Varicose veins are common venous disorders that occur both men and women. Varicose veins are located beneath the skin and can become abnormally large and swollen and painful.
Varicose veins can have various different colors but in general are bluish to purple. as varicose veins can have a tortuous warm-like appearance when they get bigger.
Causes of varicose veins
Normally there is one-way valve in the veins that carried of blood from the lower extremities to the heart.
These one-way valves allow the blood to go from the lower extremities up to the heart and prevents the blood from going back down to the leg.
If these valves are damaged, blood flow was back to the legs and pulled in the leg. This is called venous reflux disease. The buildup of blood in the leg can increase the venous pressure and cause a large varicose veins. as the varicose veins become larger, they can bulge from the skin into warm-like structure underneath the skin.
Symptoms of varicose vein include:
- Restless leg syndrome
- Pins and needles
- Charley horses
Diagnosis of varicose veins
This includes a detailed history and physical examination of the legs and an ultrasound examination to evaluate the venous anatomy of the legs and a reflux study that can be done in the office
Treatment for varicose veins
Treatment for varicose veins starts with lifestyle changes which should include not standing for prolonged periods of time, wearing compression stockings and moderate physical activity including walking
If the symptoms continue, despite noninvasive therapy and there is evidence of reflux in the veins, then the treatment would include ablation of the vein.
Endovenous Radiofrequency Ablation
Endovenous Radiofrequency Ablation is an ambulatory procedure that can be done in the office. This procedure is done under local anesthesia and takes about 15 minutes. Patient’s is able to walk out of the office and can go back to work the next day. Ablation of the saphenous vein can be done through various mechanisms such as laser or radiofrequency or injection of sclerosing agents into the vein. regardless of which method is used, once the saphenous vein is ablated there is less pressure on the very gross veins, diminishing symptoms such as pain and cramping.
After ablation of the saphenous vein, varicosities would diminish in size and prominence as well.
Subsequently if the large varicose veins still persist, they can be removed by various noninvasive procedures called microphlebectomy.
Microphlebectomy is a minimally invasive procedures that can be done in the office. During this procedure tiny 2 mm incisions are made over the varicose vein which is then removed physically. This procedure is also done in the office and the patient’s can go back to work soon after the procedure.
Sclerotherapy: small reticular and spider veins can be treated with sclerotherapy. During this procedure a sclero agent is injected into the vein that will help reduce the color of the veins.
Vein stripping is also a procedure to remove the saphenous vein. this is an older procedure which is more invasive and in general not used any more
If varicose veins are not treated, they may cause more pain, fatigue, swelling of the legs and the ankles and restless leg syndrome. If not treated, varicose veins can also cause more serious complications such as
- Bleeding from the varicose veins
- Deep venous thrombosis
- Inflammation of the vein caused superficial thrombophlebitis
- Venous ulcerations
- Hardening of the skin and the fat called lipoma dermal sclerosis
- Discoloration of the skin especially at the ankle caused by hyperpigmentation
At Encino vascular Institute, all diagnostic and therapeutic procedures regarding varicose veins are done in our vein clinic in an ambulatory setting. These procedures are done under local anesthesia and patient can walk out of the office and usually go back to work the next day.
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