Vericose Vein Treatment
Does it ever happen that you feel tired standing only for
5-10 minutes or after walking half a mile or kilometer? Take
some time from your hectic office schedules and check out
if you find heaviness of legs, appearance of bluish spidery,tortuous
veins on legs or on any other part of the body or occurence
of brownish -blue skin discloration,then you may have what
is diagnosed as Varicose veins.
Varicose veins have a peculiar appearance that become prominent
on standing or in a position of sitting with legs dangling.Some
symptoms with varicose veins are:
- Varicose veins appear as snarled, bluish-purple lines,
usually forming on the legs.
- Heaviness of legs or feeling of achy, and painful legs.
Symptoms may be worse after standing or sitting for long periods
of time.
- Skin color changes such as - dry, thinned skin, skin
inflammation, open sores or bleeding after a minor injury
or brownish-blue discoloration of skin.
- Occurence of leg-cramps
- Swelling over ankles
Varicose veins are very common, primarily affect women more
than men. More than 20 percent of women develop some form
of varicose veins, either during pregnancy or as they age.
Other common factors causing varicose veins are obesity, menopause,
aging, prolonged standing, leg injury and abdominal straining
What are varicose veins and what is the cause of their formation?
Varicose Veins/Spider veins are twisted, enlarged veins near
the surface of the skin which most commonly develop in the
legs and feet. Any vein can become varicose, but the veins
most commonly affected are those in your legs and feet. That's
because standing and walking upright increases the pressure
in the veins of your lower body.
Varicose veins develop because of faulty valves in the veins
and weakened vein walls. Normally, the one-way valves in the
veins keep the blood flowing efficiently against gravity up
toward the heart. When these valves do not function properly,
blood pools, pressure builds up, and the veins become weakened,
enlarged, and twisted.
Who is susceptible to develop varicose veins?
Varicose veins are common, primarily affecting women. More
than 20 percent of women develop some form of varicose veins,
either during pregnancy or as they age.
Varicose veins result from conditions that increase pressure
on the leg veins, such as being overweight or pregnant or
having an occupation that requires standing for long periods
of time. Some people may be more likely than others to develop
varicose veins because of inherited characteristics (genetics)
and the aging process.
How do I know if I have varicose veins?
Varicose veins appear as snarled, bluish-purple lines, usually
forming on the legs.
If you have varicose veins, your legs may feel heavy, tired,
achy, and painful. Symptoms may be worse after standing or
sitting for long periods of time.
Varicose veins can also cause skin color changes, dry, thinned
skin, skin inflammation, open sores or bleeding after a minor
injury.
It is better to see a doctor and get it diagnosed if you
have such symptoms.
How are varicose veins diagnosed?
Varicose veins are easily diagnosed by a general physical
examination. The examination is done in standing position
or in a position of sitting with legs dangling.
Standing up for 8-10 minutes makes the veins more prominent
which helps in evaluating the extent of problem. In addition
a general examination includes enquiring about family history
of varicose veins, duration, factors aggravating/worsening
the varicose veins.
Varicose veins have a very characteristic appearance that
can be examined by tourniquet test to observe the points of
reverse blood flow. A blood pressure cuff can be used for
this purpose.
Some other tests that can help in localizing the extent of
varicosity are:
1) Doppler Ultrasound: This devise maps out the veins
and faulty valves and thus examines the competency of the
valves.
2) Angiogram: This test is done rarely to rule out
other tests.
What are the risks involved with having varicose veins?
Although the treatment of varicose veins is neglected by
many patients but they can cause some serious complications
if left untreated. The risks involved with worsening of varicose
veins can lead to development of:
- Deep Vein Thrombosis
- Thrombo-phlebitis i.e. formation of blood clots
- Skin changes such as eczema, brown discoloration of skin,
thread veins.
- Ulceration of the skin over legs, formation of hard, tender
lumps on the skin surface etc
- Keloid scars
What are the treatments available for varicose veins?
Sclerotherapy - This is a minimally invasive technique
which involves injecting a chemical solution into the affected
vein which causes it to shrink and gradually disappear. The
procedure may involve 1-50 injections to cause shrinkage of
the vein. Then the leg is wrapped in a compression/elastic
bandage to ensure that the veins remain closed. No Anesthesia
is required in this technique.
Sclerotherapy helps to improve the cosmetic appearance of
varicose veins and to relieve pain, burning and aching sensations,
swelling and night cramps. It is the most commonly used technique
for treating small varicose veins in the legs.
Laser therapy or radiofrequency/Endo-venous ablation of
varicose veins- It is an advanced ultrasound guided laser
technique that uses radiofrequency or laser energy to produce
heat and thereby burn and close abnormally enlarged varicose
veins in the legs. This seal off the spider/varicose veins
thus diverting the blood flow immediately to nearby healthy
veins. The technique is very direct and accurate, and only
affects the area being treated.
The procedure involves a small puncture into the skin and
so the patient may feel a small pinch, and then the skin is
soothed by cooling after the laser is applied. Some redness
and swelling may appear but this disappears within a few days.
The duration of the treatment is usually 20 to 25 minutes;
and two to five sittings are generally needed to remove varicose
veins in the legs depending upon their severity and extent.
The advantage of Laser therapy is that it is safe for all
skin types and colors.
The procedure may be used for both cosmetic purposes and also
for reducing symptoms such as pain, swelling, discoloration,
inflammation etc.
Surgical procedures-The most common surgical options
for the treatment of varicose veins are surgical stripping
and ligation.
Surgical stripping and ligation is used in most severe cases
that take account of only 8- 10% of talengectasia cases. The
procedure is employed to remove Long saphenous vein (the largest
main superficial vein) which runs from the groin to the ankle.
The vein collects blood only from the skin surface. Incisions
are done down into the leg and locate underlying diseased
veins and then Long "strippers" of various designs
are passed through these deeper veins and then the stripper
and vein are pulled out of the leg together.
The surgeries usually done are:
- Mini-phlebectomy,done under local anesthesia and is used
to remove the faulty area of a vein through minute incisions.
- Ambulatory surgery for removal of the long saphenous vein
by making small incisions made along the course of the vein
and removing it by small surgical hooks
The surgery is performed under general anesthesia and the procedure
is performed on an outpatient basis.
When can I expect to resume day to day activities?
Rest for two weeks is advised after an operation on one leg
and if both legs have undergone surgery then, the rest period
advised would be nearly three weeks before you are able to consider
returning to work.
For those people who have a long standing job, would require
even longer duration of rest and are advised Beuger's exercise
and compression stockings.
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