Varicose Veins Treatment - Acıbadem Healthcare Services
Varicose Veins Treatment

Varicose Veins Treatment

Varicose Veins Causes, Symptoms and Treatment

Varicose veins are abnormal, enlarged and twisted 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 occurs when blood vessels just beneath the skin become larger, twisted, bulging, increasingly visible, and bluish or dark purple in color. The condition typically affects the legs and feet. It is encountered in 20% of the adult population and becomes more common with age. After 50, one in every two people has varicose veins. Women, overweight people and those who have to stand still or sit at a desk for a long time are more likely to develop varicosis.

Spider veins are a milder form of varicose veins. These are capillary varices, usually red in color and smaller than 1 mm in diameter. They may resemble a spider web on the skin 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 even more. The increased pressure makes the vessel’s wall weaker, the vein expands and becomes visible. Varicosis occurs. 

The estrogen hormone may relax the veins’ walls and trigger the formation of varicose veins. That is why the condition is more common in women. Usage of birth control pills and pregnancy may also contribute to the formation of enlarged vessels. The risk is higher for those who have a family member with varicosis. Risk factors include sedentary lifestyle, overweight, exposure to heat and hot climate, constipation, 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 deterioration in the appearance of the legs. Besides the visible part, common symptoms of varicose veins are:

  • Gradually increasing heavy feeling or leg pain during the day
  • Leg swelling, first in the evening and later continuously during the day
  • Night cramps due to venous hypertension caused by blood accumulation in the leg
  • Itching, warmth, burning sensation or throbbing in the leg
  • Small bruises that occur spontaneously or with slight bumps on the legs
  • Brown purplish spots around the ankle, discoloration of the skin
  • Wounds on the legs or ankles that take time to heal.
  • Restless leg syndrome sometimes accompanies the picture

Varicose veins symptoms may vary from one person to another. They are usually more intensive during hot weather or longer inactive periods.

Varicose Veins Stages

Doctors use the universal CEAP scale to evaluate the problem and determine the varicose veins treatment. The stages are classified as below:

  • C0 – No visible and palpable signs of venous disease
  • C1 -Telangiectasies (spider veins) or reticular veins have started
  • C2 – Large venous varicose veins now appear
  • C3 – Swelling in the feet and ankles (edema)
  • C4a – Discoloration of the feet
  • C4b – Skin changes and partial collapse
  • C5 – Healed wounds
  • C6 – Active varicose wounds that have not healed

At an 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 aesthetics. However, if you have been experiencing negative symptoms such as pain, swelling, or discoloration of the skin, contact a doctor for evaluation. Keep in mind that the longer you live with this problem, the higher your 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 reaching the severe stages. 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 leads to vascular occlusions and respiratory failure ranging from occlusion in the lungs (pulmonary embolism) to death by clot rupture.

Varicose Veins Surgery Treatment

Nowadays, open surgery is replaced by minimally invasive methods for the treatment of varicose veins. Some of them are performed as outpatient procedures and do not require a hospital stay. Thanks to the new techniques performed at ACIBADEM, better cosmetic results are obtained with maximum comfort for the patient.

To determine the right treatment, a specialist in Vascular Surgery will examine the patient and identify the source points causing the varicose. Color Doppler ultrasound is the best tool used to diagnose varicose veins and visualize the blood flow through the valves. Vessel mapping helps to evaluate which vessels should be intervened. Based on these findings, the specialist may recommend surgery or other procedures. These might include:

  • Endovenous Laser Ablation (EVLA). This is closure of the vein causing varicose with a thin catheter that emits laser energy from the inside. The most important advantages of this method are that it takes only 30 minutes and the patient can walk immediately after the procedure. The success rate is as high as 94-99%.
  • Ablation with Endovenous Radiofrequency (EVRF). This technique is similar to the laser procedure, but the vessel is closed with a different energy. A thin radiofrequency catheter is inserted inside the vein, and the leakage point is closed by giving 120 °C energy. No external surgical incision is made in this area. All procedures are performed subcutaneously under the guidance of ultrasound. 
  • Embolization with adhesive agents (Bioglue). Varicose veins treatment with adhesive agents (Cyanoacrylate) is one of the newest methods today. The adhesive agent (bioglue) is delivered very carefully into the leaking vein under ultrasound guidance. For a while (1-3 minutes), the vessel is pressed to adhere to itself. No cuts or sutures are made, and the effect is seen instantly.
  • Removal of varicose veins with a mini-incision (Miniflebectomy). Used in combination with other procedures or alone, this technique allows the removal of varicose clusters bulging outward through very small pinholes. These punctures are not sutured but only covered with aesthetic tapes. In about a week, the puncture is completely closed.
  • Sclerotherapy. This treatment aims to dry the varicose veins by delivering sclerosant medication with 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 better results. The efficacy of sclerotherapy treatment becomes evident within 4-6 weeks. Depending on the case, it may need more sessions to work. 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.