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Varicose Veins: Types, Signs and Treatment Options

Disabled World: Revised/Updated: 2018/10/02

Synopsis: Information on Varicose Veins includes causes treatment and discusses surgery options for varicose and spider veins.

Main Document

What are Varicose Veins

According to The National Women's Health Information Center, as many as 60% of all American adults have some form of varicose veins. Women, however, are more affected by 50%. By the mid 50's, 41% of women in the US suffered from either spider or varicose veins. For many women, the first signs of varicose veins appear during pregnancy. Other factors include lack of exercise, being overweight, prolonged constipation, and sitting with legs crossed.

Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the veins on the leg, although varicose veins can occur elsewhere. Veins have pairs of leaflet valves to prevent blood from flowing backwards (retrograde flow or venous reflux). Hemorrhoids are a type of varicose vein. Varicose veins are distinguished from reticular veins (blue veins) and telangiectasias (spider veins), which also involve valvular insufficiency, by the size and location of the veins.

Varicose veins appear when blood collects in a vein instead of being pumped back to the heart. Any vein may become varicose, but the veins most commonly affected are those in the legs and feet. That's because standing and walking increase the pressure in the veins in your lower body. Varicose veins develop in people who stand or sit for long periods of time.

Signs and Symptoms of developing Varicose Veins

Swelling of the legs, restlessness, leg sores, itching, leg cramps, feeling of heaviness in the legs and fatigue. There may also be a brownish discoloration of the skin which is known as stasis pigmentation. This is caused by a breakdown of blood cells leading to a leakage in the affected area and is common in people who have suffered from this condition for a lengthy period of time.

Usually diagnosis is simply a case of visual observation but sometimes a procedure called phlebography is used. This is a painless procedure in which a solution called a radio-opaque contrast medium is introduced into the bloodstream. Imaging of the veins is then carried out to detect the abnormalities in the blood flow and venous pressure.

Another diagnostic procedure available is the use of ultrasound to examine the blood flow in the major arteries and veins in the arms and legs. This procedure is known as Doppler's ultrasonography. Ultrasound is high frequency sound waves that echo off the body. It is performed by applying a water soluble gel to the body and then passing a hand held device known as a transducer over the area.

Home Treatments for Varicose Veins

Treatment of varicose veins can be as simple as wearing elasticized compression stockings, controlling your weight, undertaking a moderate exercise program, avoiding prolonged periods of standing, and elevating the legs whenever possible. Before considering having a procedure done to surgically treat your varicose veins, keep in mind that most varicose vein problems can be treated without resorting to an invasive operation.

Varicose veins develop as a result of gravitational forces. This may just be due to simple aging. To counteract this doctors may prescribe that the legs be elevated above the heart for a prescribed period of time during the day in order to help the blood trapped in the veins return to the heart for oxygenation.

In addition to the elevation of the legs most doctors will prescribe a regimen of walking or aerobic exercise as well as the application of a compression bandage that winds around the affected area. This helps decrease the volume of blood trapped in the legs and over time makes the veins shrink.

Prevention for varicose veins initially begins with the wearing of support hosiery. But a healthy diet and lifestyle can do wonders to avoid the occurrence of varicose veins.

  • Eat a balanced diet low in fat and carbohydrates and include lots of fresh fruits and vegetables.
  • Take vitamin C. Vitamin C helps strengthen blood vessel walls.
  • Keep the diet high in fiber to prevent constipation.
  • Avoid sugar, fried foods, junk foods, tobacco, salt, alcohol, processed and refined foods.
  • Exercise daily to maintain a healthy weight. Walking, swimming and bicycling all promote good circulation.
  • Do not wear tight clothes which restrict blood flow.
  • At least once a day sit with the legs above the heart level for 20 minutes to relieve symptoms.
  • Avoid standing or sitting for long periods of time.
  • Avoid crossing the legs when sitting.
  • Avoid heavy lifting and putting any unnecessary pressure on the legs.
  • Herbs, such as red clover and horse chestnut, are especially helpful in maintaining healthy strong veins.

Surgical Procedure for Varicose Veins

The most common surgical procedure used to correct varicose veins is called sclerotherapy. In this procedure, points of abnormal flow from deep to superficial veins are located and permanently obliterated by the injection of a substance called a sclerosant. Application of continuous pressure then restores the pumping capacity of the vein. This procedure is used to decrease the visibility of spider veins that mostly occur on the legs but can occur on other places of the body as well.

Before having this operation you should also be aware that it could be very uncomfortable because basically an irritant is injected into the veins to induce an inflammatory response. This causes the veins to shrink. You should also be aware that sclerotherapy only works on tiny veins and not larger ones.

You should also realize that one quarter of patients that do receive sclerotherapy also end up with a hyper pigmentation on their legs around the injection sites, which may be as objectionable to look at as the varicose veins.

You might also experience a phenomenon known as vein matting, which means that tiny clusters of veins around the site of the injection area could turn blue. Unfortunately this is because sometimes the attempt to remove one varicose vein creates several smaller ones. Sometimes these veins can be treated with another injection but the success rate of this treatment is very low.

If you do opt for sclerotherapy keep in mind that your legs may be red, discolored or bruised for a couple of weeks after the injections. In fact your legs may look worse than they did in the first place so don't get this operation with the expectation that you will look better in a bathing suit after a few days. Like most plastic surgeries, sclerotherapy is not a quick fix for varicose veins.

In severe cases, a surgical procedure called stripping and ligation may be considered necessary. During this surgery, one or more incisions are made over the varicose veins, and the vein is tied off (ligated). If several valves in the vein and the vein itself are heavily damaged, the vein (or the diseased part of the vein) is usually removed (stripped). An incision is made below the varicose vein, a flexible instrument is threaded up the vein to the first incision, and the vein is grasped and removed.

If you have varicose veins, it is necessary to seek medical advice. Your health practitioner will advise you of treatment options and will assist you in the care of your condition.

  • Ankle swelling, especially in evening.
  • Aching, heavy legs (often worse at night and after exercise).
  • Appearance of spider veins (telangiectasia) in the affected leg.
  • A brownish-yellow shiny skin discoloration near the affected veins.
  • Cramps may develop especially when making a sudden move as standing up.
  • Minor injuries to the area may bleed more than normal or take a long time to heal.
  • Whitened, irregular scar-like patches can appear at the ankles. This is known as atrophie blanche.
  • In some people the skin above the ankle may shrink (lipodermatosclerosis) because the fat underneath the skin becomes hard.
  • Redness, dryness, and itchiness of areas of skin, termed stasis dermatitis or venous eczema, because of waste products building up in the leg.
  • Restless legs syndrome appears to be a common overlapping clinical syndrome in patients with varicose veins and other chronic venous insufficiency.
  • One in-hospital death from PAD or CLI can cost $12,000.
  • The estimated total cost of PAD in 2010 was between $164 and $300 billion.
  • Peripheral arterial disease actually costs more than coronary disease and four times more than costs surrounding strokes.
  • Seventy-five percent of those with PAD are asymptomatic. While they do not have leg symptoms, 70 percent most likely have coronary and/or cerebrovascular disease.
  • Between 5 and 10 percent of patients requiring below-knee amputations die in the hospital. Approximately 15 to 20 percent of patients who require above-knee amputations die while hospitalized.
  • There is a high rate of revision amputations. This means the initial amputation did not heal adequately and the patient requires another amputation on that same leg at a higher level. The revision amputation rate is 20 percent in patients requiring below-knee amputations and 12 percent in patients who require above-knee amputations.



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