Varicose Veins A Guide for Patients What are varicose veins?

Varicose Veins
A Guide for Patients
What are varicose veins?
Varicose veins are abnormal, dilated blood vessels caused by a weakening in the
vessel
wall.
There are many causes of varicose veins - the common are hereditary, pregnancy,
obesity, previous blood clots, even excessive standing or sitting at work.
Your veins carry blood back to the heart. In your leg, this means the blood has to
flow upward, against gravity. Consequently, these veins have one-way valves to
prevent the blood from back flowing. Over time these valves can fail to close
tightly allowing blood to pool and causing the bulging and twisting characteristic
of varicose veins.
What causes varicose veins?
High blood pressure inside your superficial leg
veins causes varicose veins. Factors that can
increase your risk for varicose veins include having a family history of varicose veins,
being overweight, not exercising enough, smoking, standing or sitting for long periods of
time, and having DVT. Women are more likely than men to develop varicose veins.
Varicose veins usually affect people between the ages of 30 and 70.
Pregnant women have an increased risk of developing varicose veins, but the veins often
return to normal within 1 year after childbirth. Women who have multiple pregnancies may
develop permanent varicose veins.
What are the symptoms of varicose veins?
Some people do not have symptoms but may be concerned about the appearance of the veins. If symptoms occur, they may
include:
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Swollen legs
Muscle cramps, soreness or aching in the legs
Tiredness, burning, throbbing, tingling or heaviness in the legs
Soreness behind the knee
Itching around the vein
Brown discoloration of the skin, especially around the ankles
Symptoms often worsen after prolonged standing or sitting. In women, symptoms may be worse during menstruation or
pregnancy. Occasionally varicose veins can Sometimes the condition leads to more serious problems, such as, a painful blood
clot, referred to as superficial phlebitis (inflammation of a vein), or skin ulcers.
How are varicose veins diagnosed?
During a physical exam, the doctor will check your legs while you are standing. Your doctor also may request that you have an
ultrasound scan to check the blood flow in the superficial veins (near the skin’s surface) and deep veins.
Treatment
Compression Stockings
Your doctor may prescribe compression stockings, which are elastic stockings that squeeze your veins and stop excess blood
from flowing backward. Compression stockings also can help heal skin sores and prevent them from returning. You may be
required to wear compression stockings daily for the rest of your life.
Photoderm
This procedure is done in the surgical day ward. A small probe, which emits intense, pulsed light, is placed on the affected area.
This is used to selectively damage or destroy abnormal small veins including small spider veins, certain sizes of varicose veins
and vascular birthmarks.
Laser Treatment
Your doctor inserts a tiny fibre into a varicose vein through a catheter. The
fibre sends out laser energy that kills the diseased portion of your varicose
vein. The vein closes and your body eventually absorbs it. This procedure is
performed under local anaesthetic and takes about 45minutes. You will be up
and walking as soon as it is over and you can go home straight away!
Vein Stripping
To perform vein stripping, your surgeon disconnects and ties off all varicose veins associated with the saphenous vein, the main
superficial vein in your leg. This vein is then removed from your leg. A procedure, called ‘small incision avulsion’ can be done
alone or together with vein stripping. Needle avulsions allow your surgeon to remove additional varicose veins branches from
your leg using hooks passed through small incisions. The skin is closed using steristrips (sticky paper strips) and if possible no
stitches are used. You are usually let home on the same day.
Post-operative instructions
You are encouraged to walk as soon as possible. You can return to work within a day post-laser treatment, or within one week
post vein stripping.
You may have some bruising and soreness for 7-10 days after the treatment, and you will be given a prescription for some antiinflammatory pain medication.
Day 2: Remove the first (Class II) elastic stockings from leg, leaving 2nd elastic compression stocking in place for one week
Day 7: Remove elastic stocking from leg and soak in warm bath, with Savalon or salt. This will remove the steristrips. Reapply
elastic stocking and continue to wear for at least two more weeks.
Week 6: You will have a check-up appointment. Options for treating rare small persistent veins or spider veins, e.g. photoderm
therapy, can be discussed at this point.
Complications:
Complications following Laser therapy are rare. However, a few complications are associated with vein stripping.
• Bruising or tender lumps may occur along the course of the removed vein. These resolve within 6-8 weeks.
• Swelling of the foot and ankle may occur but usually disappears within a few weeks. A few simple measures help
alleviate this, such as, wearing compression stockings, avoiding long periods of standing, sitting with you feet
elevated, taking short walks and keeping mobile.
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Rarely, the procedure can damage superficial nerves that lie near the stripped vein, causing a patchy area of numbness
in the leg. The nerves usually recover, however, and sensation returns within 6 to 12 months.
Department of Vascular and Endovascular Surgery
University College Hospital Galway
Phone: +353 91 542346
Fax: +353 91 542360
E-mail: [email protected]
www.vascular.ie