What it is?

Varicose Veins (VVs) are enlarge visible veins mainly locate on the medial calf and thigh. Is the result of the superficial vein insufficiency of the leg. The normal blood circulation on the leg veins is from the ankle to the groin. When the veins lose their ability to beat the gravity and to carry the blood centrally the blood flow backwards and the result is the enlargement of the veins which are visible (varicose veins).

Symptoms

At the beginning varicose veins may cause no symptoms. By the time you may notice swelling on the ankles by the end of the day. Aching, pain and heaviness of the legs are more severe symptoms. Night cramps and itching could be related with varicose veins. More severe symptoms are the discoloration on the distal calf and on the chin. The skin could become dark and bluish. The last stage of the disease is the development of ulcers. The ulcers could be healed or unhealed vein ulcers.

How that happens?

In the lumen of the veins they are valves. Because on the legs the veins have to beat the gravity the body developed the valves. Their function is to keep the blood flow upwards by opening and closing.  When the valves lose their function to close properly the blood flow instead of centrally goes distally. And because of the gravity the blood accumulates in the veins of the calf increasing the pressure in the veins. Then the veins become distended and visible. The result is called varicose veins.

Risk factors

• Age
  • By the age the veins are losing their elasticity and the valves could be damaged.
• Sex
  • Varicose Veins are mostly affect the female gender develop than the male
• Pregnancy
  • The fetus in the abdomen increases the abdominal pressure and the pressure to the veins. By that way the blood flow in the pelvis decreased and the pressure in the legs veins is increased. Bu that way the valves could be damaged.
• Obesity
• • As the body weight increases this puts more pressure to the legs veins.
• Family History – Heredity
  • People who their mother or their father suffers from varicose veins tend to developed easier varicose veins.
• Long Standing or Sitting position
  • Long standing or sitting position increased the pressure on the veins and can cause varicose veins.

Diagnosis

A clinical examination by a certified vascular surgeon is the first step. The doctor will examine your legs for swelling, pain, visible varicose veins, discoloration and ulcers. If there is indication then the doctor will performed an ultrasound duplex scan of the vein system to check for vein insufficiency and which valves have function problem.

Treatment

The treatment depends on the diagnosis and the symptoms. The doctor will either will give you conservative treatment or will request a procedure.

The conservative treatment includes the use of compression stockings, exercise and the use of phlevotonic drugs.

If you have severe problem then the treatment is to remove or to destroy the incompetent veins. The methods we use today are:

• Laser or Radiofrequency
• Stripping
• Foam sclerotherapy
• Combination of the above.

Complications

The complications could be:

• Superficial thrombophlevitis is when a clot developed in the vein. The skin is hot, red, tender and hard to touch.
• Vein ulcer is the skin necrosis because of the underlining pressure from the vein stasis. The ulcers could be healed or unhealed. There is increase risk for the ulcers to get infected.