A varicose vein is a bulging, protruding and rope-like vein that develops due to blood flowing the wrong way in the vein. Properly functioning valves inside the veins ensure that blood cannot flow backwards, but reflux is caused when there’s a faulty valve, weak vein wall, or a combination of both.
Other than their unsightly appearance, varicose veins often cause pain, discomfort, itching and a burning sensation. Patients complain that their legs feel heavy and swollen, particularly towards the end of the day and during fluid-retention days of a woman’s menstrual cycle. Others complain of a tired feeling in their legs, which might also feel achy, restless and suffer from night cramps.
Patients with varicose veins are prone to phlebitis, blood clots and DVT (deep vein thrombosis) due to the poor movement of blood in their veins. Longstanding varicose veins result in a medical condition called chronic venous insufficiency (CVI). The hallmark of CVI is increased pressure in the leg veins. Left untreated for long periods this can cause changes in the skin, especially around the ankles and lower calf. The skin becomes leathery, hard, dark in colour and is prone to ulcerations.
Untreated varicose veins increase in number and size over the years. Lifestyle factors that worsen the condition include: prolonged standing, a sedentary lifestyle, and obesity. In pregnancy, squeezing of the pelvic veins by the enlarged uterus, the hormonal changes and the mere effect of added weight combine to significantly worsen varicose vein problems in genetically predisposed women.
Patients with varicose veins are encouraged to exercise regularly, lose weight and wear graduated compression stockings. The use of these stockings can alleviate the symptoms of varicose veins, improve blood flow in the veins and lower the risk of complications. They are not a final treatment for the condition by themselves.
Patients with varicose veins should undergo an evaluation to determine the underlying cause. The non-invasive evaluation usually consists of an in-office venous duplex ultrasonography (an ultrasound of the legs). The exam allows our vascular surgeon to determine which veins are affected by reflux.
Your surgeon will the assign a classification level for your condition – 1 being the mildest and 6 being the most severe.
Varicose Veins can be treated with sclerotherapy (particularly foam sclerotherapy) or endovenous ablation techniques, depending on their size and underlying cause. Some of the ablation techniques are LASER based (endovenous LASER ablation of the saphenous vein and endovenous LASER treatment), while others are radiofrequency based (Fast Closure).
Additionally, microphlebectomy (also known as mini-phlebectomy and ambulatory phlebectomy) or foam sclerotherapy may be used as supporting procedures in the treatment of varicose veins.