Home | Articles | Varicose Veins

By Dr. Sibasankar Dalai

Sr. Consultant Neuro Vascular Intervention
Published on: 23 Sep 2021

By Dr Dhananjay Bansal

Consultant - CTVS

Dr Sridhar Reddy Baddam

Senior Consultant Vascular & Oncointerventional Specialist

Article Context:

  1. Varicose Veins
  2. Varicose Veins Symptoms
  3. Varicose Veins Causes
  4. Varicose Veins Treatments
  5. Risk Factors
  6. Preventions
  7. Faqs

What Are Varicose Veins?

They are abnormally dilated, tortuous superficial veins. These are commonly formed in legs due to defective, incompetent venous valves, and are widely observed in the legs of females aged 40s and rarely seen in males.

  • Varicose veins are enlarged, swollen, and distorted, often blue or dark purple. They occur when defective valves in the veins allow blood to flow or pool in the wrong direction. Varicose veins are believed to affect more than 23 percent of all adults.
  • Stages Of Varicose Veins:-

  • Stage I - Small thin, thready veins
  • Stage II - Large dilated visible veins
  • Stage III - Swelling in leg / Edema
  • Stage IV - Venous Ulcers, Discoloration of skin
  • Varicose Veins

    Varicose Veins Symptoms

    Many patients have different complaints. The most common complaints are pain, itching sensation, soreness, cramps in the legs, and swelling legs.

    • Highly noticeable, misshapen veins are the main signs of varicose veins, usually on your legs. You can also have stiffness, swelling, weightiness, and discomfort around or around the swollen veins.
    • You may experience swelling and discoloration in some cases. The veins can bleed substantially in extreme cases, and ulcers can form.
    • In color, veins that are dark purple or blue
    • Twisted and bulging veins; they are also like cords on your thighs,
    • A tight or achy sensation in your legs
    • In your lower legs, burning, throbbing, muscle cramping, and swelling
    • Worsened discomfort after a long period of sitting or standing
    • Itching along with one of your veins or more
    • Change in the color of the skin around a varicose vein
    • Varicose veins are similar to spider veins, but they are narrower. Closer to the surface of the skin, spider veins are located and are mostly red or blue.
    • On the legs, spider veins occur, but can also be located on the face. They differ in size and also look like the web of a spider.

    Symptoms

    Muscles in the legs may be tired, heavy, or sluggish, especially after physical activity.

    Severe varicose veins can cause venous ulcers on the skin.

    Burning sensation in the foot and skin dryness.

    Varicose veins typically appear in the lower half of your body, particularly calves, ankles, and feet. They can also form in the pelvic area (pelvic congestion syndrome), particularly in women who had children. Varicose veins in the testicles (Varicocele) can cause infertility.

    When to consult a doctor:-

    When a patient notices the dilated visible veins in the legs or any symptoms mentioned above, they should consult a doctor for a medical opinion.

    Varicose Veins Causes

    Usually, the blood (Bad or Dark blood) flows from the legs back to the heart in the veins and this flow is guided by valves allowing one-way flow. The blood flows from superficial veins to deep veins (veins in the leg muscles) and from deep veins to the heart. When the guiding valves are incompetent or defective, blood flows in the opposite direction i.e., from deep veins to superficial veins, and blood starts pooling in superficial veins along gravity. The veins, over time, dilate and get distended, filling with bad blood, causing Visible Veins In the Legs called "Varicose Veins."

  • When veins are not working properly, varicose veins occur. Veins have one-way valves that prevent the backward flow of blood. Instead of continuing into your heart, blood starts to pool in the veins as these valves fail. And the veins enlarge. Sometimes, varicose veins damage the legs. There are the veins the farthest from your heart, and gravity makes it more difficult for the blood to flow upwards. For varicose veins, some possible causes include:
    • Menopause
    • Pregnancy
    • Obesity
    • Age over 50
    • Standing for long periods
    • Family history of varicose veins

    Risk Factors

  • Age: With age, the risk of varicose veins increases. Aging in your veins induces wear and tear on the valves that help control the flow of blood. Ultimately, the wear causes the valves to allow some blood to flow back into the veins where it pools instead of flowing to the heart.
  • Sex: Women have a higher risk of developing the disorder. As female hormones appear to relax vein walls, hormonal changes during pregnancy, pre-menstruation or menopause can be a factor. Your risk of varicose veins can be increased by hormone therapies, such as birth control pills.
  • For Pregnancy: The amount of blood in your body increases during pregnancy. The developing fetus is helped by this move, but it can also cause an unfortunate side effect: swollen veins in your legs. A function can also be played by hormonal shifts during pregnancy.
  • History of Families: If there are varicose veins in other family members, there is a greater risk that you will, too.
    • Being overweight places extra strain on your veins.
    • Standing for long periods, or sitting. When you're in the same place for long stretches, the blood doesn't flow as well.

    Who is at risk of developing varicose veins?

    Varicose veins can affect anyone. Certain factors which increase your the chances of developing varicose veins are:

    • Long standing: Any profession which involves long-standing as in teachers, traffic police are most affected.
    • Sedentary lifestyle: As in IT professionals, bankers are most affected due to sedentary lifestyle.
    • Gender: Hormones in the females can allow the walls of the veins to stretch.
    • Age over 50: Because of the aging process, veins lose elasticity and stiffen.

    Complications

    Vermin Ulcers

  • Near varicose veins, particularly near the ankles, painful ulcers can form on the skin. Typically, a discolored patch on the skin starts before an ulcer emerges. If you think you have developed an ulcer, see your doctor immediately.
  • Blood Clots

  • Veins deep inside the legs are sometimes widened. The affected leg can become painful and swell in such cases. Any recurrent leg pain or swelling requires medical attention since a blood clot, a condition medically known as thrombophlebitis, may be indicated.
  • Hemorrhages

  • Veins very close to the skin can burst occasionally. Normally, this causes only mild bleeding. But medical attention is needed for any bleeding.
  • Complication if left untreated:

    Varicose Veins Preventions

  • There's no way to avoid varicose veins entirely. But it can reduce the chance of forming varicose veins or having extra ones by improving your circulation and muscle tone. These same steps are important and you should take to treat varicose vein pain at home can help you to avoid the varicose veins which are.
    • Doing workout
    • Observing your weight
    • Eating a low-salt, high-fiber diet
    • The avoidance of high heels or any uncomfortable sandals and tight trousers
    • Uplifting your legs
    • Regularly modifying your sitting or standing position

    How are varicose veins diagnosed?

    Varicose veins are found near the skin's surface and can be diagnosed during a physical examination.

    Ultrasound: It is a safe, painless test that shows blood clots and how your valves are working.

    Varicose Veins Treatments

    Over the years, management has evolved for better improvement in patient symptoms, and remarkable differences are observed in treatment results and outcomes of varicose veins.
    Earlier, a patient used to undergo multiple incisions or cuts on the legs to get treated, and still, there was a high probability of recurrence. But, with the latest medical advances and treatment options available at Medicover hospital, we have seen 0% recurrence and great asymptomatic results.

  • The latest treatment options are:
  • 1. EVLT - Endo Venous Laser Treatment
  • 2. Sclerotherapy - Foam Sclerotherapy
  • 3. VENASEAL - Endovenous Glue Embolisation

  • This treatment includes ‘No cut ‘ techniques, where the patient has no incision or scar on the leg after the surgery and are done as day care procedures. After 2 hours of surgery, the patient starts walking and can resume regular duties the same day.
    No scar/ mark is seen anywhere on the leg. The patient is advised to wear compression stockings for 4-6 weeks after the procedure and thereafter can live a normal life.
    We offer the best possible treatment for the Varicose veins, keeping the patient profile in mind, and provide the best results with almost no possibility of recurrences.

    Lifestyle Changes

  • The following improvements can help prevent the formation or worsening of varicose veins:
    • For long periods, stop standing.
    • Lose weight or maintain a safe weight.
    • To boost circulation, work out.
    • Use socks or stockings with compression.
  • You should take these measures to avoid new varicose veins if you already have varicose veins. Whenever you are resting or sleeping, you can also lift your legs.
  • Compression

  • You may be recommended to wear special compression socks or stockings by your doctor. These put enough pressure on your legs so that blood can flow to your heart more easily. They often minimize swelling. Compression levels differ, but most forms of compression stockings are available.
  • Surgery

  • Your doctor may try an invasive procedure if lifestyle changes are not working, or if your varicose veins are causing a lot of pain or harming your overall health. A surgical treatment that involves anesthesia is vein ligation and stripping. Your surgeon makes cuts on the skin throughout the operation, cuts the varicose vein, and removes it through the incisions. While updated versions of vein-stripping surgeries have been developed, since newer, less invasive alternatives are available, they are less frequently carried out.
  • Other ways

  • A broad range of minimally invasive treatment options for varicose veins is currently available. They include:
    • Sclerotherapy, using a chemical injection of liquid or foam to block a larger vein from
    • Using liquid chemical injection to block smaller veins, micro sclerotherapy
    • Laser surgery, which uses light energy to block a vein from
    • Using heat and radiofrequency waves to block a vein, endovenous ablation therapy.
    • Endoscopic vein surgery with a small light scope inserted through a small incision to obstruct the vein Before selecting a procedure.
    • You should always speak to your doctor about your care options and the risks. The recommended technique will depend on your symptoms, size, and location of varicose.

    Treatment

    • Injection therapy (sclerotherapy): During sclerotherapy, a solution is injected into your vein causing the vein walls to stick together. Your vein eventually turns into scar tissue and fades away.
    • Laser therapy: In endovenous thermal ablation (EVLT), a catheter (a long, thin tube) and laser is used to close off a damaged vein.
    • Glue treatment: This is the most advanced and effective mode of laser treatment which is completely pain free and patients can walk home just within a few hours after glue treatment.

    All the above procedures are non-surgical which involves no cutting, suture or scar. It is just an IV cannula technique, where a cannula is placed in the ankle area and through it using ultrasound guidance, a hair thickness probe is passed into it, and laser treatment is done.

    Post procedure absolutely there are no signs of any surgery, in fact you will not even know from where it is done.

    • Vein surgery / Surgical stripping: The surgeon will tie off your affected vein (ligation) to stop blood from pooling and may remove the vein to prevent varicose veins. So it is also known as ligation and stripping. This is more of a surgery where it involves surgical cutting and opening. Basically it’s a procedure done and practiced 10-15years back and now it's almost outdated.

    Book an appointment with our Top Vascular Surgeon


    Reference link:

    Frequently Asked Questions:

    Poor vein walls and valves normally cause varicose veins. There are tiny one-way valves within your veins that open to allow the blood in, and then close to keep it from flowing backward. The walls of the veins are often stretched and lose their elasticity, which allows the valves to weaken.

    The resulting twisted blue bulges, referred to as varicose veins, can make your legs feel thick, exhausted, or achy and make you feel self-conscious about their unsightly appearance, but they are not a big threat to your health.

    • Carbohydrates Processed
    • The Sugar Added
    • Processed foods
    • Alcohol
    • Frozen Goods
    • Salty Foods

    Small lifestyle changes can work well for varicose veins, and walking is a perfect way to make those veins less visible and less painful. Varicose veins are caused by the failure of a vein to pump blood upwards properly through your body.

    Most of the time, about 3 to 4 months after the birth of a boy, varicose veins go down. During birth, wearing compression tights and such will help speed up the process while still covering them up.

    Regular workout. For your stage of pregnancy, remain within the recommended weight range. Whenever possible, elevate your feet and legs to your heart level or above. When seated, do not cross your legs or ankles. For long periods, don't sit or stand.

    These are the most advanced and highly successful treatments options preferred world over, when done by well trained and experienced vascular interventional radiologists.

    Spider veins are smaller red or purple lines that appear on the skin surface.

    Although treatments are very effective if done by experienced surgeon, varicose veins can return in non compliant and obese patients, however the success percentage is more than 95-98%.

    You should visit the doctor immediately if the skin or veins are bleeding, discolored, painful, red or warm to touch and swollen.

    Varicose veins mostly appear on the feet and legs. Spider veins are rarely painful. They can appear anywhere but they are most commonly found behind your knee, on your feet, or on your face.

    Vascular interventional radiologist usually does the procedures preferably as he has good understanding of the doppler imaging. Imaging is the key to success of the treatment.

    Yes, this is a successful non surgical treatment with almost no recurrence if post procedure instructions are strictly followed.

    You can resume normal activities from the next day and can go back to work after 2 days.

    Absolutely there is no restriction of any activity or food.

    Yes, absolutely after two days all activities can be resumed.