVLT)
Endovenous laser therapy is a relatively new technique for treating the saphenous veins and large branch veins. This technique involves destruction of the offending veins by heating them from inside the vein with an intravenous laser fiber. Endovenous laser treatment is available in a limited number of specialized centers in Canada and has become very popular. It is proving to have a higher success rate and fewer complications than any other procedure for treating the saphenous veins. The advantage of this procedure is that it is an in-office treatment using local anaesthesia with no incisions. Work and normal daily activities can be resumed almost immediately.
Ligation (tying off a vein) and stripping (removing a vein) can be used to treat varicosities of the two main superficial veins (the Greater and Lesser Saphenous veins) as well as some other branch veins. Surgery is performed in hospital, but frequently patients can be discharged the same day. Recovery can take from a few days to a few weeks depending on the extent of the surgery. Follow-up sclerotherapy treatments are sometimes required to treat smaller veins post surgery. These treatments can usually be started approximately 4 weeks after surgery.
Support hose help the veins function properly and can significantly relieve pain and swelling, as well as reduce the formation of new varicosities.
Exercise, weight control, support hose and yearly check-ups can retard the development of varicose veins.
*For further information go to: www.phlebology.org/patient-information
*This is the website of the American Collage of Phlebology of which Drs. Williams and April Sanders are members.