Varicose veins are enlarged veins that can be painful and may even cause swelling of the ankles. They typically form in the legs and are caused by malfunctioning vein valves, which don’t allow the blood to flow backwards.
As a result, superficial veins carrying high-pressure blood from the deeper system become affected. Varicose veins show as the typical 'blue road map' pattern of lumpy veins seen showing under the skin.
Typically, people with varicose veins can experience pain, aches, cramping, swelling, itching or skin marks, or a combination of these. Some factors that can worsen the condition include walking or standing for prolonged periods of time. Pregnancy and genetics can also cause varicose veins. Chronic high pressure in these veins can cause skin changes including thread veins and brown pigmentation (lipodermatosclerosis), and if left untreated, the condition may progress to severe skin changes and ulceration of the leg around the ankle.
Due to the inherent complexity of the many vascular disorders, there may be more than one way of managing a particular condition. For this reason, when planning a procedure, your consultant will discuss all the treatment options in a multidisciplinary team meeting, to ensure that all perspectives are considered before recommending a course of action to a patient.
Treatment Options
A revolutionary procedure which treats the cause of varicose veins more quickly and simply, requiring one injection as opposed to the multiple requires by traditional procedures.
Endovenous Laser Therapy (EVLT)
A new method of treating varicose veins without surgery. Instead of tying and removing the abnormal veins they are heated by a laser. The heat kills the walls of the veins and the body then naturally absorbs the dead tissue.
Foam and micro-injection of varicose and flare veins (Sclerotherapy)
A medical procedure whereby a chemical is injected into a vein to entirely obliterate it. This chemical damages the innermost lining of the vessel, resulting in a clot that blocks the blood circulation in the vein beyond.
VNUS Closure-Fast (Radiofrequency ablation)
Minimally invasive treatment for superficial venous reflux. A thin catheter is inserted into the vein through a small opening. The catheter delivers thermal energy to the vein wall, causing it to heat, collapse, and seal shut.
Lifestyle advice to improve vascular health
We know that there are risk factors that speed up the process of vascular disease and make some people more likely to develop this condition. Changing certain lifestyle factors such as stopping smoking, losing weight and lowering your cholesterol can all help.
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Frequently Asked Questions
What are the causes of Varicose Veins?
Varicose veins are enlarged veins that are visible under the skin. At their worst, they look like bunches of grapes lying beneath the skin and at their least severe they can take the form of thread veins (also known as spider veins), which are smaller and do not protrude from the skin. Any superficial vein can become varicose or develop into a thread vein if the blood does not flow through the venous system quickly enough, and the thin walls surrounding the veins stretch. The legs and feet are most commonly affected.
How do varicose veins develop?
In a normal vein, blood flows in one direction only- towards the heart. There are valves within the inner wall of most veins, which prevent blood flowing backwards by opening to allow the blood through and then closing to keep it from back draining. A vein becomes “varicose” when these valves fail to work properly. Blood pools within the vein, and the increased pressure causes the vein to bulge and lengthen, resulting in a varicose vein.
Factors which make you more likely to develop varicose veins:
+ Gender: It is thought that female hormones make the walls of veins more likely to stretch.
+ Pregnancy: The higher levels of female hormones and the pressure exerted by the uterus on the main veins in the body make a pregnant woman more likely to develop varicose veins. However, 40% of these women find that their varicose veins disappear within 3 months of giving birth.
+ Genetics: Your risk of developing varicose veins is greater if a close family member has them.
+ Obesity: Excess weight exerts pressure on the venous system, increasing the chances that varicose veins will develop. Lack of mobility and high blood pressure which are caused by obesity will also make the symptoms of varicose veins worse.
+ Age: All the tissues in out body loose elasticity as we get older, including the walls of veins. This makes them more likely to stretch and become varicose.
What are the treatments for Varicose Veins?
Varicose veins are enlarged veins that are visible under the skin. At their worst, they look like bunches of grapes lying beneath the skin and at their least severe they can take the form of thread veins (also known as spider veins), which are smaller and do not protrude from the skin. Any superficial vein can become varicose or develop into a thread vein if the blood does not flow through the venous system quickly enough, and the thin walls surrounding the veins stretch.
At their worst, varicose veins can result in toxins leaking onto the tissues of the ankle and calf, ultimately causing ulceration of the skin. There are therefore compelling clinical reasons to operate on a significant number of people with this problem. There are also many people who are not at risk of developing ulceration, but who dislike the unsightly varicose or thread veins. No one wants to feel ashamed of their legs, especially if it limits what you feel comfortable wearing or where you feel comfortable going.
There are multiple treatments for varicose veins, and the best choice of treatment for each individual takes into account the pattern of disease, the aims of treatment, the size of the veins affected and the symptoms they are causing.
Some treatment options for varicose veins include:
+ Radiofrequency ablation: A probe is threaded into the vein which is the source of the varicosities below. The probe delivers microwave energy to the lining of the vein to heat it up which causes it to close.
+ Endovenous laser treatment: This technique is very similar to radiofrequency ablation, although laser is used to close the vein instead of microwaves.
+ Sclerotherapy: A chemical is injected directly into the visible varicose veins, which causes them to close. This treatment option may take several sessions and is suitable for smaller veins only.
+ Phlebectomies: Sometimes surgical removal of the visible varicose veins is the best option. This is done through tiny incisions made with a needle.
+ Ligation and stripping: In some cases, traditional surgery may be the best option. Small incisions are made at the top and bottom of the target vein which is then removed.
Please see one of our vascular surgeons to discuss which of these treatments may be right for you.
What are the symptoms of Varicose Veins?
Varicose veins are enlarged veins that are visible under the skin. At their worst, they look like bunches of grapes lying beneath the skin and at their least severe they can take the form of thread veins (also known as spider veins), which are smaller and do not protrude from the skin. Any superficial vein can become varicose or develop into a thread vein if the blood does not flow through the venous system quickly enough, and the thin walls surrounding the veins stretch. Symptoms usually associated with varicose veins can be present without obviously visible varicosities, but as a result of poor blood flow through the superficial venous system in your legs which can also be the cause of visible veins.
Some symptoms associated with varicose and thread veins can include:
+ Heavy or aching legs: an unusual feeling of weight in the legs is an indication that something is not normal; heavy legs can be accompanied by soreness, tenderness to the touch, and swelling
+ Cramping: an abnormal cramping and/or throbbing in your legs can be a sign that the blood is pooling in the veins and not circulating around your legs as it should
+ Itchy and/or Flaky Skin: this symptom can sometimes be mistaken for dry skin, but if you are experiencing chronic itchiness and flaky skin on your lower leg it may be because of varicose veins
+ Swollen Ankles: If you are suffering from varicose veins you may experience swelling in your ankles due to the effects of static blood in your legs.
For most people, varicose veins are usually an aesthetic problem as well as a medical one. Consult your doctor if you need help and advice for varicose veins, or if you have concerns about the impact of varicose veins on your health.
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