Varicose Veins

Veins are thin-walled, soft structures that carry blood back to the heart. Normally, the blood flows in one direction (toward the heart), as the valves inside the veins prevent blood from refluxing in the reverse direction.

Varicose veins are enlarged, superficial veins in the legs that can be felt or seen under the skin. They develop due to loss of valve function and due to weakness in the wall of the vein. As a result, the vein becomes enlarged, elongated and varicose.  Smaller varicose veins, less than one millimeter in diameter, are called spider veins or telangiectasias.

Most varicose veins are caused by weakness in the wall of the vein, usually with loss of valve function. This may often start during pregnancy. They may also be inherited, and occur among members of the same family. Valves may also lose their function after blood clots (Deep Vein Thrombosis (DVT)).

Varicose veins by themselves pose no threat to your health. However, they may be a source of discomfort, due to cosmetic reasons or symptoms.

Symptoms
Symptoms and signs of varicose veins may include:

• Pain in the legs: fullness, heaviness, aching
• Itching
• Visible, enlarged veins
• Mild swelling of ankles
• Discoloration of the skin
• Skin ulcers near the ankle

Risk Factors of Varicose Veins
There are several risk factors for varicose veins.  The most common include:

• Increasing age
• Pregnancy and multiple pregnancies
• Family history
• Female
• Obesity
• A profession in which you stand on your legs for long periods of time

What to Expect at Your Medical Exam
Most of the time, varicose veins may be accurately diagnosed with history and physical examination. Your surgeon may ask about your symptoms, any history of DVT, and about any risk factors.

Diagnostic Tools
If your doctor has determined that you have varicose veins, then a Duplex ultrasound may be ordered. This is a noninvasive test that  can accurately image the veins, give information about valve function and measure the size and function of the veins. It can also determine if you have had a previous blood clot (DVT) in the veins.

Treatment for Varicose Veins
There are several treatment options for varicose veins. The type of treatment depends on the extent and severity of the varicose veins and the symptoms. Options may include:

• Compression garments or stockings
• Endovenous ablation therapy
• Sclerotherapy
• Surgical vein stripping
• Laser vein ablation
• Phlebectomy