Varicose Vein.

Varicose veins, also spelt sometimes as vericose veins, are enlarged or engorged superficial veins in legs. A varicose vein is more commonly seen in women than in men, and is seen usually  in child  bearing  and advanced age.

Vein varicosity occurs in the superficial veins of the legs which are normally not visible. These superficial veins of the legs drain into the deep veins of the legs. These deep veins  transporting blood from the legs to the heart have to do this against gravity.

They are therefore provided with a few valves along their length that have leaflets  which prevent the blood from flowing backwards due to gravity.
The deeper veins in the leg propel blood upwards towards the heart with the help of the pumping action of the leg muscles.

Cause of  Varicose Veins.

When these leaflet valves of the leg veins do not function properly, the blood stays back in the veins. There is back flow due to which blood accumulates in the deep veins and the superficial veins which causes them to get engorged resulting in vein varicosity. The superficial engorged veins of the leg become visible through the skin and are called varicose veins. Vein varicosity is therefore a result of engorgement of the veins in legs due to improper blood flow through the veins.

Image of varicose veins.

Photo of Varicose vein.

Spider Vein.

Similarly, when the small superficial veins in the skin get enlarged, they are called spider veins because of their appearance. Spider veins are usually seen in the legs and around the face. Varicose veins are usually singular while spider veins are seen as a network of  tiny small veins. A spider vein is closer to the skin than a varicose vein. Spider veins look like tree branches or legs of a spider and hence the name.

Photo of Spider veins.

Causes of Varicose Veins.

Varicose vein results due to various causes.

• Hereditary factor.
• Pregnancy.
• Menopause.
• Advancing age.
• Obesity.
• Occupational compulsion of prolonged standing hours.
• Straining due to chronic constipation or during urination due to an enlarged prostrate.
• Any pathology obstructing the vein.

Varicose Vein Symptoms.

• The affected leg feels heavy and is painful.
• Skin becomes bluish around the varicose vein site.
• The ankle of the affected leg becomes swollen.
• Leg cramps are felt.
• Itching near the varicose veins. Scratching can lead to a varicose  ulcer which does not heal easily.

Complications of Varicose Vein.

Complications of varicose veins occur due to poor circulation of blood in the veins in the legs.

• Inability to stand for prolonged period.
• Dermatitis of the skin develops which can lead to ulcer formation.
• Rarely, a long standing ulcer becomes malignant.
• Any injury  to the affected leg may result in severe bleeding.
• Due to sluggish circulation of the blood , blood clotting may form. However, being in the superficial veins, these clots are harmless.

Varicose Vein Therapy.

This is an initial therapy for varicose veins to help the patient tide over the varicose vein symptoms.

• Periodically during the day, adopt a sitting or sleeping position to elevate the legs above heart level. This will help to empty the engorged veins with the help of gravity.
• Wear compression stockings for varicose veins in the morning. This will keep the engorgement of the vein to the minimum.

Prevention of  Varicose Vein.

If you have a hereditary predisposition, follow the tips below to prevent this condition.

• Avoid drinking alcohol.
• Avoid standing for a long time.
• Lose weight, if you are over weight.
• If you have chronic constipation, get it treated.
• If you an enlarged prostrate, get it treated.
• If you have a sitting job, take periodic breaks and walk around a bit.
• Resort  to  walking exercise everyday.
• Avoid a tight belt around the midriff.

Varicose Veins and Pregnancy.

In Pregnancy, it is best to wait for about  8  weeks after delivery,  for treatment of varicose veins in pregnancy, because  till then most of the varicose veins will disappear.

Varicose Vein Treatment.

There are various varicose veins treatments and their  main purpose is to close or remove the varicose veins so that the blood flows through the good veins.

1) Sclerotherapy.

This procedure entails injection of medicine or foam into the affected vein to obliterate it. This is not  very successful. Occasionally, allergy to the medicine may develop.

2) Varicose Vein Laser Treatment.

Varicose vein laser surgery requires the varicose vein to be visualized with the help of an ultra sound machine. Under vision, the laser is passed over it to close the affected vein. It is usually done for small spider veins. This is  not time proven and repetitive treatment with laser is required.

3) Surgery for Varicose Veins.

There are various  procedures for varicose vein surgery that are followed depending on the severity and age of the case.  They are explained below.

• Ambulatory Phlebectomy in Varicose Vein surgery– The affected vein is mapped on the skin and through a series of tiny incisions the varicosed vein is removed. This varicose vein removal is generally indicated in larger veins and this procedure is performed under local anesthesia.
• Veno stripping for Varicose veins: This is indicated in the varicosed  long Saphenous  vein. Through an incision in the groin and at the knee , a tunneling flexible device is inserted, and the  long saphenous vein is pulled out. Its  connection to the deep veins of the legs are then tied. Bleeding is stopped by compression.  After ten days, the patient is able to resume normal duties. Disadvantage of veno stripping lies in the fact that, this is the vein that is used for cardiac bypass surgery and  it becomes unavailable for a bypass if required at a later date.
• Endovenous Thermal Ablation is a newer alternative to vein stripping. It is indicated in larger veins such as the great Saphenous vein or the small saphenous vein. In this procedure,  a catheter is introduced in the varicose vein through a small incision and heat is passed through the catheter. The catheter is then removed and the varicosed vein collapses due to scarring  by  the heat.

Picture of  Thermal Ablation of varicose vein.

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