Varicose Veins are very common. Most often there is no danger to health, but occasionally can lead to more serious problems.
What are varicose veins?
Varicose veins are dilated, tortuous veins, most common on the legs which arise due to dysfunction of the valves in the veins. This causes the veins to enlarge with time.
How are varicose veins diagnosed?
The diagnosis of varicose veins can be made with a simple examination of the leg. They generally cause unsightly bulges on the leg and can cause various symptoms, including discomfort, tingling or even a warm sensation.
A duplex ultrasound scan will show which valves are involved and will help determine how best to deal with the varicose veins.
What are the treatment options?
Treatment is determined by the extent to which the veins bother the patient. If the varicose veins are not troublesome, and there is no concern about their appearance, then there is really no need to intervene.
Mild symptoms can often be controlled with compression stockings which may also prevent the veins from enlarging.
For relatively minor varicose veins with trivial venous reflux, injection sclerotherapy alone may be sufficient to control the veins.
For prominent varicose veins, a more definitive procedure is required. This can be achieved by either open conventional surgery or newer less invasive methods such as Endovenous Laser (EVLT), Radiofrequency (RF), or gluing. Refer to the treatment section for more information.
What are the potential complications?
Most patients with varicose are not at risk, though a small but significant number can go on to have significant complications. These include:
Acute superficial thrombophlebitis. This is due to a thrombosis (clot) in a varicose vein. The vein becomes hard, tender and inflamed, and may take several weeks to settle. Unlike a deep vein thrombosis, this is usually not dangerous and does not require anti-coagulation (blood thinners).
Bleeding. This is a very uncommon event, but if it occurs the bleeding can be frightening. Treatment involves compression of the bleeding point with a bandage, and elevation of the leg.
Swelling of the leg. This can occur due to faulty valves and high pressure in the veins.
Venous pigmentation and eczema. These are skin changes that reflect very pressure in the veins. They are often an indication that treatment of the varicose veins and venous insufficiency is necessary.
Lipodermatosclerosis. This is hardening of the soft tissues of the lower leg, and again a reflection of exceedingly high venous pressures. These patients are at risk of ulceration.
Venous ulceration. This typically occurs in patients with signs of venous hypertension such as lipodermatosclerosis and venous eczema. It most often overlies the inner ankle (medial malleolus).
For information about the surgical treatment of varicose veins, CLICK HERE!