Varicose veins are dark, bulging, twisted veins that usually appear on the back of the calf, on the inside of the leg, or in the groin. Varicose veins develop when the specialized, one-way valves that keep blood moving upward through the legs toward the heart deteriorate. In normal veins a series of these valves work together, opening to allow blood to flow upward, then closing to keep the blood from flowing back toward the feet. As the valves deteriorate blood leaks or flows backward and pressure in the vein increases, stretching and dilating the vessel. The backflow of blood can also result in the formation of a blood clot, a condition called deep vein thrombosis.
Risk Factors and Symptoms
Varicose veins occur more frequently in women than in men. People who are overweight, who spend much of their day standing, and women who are pregnant are more likely to develop varicose veins. Age and heredity are also risk factors for developing varicose veins.
Varicose veins can become very uncomfortable, causing swelling as well as painful aching, throbbing, or cramping in the feet and legs.
Doctors may use a venous ultrasound test to determine the cause or severity of the condition and to see whether the enlarged veins contain blood clots.
Minimally Invasive Procedures
Most varicose veins can be managed with non-surgical treatment such as compression stockings, which apply a steady pressure to the legs to help the veins and leg muscles move blood efficiently toward the heart. Exercise, elevating the legs when sitting, and avoiding long periods of standing can also help.
Endovenous Laser Therapy: Doctors treat some people with varicose veins with endovenous laser therapy (EVLT). During this procedure vascular specialists introduce a long, flexible, hollow tube called a catheter into the body through a needle puncture in the groin. The catheter, which is tipped with a laser, is guided to the varicose vein and inserted into it. Laser energy is shone into the interior of the vein, causing the vein to contract. The optical fiber is slowly withdrawn, and the vein closes up behind it.
Sclerotherapy: Sclerotherapy is a simple procedure during which doctors remove small varicose veins. Doctors inject a concentrated saline or other solution into the varicose vein, which irritates the lining of the vein and causes it to close up or collapse. Healthy blood vessels nearby absorb the blood flow of the collapsed vein. Patients usually wear compression stockings or elastic bandages for several days after the procedure.
Vascular specialists may recommend surgical treatment for patients whose varicose veins cause severe aching, infections, or venous ulcers, or whose varicose veins are particularly large or severe or involve large veins in the groin.
Ligation and stripping: Vascular specialists perform surgical ligation and stripping by making short incisions in the skin along the leg, and tying off, or ligating, the varicose vein by tying a small stitch around it to block blood flow. If only one valve is damaged, the ligated vein may be left in place. If numerous valves are damaged, doctors remove, or strip, the vein by using a special instrument to grasp and remove it. The other veins in the leg take over the work of those that are removed. Patients may wear an elastic bandage or support stocking for a few days following the procedure to control swelling and bruising.