Overview

Overview

Varicose veins are bluish, twisted visible veins, just below the skin, seen over your legs.

Common signs and symptoms of varicose veins include:

  • Enlarged veins that are visible on your skin
  • Mild swelling of your ankles and feet
  • Painful, achy, or “heavy” legs
  • Itchy legs
  • Discoloration of your skin surrounding the varicose veins

Veins are blood vessels that take impure blood from the body to the heart. There are two systems of veins, one under the skin (superficial) & one in the muscles of the leg (deep veins). These are all connected through a series of channels called perforators. These have multiple valves which allow the blood to flow in one direction only. The direction of flow of blood is from foot to the heart & from superficial to deep veins. Any factors which cause damage to the valves can change the direction in which the blood flows. In your legs, this causes all the blood to flow back into the leg & pool. Over a period of time, this causes the stretching of the veins & they become visible & dilated. 

Risk Factors

Genetics. Approximately half of the people who get varicose veins have a family history of them.

Age. The normal wear and tear of aging may cause valves to weaken and not work as well.

Gender. Women are two to three times more likely to develop varicose veins than men. Changes in hormones or taking birth control pills may increase a woman’s risk of developing varicose veins.

Pregnancy. During pregnancy, the growth of the fetus increases the pressure on the veins in the legs. 

Overweight and obesity. Having extra weight on the body can put additional pressure on the veins.

Prolonged standing or sitting, When standing or sitting with legs bent or crossed, the veins have to work harder to pump the blood up to the heart.

How are the varicose veins diagnosed?

Varicose veins if visible are diagnosed clinically by your surgeon. A venous doppler is asked for, which is an ultrasound of your leg, to see the blood vessels, blood flow in them & status of valves & perforators. This also helps the surgeon know the site of defect in the veins & plan the surgery.

What are the general measures in treating varicose veins?

Avoid excess amounts of standing when possible. Walking is good.

Elevate your legs when sitting, resting, or sleeping.

Wear compression stockings throughout the day..

Lose weight. 

Avoid wearing tight clothes

What are the surgical measures?

Sclerotherapy. This involves several injections into the affected veins. A special chemical called sclerosant is used which obliterates the vein. This is followed by a compression dressing. This is good for small or residual varicosities. You may need several sittings.

Endovenous ablation therapy. A tiny tube or a catheter is introduced into the varicose veins & an energy source (laser or radiowave) is used to destroy the lining of the veins making it to close off. The procedure is carried out under doppler ultrasound guidance. Once the diseased veins close blood flows through veins with normally functioning valves.

Generally the surgery is either carried out as a daycare procedure & occasionally requires an overnight stay. Both the procedures are carried out in conjunction.

After the procedure the veins that were prominent become hardened initially and then gradually disappear over few months. Compression garments are recommended during this period.

You can check out an animation of the procedure by clicking on videos on the resource tab on home page