What are Varicose Veins ?
Varicose veins are dilated and engorged veins in the legs due to leakage of blood going down the leg on prolonged standing and may lead to pain, discolouration and ulcers which do not heal easily. They are usually familial or occupation driven mostly due to prolonged standing hours. They start as small veins at the ankle and progress to large dilated veins sometimes visible throughout the leg. They can be associated with bleeding or ulcer formation which is quite painful and the ulcers may not heal with conventional wound care.
Why do Varicose Veins occur ?
Blood flows via 2 channels, ‘good’ blood from the heart to the foot and ‘bad’ blood from the foot back into the heart. The flow of blood in these veins are assisted with valves which push blood from down to up and from outside to inside and up.
These valves can get dilated with the veins, leading to valve dysfunction and hence leakage. The leakage is not significant while sleeping or keeping the legs straight; however on long hours of keeping the legs down, they lead to dilatation and engorgement of the veins, thus leading to the symptoms of varicose veins.
Can you Prevent Varicose Veins ?
- Avoid long hours of standing or keeping legs down
- Exercise or walk regularly to keep blood flowing
- Keep weight under control
- Wear stockings if having high risk of varicose veins
When to meet a Vascular Surgeon for Varicose Veins ?
- Skin ulceration of flaking
- Bleeding varicose veins
- Pain over the varicose veins
- Redness over the area over the varicose veins
Treatment options of Varicose Veins
- Medicines – Vein strengthening medications
- Compression therapy – Compression stockings are used as frontline therapy for varicose veins to see if compression relieves the symptoms. In case of venous ulcer, 4 layer bandaging can be done.
- Endovenous Therapy for Varicose Veins included Endovenous Laser Ablation, Radiofrequency Ablation, Endovenous Glue Ablation, Endovenous Microwave Ablation and Sclerotherapy
- Microphlebectomy : Hooking of small veins with mini incisions over the skin
- Open Surgical Stripping of the veins – Not recommended with current modalities
After the procedure :
Stockings are recommended only for a few weeks post procedure until the post operative inflammation subsides. However treatment of varicose veins does not guarantee the advent of new veins as varicose veins can occur to any normal vein due to age. Hence lifestyle modification is required to prevent more varicose veins.