Varicose Veins
"varicose" refers to a vein that is unnaturally and permanently stretched and dilated. These veins near the skin can become damaged from natural stretching or weakening because of the pressure of the blood flowing through the veins. Varicose veins often appear through the skin on a person's legs as blue, bulging and twisted veins; in some cases the veins may be raised or stand out on the surface of the skin.
Left untreated, varicose veins can cause tiredness or heaviness in the legs. In severe cases, varicose veins can lead to swollen ankles and scaly dry skin.
RISK FACTORS
People tend to develop varicose veins:
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Between the ages of 30 and 70
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During pregnancy
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Obesity
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Smoking
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Leg injury
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Prolonged standing (as in a work environment).
SYMPTOMS
Some of the symptoms of varicose veins may include:
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Leg cramps
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A change in the appearance of the skin on the calf or leg;
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The appearance of small clusters of veins on the leg;
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An ache or heavy feeling in the affected leg;
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A burning sensation in the affected leg;
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A restless feeling in the affected leg; and
People with significant varicose veins may be at a slightly increased risk of deep venous thrombosis (DVT). DVT may cause unusual and sudden leg swelling, which requires immediate medical attention.
DIAGNOSIS
Physicians diagnose varicose veins by taking a thorough history and performing a complete physical examination. A physician may also order a duplex ultrasound, which allows him or her to visualize vein structure and assess the flow of blood through the veins.
TREATMENT
Without treatment, varicose veins do not get better and may get worse. The physician first attempts to treat the symptoms by prescribing conservative non-surgical treatments, such as:
Minimally invasive and surgical treatments may include:
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Endovascular Ablation: In endovascular ablation (thermal or radio-frequency ablation), the tip of a catheter equipped with electrodes is inserted into an affected vein that has been exposed and pulled through an incision. These electrodes touch the inside of the vein wall, sending bursts of radiofrequency energy through the electrodes. The energy heats the vein walls and destroys the tissue along the length of the vein. The vein is then no longer able to carry blood, breaks up, and is reabsorbed by the body.
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Vein Stripping: In Vein stripping (saphenectomy), physicians disconnect and tie off all vein tributaries associated with the great saphenous vein through a small incision at the groin crease. Through the incision a stiff but flexible length of wire with an attached head is inserted into the vein. The wire is threaded through the vein and out an incision in the upper calf. The wire is pulled downwards, and the attached head travels through the vein, inverting it and pulling it away from each tributary vein. In this way, the length of vein is removed through the incision in the upper calf.
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Sclerotherapy: In sclerotherapy (chemical sclerosis), the physician injects a chemical substance into the affected veins to harden (sclerose) the veins from the inside out. The veins are no longer able to fill with blood and form a hardened cord, which breaks up naturally and is reabsorbed by the body.