Varicose Veins Treatment
VARICOSE VEINS CAUSES, SYMPTOMS, AND TREATMENT
Varicose veins are abnormal, enlarged, and twisted blood vessels on the legs and feet. If left untreated, they may cause discomfort, pain, ulcers, and clots.
What are varicose veins?
Varicose veins (or varicosis) occur when blood vessels just beneath the skin become large, twisted, bulging, increasingly visible, and dark purple or bluish. The condition typically affects the legs and feet. It occurs in 20% of the adult population and becomes more common with age. After 50, one out of two people has varicose veins. Women, overweight people, and those who must stand still or sit at a desk for long periods are more likely to develop varicosis.
Spider veins are a milder form of varicose veins. These are capillary varices, usually red and less than 1 mm in diameter. They may resemble a spider web on the skin’s surface.
What causes varicose veins?
A varicose vein develops when the small valve inside stops working properly. The blood is not pumped to the heart effectively; it accumulates inside the vein and deforms the valve further. The increased pressure makes the vessel’s wall weaker, and the vein expands and becomes visible: varicosis occurs.
Estrogen can relax the vein walls and trigger the formation of varicose veins, which is why varicosis is more common in women. Pregnancy and the use of birth control pills may also contribute to the formation of enlarged vessels. The risk is higher for those who have a family member with varicosis than for those with no family history. Risk factors include a sedentary lifestyle, overweight, hot climates, exposure to heat, constipation, and wearing accessories such as knee pads, knee bands, or high-heel shoes.
Varicose veins symptoms
Swollen veins have a distinctive look, and, therefore, the most common complaint is the deterioration of the appearance of the legs. In addition to the visible symptoms, common symptoms of varicose veins are:
- A gradually increasing heavy feeling or leg pain during the day
- Leg swelling, first only in the evening and later throughout the day
- Night cramps due to venous hypertension caused by blood accumulation in the legs
- Itching, warmth, a burning sensation, or throbbing in the legs
- Small bruises that occur spontaneously or with slight bumps on the legs
- Brown or purplish spots around the ankle
- Discoloration of the skin
- Wounds on the legs or ankles take a long time to heal
- Restless leg syndrome
Varicose vein symptoms may vary from one person to another. They are usually more intense during hot weather or longer periods of inactivity.
Varicose veins stages
Doctors use the universal CEAP scale to evaluate the problem and determine the varicose veins treatment. The stages are classified as follows:
C0: No visible or palpable signs of venous disease
C1: Telangiectasias (spider veins) or reticular veins begin to appear
C2: Large venous varicose veins now appear
C3: Swelling of the feet and ankles (edema)
C4a: Discoloration of the feet
C4b: Skin changes
C5: unhealed wounds
C6: Active varicose wounds that have not healed
In the early stage, the symptoms of varicose veins can be controlled with lifestyle changes, such as a healthy diet, regular exercise, and compression stockings.
When to worry about varicose veins
Varicose veins are a common condition, and for many people, they do not cause problems other than aesthetic concerns. However, they can cause symptoms such as pain, swelling, or discoloration of the skin, in which case a doctor should be consulted. The longer the problem is left untreated, the higher the risk of complications.
Are varicose veins dangerous?
Varicosis is one of the most neglected diseases by both physicians and patients. It is typically ignored until it reaches a severe stage. Varicose veins are much more than a cosmetic problem. If left untreated, leaking valves may cause clotting and inflammation (thrombophlebitis) in the vein. This condition can lead to vascular occlusion and respiratory failure, ranging from occlusion in the lungs (pulmonary embolism) to death by clot rupture.
Surgical treatment for varicose veins
Nowadays, open surgery is often replaced by minimally invasive methods to treat varicose veins. Some surgeries are performed as outpatient procedures and do not require a hospital stay. Thanks to the new techniques we perform at Acıbadem, we achieve good cosmetic results with maximum comfort for the patient.
To determine the right treatment, a vascular surgery specialist will examine the patient and identify the source of the varicosis. Color Doppler ultrasound is the best tool for diagnosing varicose veins and visualizing blood flow through the valves. Vessel mapping helps evaluate which vessels require intervention. Based on these findings, the specialist may recommend surgery or another procedure, including:
- Endovenous laser ablation. This technique closes the vein causing varicosis with a thin catheter that emits laser energy from the inside. The advantages of this method are that it only takes 30 minutes and the patient can walk immediately after the procedure. The success rate is as high as 94–99%.
- Endovenous radiofrequency ablation. This technique is similar to the laser procedure, but the vessel is closed using a different energy. A thin radiofrequency catheter is inserted inside the vein, and the leakage point is closed using 120°C energy. No external surgical incision is made in this area. All procedures are performed subcutaneously under ultrasound guidance.
- Embolization with adhesive agents (BioGlue). Treatment with adhesive agents (cyanoacrylate) is one of the newest methods. The adhesive agent (BioGlue) is carefully delivered to the leaking vein under ultrasound guidance. For 1–3 minutes, the vessel is pressed so it will adhere to itself. No cuts or sutures are made. The effect is instant.
- Removal of varicose veins with the mini-incision technique (mini-phlebectomy). Used alone or in combination with other procedures, this technique allows the removal of varicose clusters bulging outward through very small pinholes. These punctures are not sutured but only covered with medical tape. In about a week, the puncture is completely closed.
- Sclerotherapy. This treatment aims to dry the varicose veins by delivering sclerosant medication through very fine needles. The closed vein is dissolved by the body and eliminated over time. The method requires compression over the affected site for at least 2–3 days for best results. The efficacy of the sclerotherapy treatment becomes evident within 4–6 weeks. Depending on the case, it may require further sessions. The administration of sclerotherapy to very small vessels is called microsclerotherapy. It requires special needles and magnifiers, as well as a skilled physician for optimal outcomes.
