Varicose veins are damaged veins that have become enlarged and sometimes twisted. They appear blue to dark blue in colour due to the accumulation of deoxygenated blood, and can often bulge out from the surface of the skin. Varicose veins can cause mild to moderate pain and are sometimes associated with ulcers or sores on the skin. Although varicose veins can occur anywhere on the body, they are most commonly found on the legs.

What Causes Varicose Veins

While oxygenated blood travels through the body in the arteries, deoxygenated blood travels back to the heart through the veins. Since the pathway back to the heart must go against gravity, veins have a system of small leaflet valves that are designed to prevent the back flow of blood. However, if the leaflets of these valves become damaged so that they do not close properly, the deoxygenated blood can flow back and accumulate in the veins causing varicose veins. The condition is exacerbated if the walls of the veins become weakened. In some cases, these factors are hereditary. However, lifestyle factors, such as being too sedentary, can also contribute to vein valve damage and the weakening of the vein walls. For women, hormonal imbalances can also contribute to the formation of varicose veins.

Dangers Of Varicose Veins

One of the most frequent problems encountered with varicose veins is serious bleeding. This occurs because skin over the varicose veins is often very thin and fragile. Therefore, it is easier for bleeding to occur in these areas if the skin is broken. For this reason, people with varicose veins should be more gentle when drying off with a bath towel and when scrubbing the skin around their varicose veins, such as with a loofah sponge or another type of abrasive cleaning aid. The most serious potential danger of varicose veins is the formation of blood clots.

There are two basic types of blood clots. The first type of blood clot is called superficial thrombophlebitis. This occurs just below the skin and can be painful, but it is usually not life threatening. The second type of blood clot is called deep vein thrombosis (DVT) which is a clot in a deeper vein. This second type of blood clot can be life threatening, in part because it often goes undetected, and because it can potentially break off and travel to the lungs.

Treatment Options For Varicose Veins

There are several types of treatment for varicose veins. Here are the most common treatments:

1. Compression Stockings
You can buy these stockings over the counter or have them prescribed by your doctor. These stockings are designed put pressure against your veins which can relieve pain and prevent accumulation of fluids in your legs and feet. Prescription compression stockings usually provide more pressure than over the counter ones. If you need just a little support, you can also try using support pantyhose.

2. Sclerotherapy

This procedure can be performed in a doctor's office with no anaesthesia. The doctor injects each varicose vein with a chemical that causes the vein walls to swell so much they stick together and then permanently seal shut. The sealed vein then turns into scar tissue, and in most cases, the colour completely fades away. In some cases, it may take more than one sclerotherapy treatment to get the vein to seal permanently and fade.

3. Ultrasound-guided Sclerotherapy

This procedure is very similar to sclerotherapy except ultrasound is used to guide the needle. This is used for varicose veins that are not as close to the surface and may be difficult for the doctor to view.

4. Stripping

Stripping is a type of surgery where the varicose veins are tied shut and then surgically removed through small cuts in the skin. This procedure does require anaesthesia and approximately four weeks recovery time.

How To Prevent Varicose Veins

Even if varicose veins run in your family, there are several ways you can prevent, or at least reduce, varicose veins. Here are some of the best ways:

1. Walking and Other Exercise

Walking and any other forms of exercise that gets your legs moving creates a blood pump in the leg muscles that strengthens the veins and improves blood flow. Fun activities like gardening, bike riding, tennis, chasing the kids, and playing with your dog can help a lot.

2. Don't Cross Your Legs

When you are sitting, do not cross your legs as this can seriously impair blood flow.

3. Lose Weight

Extra weight puts a lot of extra pressure on your legs and can hasten the formation of varicose veins.

4. Don't Sit Or Stand In One Place Too Long

If you have a sedentary job, try to get up at least once an hour and move around a bit. When you are sitting, try to elevate your legs on a footstool.

Posted
AuthorNicholas Kemp

We are often asked the question, how safe is EndoVenous Laser Treatment for varicose veins in elderly patients? An international study by veindoctors has shown the treatment is feasible, safe, and well-tolerated by elderly patients.

Background

Varicose veins are a common vascular disease in elderly patients. Both endovascular laser ablation (EVLA) and radiofrequency ablation (RFA) are reported to have good technical, clinical, and patient-reported outcomes for the treatment of varicose veins. We did not find any reports on treating elderly patients with endovascular ablation procedures in the literature. The aim of this study was to determine whether endovenous thermal ablation techniques are safe and effective in treating elderly patients with varicose veins.

Method

A retrospective analysis of 57 EVLA cases and 46 RFA cases was conducted at a single center. Patients in the 65–88-year age group were assessed for postoperative pain, hematoma, thrombophlebitis, hyperpigmentation, wound infection, and skin burn.

Results

Minor complications identified in the studied patients were hematoma (2.9%), thrombophlebitis (5.8%), hyperpigmentation (8.7%), wound infection (4.9%), and skin burn (1%). In the RFA group, 38 patients (83%) had no need for oral analgesic tablets on postoperative Day 3. In the EVLA group, 25 patients (44%) had no need for oral analgesic tablets on postoperative Day 3. Two patients in the EVLA group needed a secondary intervention due to recurrent vein issues. There were no major complications in either group.

Conclusion

The outcomes for our older patients who underwent endovascular ablation therapy were comparable to other studies performed with the general population. Our results show that both EVLA and RFA are feasible, safe, and well-tolerated by elderly patients.

Lam P, Chao L. Endovascular Ablation Therapies for Varicose Veins in Elderly Patients. International Journal of Gerontology, 2014 ; 8 (4) 219–222.

Posted
AuthorNicholas Kemp


Varicose veins are twisted, enlarged and swollen veins that are often visible underneath the skin’s surface. They usually appear in the legs or ankles, and are often red or blue in colour. There are numerous remedies (both medical and non-medical) which are used for treating varicose veins, including laser therapy. Lasers are typically used for treating severe cases of varicose veins, where the veins have become excessively swollen, painful and are causing blood clots.

A laser is basically a highly focused beam of light. In the treatment of varicose veins, lasers are used to heat the veins to the point of scarring. This scarring damages the targeted vein and causes it to wither, collapse and close. The closed vein then loses its source of blood and
dies. With time, this vein disappears and is no longer visible underneath the skin’s surface. There are two major types of laser treatments for varicose veins: simple laser treatment and EndoVenous Laser Treatment.

Simple Laser Treatment

Simple laser treatment can be used for treating tiny varicose veins and spider veins (spider veins are extremely minute varicose veins), and for treating veins close to the surface of the skin. To treat the targeted vein, a mild laser is applied from outside the skin and a laser charge applied on the skin over which the varicose vein, or veins, is visible. The objective is to scar the vein without affecting the skin.

To achieve optimum results, the treatment is usually carried out over a number of sessions, and usually scheduled every 6 to 12 weeks. In each session, the affected area is subjected to a laser discharge. The collective subjection causes the varicose vein to dry-up and close. The spacing is to minimise the effects of the lasers on the skin by giving it enough time to heal. 

EndoVenous Laser Treatment

EndoVenous Laser Treatment is used for treating larger varicose veins, especially those that are buried deep beneath the skin surface. Using this method, an incision is made by a doctor on the skin through which a thin tube (catheter) is inserted. The doctor then uses an ultrasound to guide the catheter until it enters the varicose vein and is in the correct position. Once in position, a laser is passed through the catheter and into the varicose vein.

The laser then delivers short bursts of heat energy into the vein. The heat burns up the vein, causing it to shrivel, dry up and close. Using the ultra-scan to guide the process, the entire length of the vein is traversed and the process repeated. The treatment ends when every inch of the varicose vein has been closed. The catheter is then withdrawn and the incision sewn up.

EndoVenous Laser Treatment is usually carried out using either local anaesthesia or a mild sedative. After the procedure, the patient usually feels a little tightness around the area. Sometimes, mild pains or bruises occur, but these usually wear off within a very short time. The procedure is known to have a 94% success rate in closing varicose veins. In most cases, simple laser treatment is used to close up the remaining 6% of the varicose veins.

On the whole, both types of laser treatments are much more effective and carry fewer risks than other treatment options, like the surgical removal of varicose veins. A patient is usually able to resume their normal life within minutes of completing a laser treatment session. Even then, the mild burns and pains associated with laser treatments can be a source of discomfort. As such, it is usually advisable to speak to one’s doctor about the various options available. Generally, laser treatment is recommended for varicose veins which cannot be treated using other non-medical options, like exercise and wearing compression stockings.

Posted
AuthorNicholas Kemp