Varicose Veins
What are Varicose Veins?
Varicose veins is a disorder in which veins, especially on the leg, become elongated, dilated, enlarged and twisted.
Other than leg, the disorder can happen on any vein from the body. Veins are attached to each other through valves and help in preventing the backflow of the blood. In leg, veins through leaflet valves pumps or push the blood to reach the heart and function properly. Now, due to this disorder the veins become elongated and the valves too become enlarged. Because of this, veins do not attach properly to the leaftet valves of the other veins and restrict proper flow of the blood in the body. It takes to the condition, where the blood accumulated in the veins making it more enlarged and elongated. This causes pain and discomfort in walking and other activities done by the legs.
The disorder is caused as a result of deep vein thrombosis (DVT), commonly known as vein failure. Other than pain, it also causes itching in the affected region, resulting in skin ulcer. By looking at the size and place of the affected veins one can distinguish it from the blue veins and spider vein that naturally have some symptoms like varicose veins.
The disorder can be classified into two categories such as primary varicose veins and secondary varicose veins.
Primary varicose veins is a disorder affecting superficial veins that are very close to the skin’s surface.
Secondary varicose veins is found in the very deep veins enlarging the veins near to skin’s surface.
The disorder can be treated by the application of latest technologies like radiofrequency ablation and endovenous laser treatment. And, if the disorder is very severe, surgical removal of the affected veins is suggested.
Symptoms of Varicose Veins
1. Pain in walking and standing. Usually, the disorder happens to the veins in the leg causing enlargement and elongation, further resulting in the pain.
2. The sufferer might feel cramps happening in the affected leg at night, when the body is in rest. In night there is slow flow of the blood in the body.
3. Some times due to improper flow blood from the leg, the sufferer might feel numbness and restless in the legs.
4. Elongation and enlargement may cause itching in the skin surface, further resulting in ulcer and skin discoloration. Enlongation in the legs might cause swelling around the joints, meaning in the ankles.
5. One can find symptoms of spider veins, scientifically known as telangiectasia, in the affected legs.
6. The injuries happened during this time might take more time to get recover and the amount of bleeding is more than usual one.
7. Some white scars in a very irregular pattern are seen in the ankles of some patients.
8. Disorder happening in the fatty people might cause hardness around the ankle, because of high fat accumulation in that region.
Causes of Varicose Veins
There are various causes and risk factors behind the disorder. They include:
1. Age: Varicose veins mostly happens to the older people. It is because of the fact that as a person grew old , the strength of the body starts weaking and hence he/she feels discomfort in walking and standing. This lead to improper flow of blood in the body causing varicose veins. Also, the elasticity of the vains decreases in older age and the attachment between the veins are not properly sealed, resulting in high risk of varicose veins.
2. Gender: Varicose veins are generally found in women more than men because of the hormonal changes their body having.
3. Heredity: Cases are mostly seen from the people who are having family history of this disease, that’s why varicose veins is considered as genetical disease.
4. Hormonal changes: Body of women goes through lot of changes during pregnancy and menopause. Secretion of estrogen or progesterone causes this disease to happen. Other than this, women who take birth control pills are on higher side of risk to get the disease.
5. Obesity: Weight issues are certainly very much attached to this problem. As increase in weight causes lot of burden in the ankle and on the feet of that person. The burden disturbs the proper functioning of the veins leading to varicose veins.
6. Too much pain and distress in the body can further take a person to the complications like varicose veins.
7. Post phlebitic obstruction and venous and arteriovenious are some rare causes of varicose veins.
Complications of Varicose Veins
Generally, varicose vains does not affect a patient very much, but not treating this disorder properly can lead to severe complications. Like:
1. Skin loss can happen from the affected region because of the change in skin conditions and dermatitis.
2. Itching in the affected region can further result in skin ulcers, specifically known as venous ulcer,
3. Pain and discomfort in the legs restrict standing for long hours and thus affects the work very much.
4. Excess of bleeding for a mild wound causes problem to any body, especially, to older people.
5. Secondary varicose veins happens deep in the skin’s surface, causing clotting of the blood their. The condition leads to another complication, named thrombophlebitis.
6. Persistent of venous ulcers for long period can sometimes take to a very serious conditions like carcinoma.
7. Fatty women are on more risk of getting acute fat necrosis.
Diagnosis of Varicose Veins
Physical examinations are done to diagnose the changes happening in the veins and skin of the legs that are different from normal conditions. Treatment can only be done after knowing exact cause of the disorder. Duplex ultrasound test is performed with color flow to get the images of the structures under the skin. Through reflection and transmission of sound waves applied in this test, one can get the images of affected veins very well. Color flow is used, alongwith, to get the direction of the blood flow. This further indicates that the flow of blood to the heart is appropriate or not, like if their is any backflow happening in the veins.
Sometimes in places where the application of ultrasound is not very successful, like in the pelvis or in the deep venous system, one can go for magnetic resonance venography to detect the disorder.
Treatment of the Vericose Veins
1. Conventional treatment:
a. Very immediate treatment is to elevate your legs. This exercise can help in providing temporary symptomatic relief.
b. Doctors recommend the patient to wear graduated compression stocking having pressure of 30-40mmHg to reduce swelling in the legs. The stocking not only help in reducing the level of swelling, but also improvises nutritional exchange and the microcirculation of the blood in the varicose veins. But it is not advisable to people having arterial disease.
c. Medications like antinflammatory medicines including aspirin and ibuprofen are given to provide immediate relief from the pain caused due vericose veins.
d. Some dietary supplements like Diosmin 95 are available. But, they do not have any confirmed results linked with them.
2. Interventional treatment:
Types of surgical and non –surgical treatments are given under active medical intervention.
i. Surgical Treatment:
Surgical treatment include saphenous stripping of veins, superficial phlectomies and CHIVA treatment.
a. Saphenous Stripping:
All the saphena vein main trunk are stripped or removed from the groin till the ankle in the leg in this treatment. It is recommended for some complications like deep vein thrombosis, pulmonary embolism, and infection caused due to some wound. As, the saphenous main trunks is completeley removed in this treatment, one can not go for venous by-pass to treat any coronary or leg artery vital disease in the future.
b. CHIVA
CHIVA is defined as Conservative and Haemodynamic cure of Incompetent. The treatment is based on an haemodynamic impairment examination by using data and evidences accumulated.The treatment search for exact cause of the disorder, so that it can be healed properly. To get the best result from the treatment, one should always studies the data obtained from haemodynamic impairment examination and ultrasound dynamic venous analysis accurately.
ii. Advanced Treatment:
Advanced treatment include non-surgical treatment based on laser application:
a. Sclerotherapy:
The treatment is applied on spider veins and varicose veins that recurr after stripping treatment. Microfoam sclerosants are used along with ultrasound application to treat the affected veins.
b. Endovenous laser and Radiofrequency Ablation:
The treatment is recommended to cure disorder for short term. Although , side-effects of this treatment is compartively very less than stripping treatment.
