Varicose veins are squiggly blood vessels that shine blue-purple through the skin. These can be very small blood vessels or bigger swollen vessels that are visible as lumps. Varicose veins can occur in all limbs, but are usually found in the legs. In many cases they cause no symptoms, but sometimes they cause itch, tired legs or leg pain.
Cause
How varicose veins arise is not all clear, but it seems mainly related to bad closing valves in the (leg) veins. As a result, the blood cannot flow properly upwards. That causes more accumulation (congestion) of blood, making the veins expand even further. This gradually leads to varicose veins.
The following factors contribute to having varicose veins:
- Overweight.
- High blood pressure.
- Heredity.
- Menopause. Hormonal changes can cause varicose veins.
- Pregnancy. During pregnancy, chances of having varicose veins increases by, among other things, altered hormone levels and the growing uterus (causing a poor blood flow back to the heart).
- A standing profession. Teachers, retail and hospitality staff have more chances of having varicose veins.
Symptoms
In most cases, varicose veins don’t hurt. However, a person can experience the following signs and symptoms:
- Visible squiggly (blue) lines that disfigure the legs. They have a thickness of a few millimeters to more than a centimeter and may be several centimeters long.
- Tired and/or heavy legs.
- Burning sensation in feet and ankles.
- Nightly cramps.
- Swollen ankles (edema).
Sometimes, a vein may get inflamed. At the location of the varicose vein, a red, swollen, painful, hard strand emerges. When inflamed varicose veins are not treated in time, they can lead to complications, such as phlebitis, deep vein thrombosis, bleeding in the leg and gray-blue discoloration of the ankles.
Diagnosis
The diagnosis of varicose veins is sometimes already clear after physical examination. Additional examination will often be done in the form of doppler or duplex ultrasound. The latter examination can usually determine the cause of varicose veins with certainty.
Sometimes, X-rays are made of the veins in the leg. A contrast fluid is used then, which is injected into a vein. The examination provides information about the discharge of blood and the operation of the valves in the deep (not visible) calf veins.
Treatment
Although varicose veins don’t hurt, most people want to get rid of them because they disfigure their legs. Varicose veins may eventually cause complications. There are several treatments available to reduce the symptoms and/or remove varicose veins:
- Spray the varicose veins away (sclerosing). A special fluid is injected into the veins through a thin needle. After the injection of the fluid, the veins are compressed and the vessel walls will stick to each other. After treatment, the patient should wear compression stockings for some time, so that the vessels remain compressed.
- Laser treatment. Through an incision in the vein, a catheter and laser wire are inserted. The varicose veins are lasered and closed from within by slowly pulling back the laser catheter from the vein.
- Compression therapy. This treatment stimulates blood circulation in the legs by pressure of a bandage or elastic stockings. This allows the symptoms to decrease.
- Surgery. A surgeon can remove large varicose veins and completely pull them out of the leg through an incision in the groin. Or by means of small incisions in the skin next to the varicose vein. With small hooks, the smaller unsightly veins are pulled out.
- VNUS closure procedure. This is one of the most modern techniques for removing varicose veins. With this treatment, only a small incision is made in the skin. Then, a catheter is inserted in the open vein. With high-frequency radio waves, the varicose vein is then heated, causing it to shrink. By gradually pulling back the catheter, the entire varicose vein can be closed by means of heating. The treatment lasts up to one hour.
Prognosis
Varicose veins usually don’t need to be treated. However, it’s impossible to predict whether varicose veins can cause problems. After treatment or removal of varicose veins, new varicose veins may arise again.
Considerations
Tips to prevent varicose veins:
- Plenty of exercise. This ensures that the blood circulation keeps going, which prevents varicose veins.
- Avoid prolonged standing and sitting with legs down. Put the legs high while sitting.
- Avoid overweight.
- Wear compression stockings during a long drive or flight, during pregnancy and in early varicose veins.
