Varicose veins are enlarged veins that often appear in the legs. Normal veins have a series of valves, which prevent the pooling of blood in the lower leg. Each normal valve allows blood to move up in the vein, but blocks it from moving back down. If a single valve fails, the valve below has to hold up a longer column of blood, making the lower valve prone to fail as well. This process can go on over years, eventually causing most of the valves to fail. Eventually, this results in a vein that may be stretched to several times its normal size.
The development of varicose veins is related to several factors. These include genetics, being female, pregnancy, standing for protracted periods and high-heeled shoes. Some people with no known risk factors still develop varicose veins.
In some cases, symptoms of varicose veins are obvious. They can appear as rope-like blue veins just under the skin. In other cases, the symptoms will include aching, itching, cramping or burning in the legs. Sometimes, the main symptom is restless legs.
One option for treatment is the use of endovenous laser therapy, a procedure to seal the major varicose vein shut without removing it. We do this by threading a small laser fiber up the abnormal vein beginning near the level of the knee. The laser is activated and slowly removed from the vein, resulting in closure of the vein.
The veins which cause the symptoms are part of the superficial venous system, which carries only 10 percent of a leg’s blood back to the heart, and abnormal veins carry even less. The deep venous system, which carries the other 90 percent, is not disturbed in the procedure. Prior to recommending a vein procedure, both vein systems are tested to make sure that the deep system is functioning and to confirm the diagnosis of an abnormal superficial system.
Recovery requires the patient to wear elastic compression stockings for the first two weeks after the procedure. This compresses the treated veins as they heal in a closed position. There may be some bruising, which slowly resolves. Patients are encouraged to be up and about beginning the day following the procedure.
Since varicose veins cause pain and other unpleasant symptoms, including swelling, skin ulcers and inflammation, the treatment is considered a medical procedure and not a cosmetic one.
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