Varicose Veins are large dilated veins due to malfunction of venous valves. As a result long standing venous insufficiency occurs; due to the poorly functioning valves which will allow the blood to pool in the lower leg and cause symptoms. They are not always seen superficially, but most people notice them bulging veins in the legs. Symptoms can differ from one patient to another.
Varicose veins occur due to many reasons: for instance pregnancy, over weight, compression of the Iliac veins, previous deep vein thrombosis increases the risk of developing varicose veins. They can also be congenital. In general varicose veins are a benign condition that is not life threatening; but can be disabling to the patient as the symptoms progress.
– Symptoms may be absent.
– Pain, itching, swelling, burning, leg heaviness or tiredness, skin color changes.
– Superficial Vein Thrombophlebitis (SVT); clotting of the varicose veins which may become painful, hot, hard and discolored. This is called phlebitis; which is a misnomer as it is thrombosis of the veins. Treatment depends on the patient’s symptoms but most of the times it is a self-limiting disease. SVT is treated with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and short course of oral anti-coagulant.
– Venous Ulceration; which is a result of long standing venous insufficiency . Treatment is focused on managing the ulcer and treating the underlying venous insuffiency.
Diagnosis should include a detailed history taking from the patient, physical exam and performing an ultra-sound scan of the veins ( determines the anatomy and helps in selecting the treatment method). In some case a CT scan dedicated to the veins is require for more details of the condition)
It depends on the patient condition, status of the veins, anatomy of the veins and age. Appropriate treatment method selection is very important, as treatment should be individualized to every patient.
– Surgical ligation or stripping of the vein.
– Sclerotherapy (For small and superficial spider veins)