The heart, veins, and arteries make up the circulatory system. Arteries carry oxygen-rich blood from the heart to nourish your tissues, while veins have one-way valves which channel oxygen-poor blood back toward the heart. If these valves are damaged, the blood pools in the leg veins leading to feelings of fatigue, heaviness, aching, burning, itching, cramping, restlessness, swelling and even eczema and leg ulcers .
What causes varicose veins?
Heredity is the cause of most varicose veins. If one parent has varicose veins, your risk of having them is about 70%. Other predisposing factors include standing occupations, obesity, leg injury and multiple pregnancies.
Are varicose veins a threat to my health or are they just cosmetic?
Varicose veins indicate that the pressure in the veins of the legs is too high (a condition called venous hypertension). Longstanding venous hypertension can result in damage to the deep leg veins and to the overlying skin. Impairment to the deep veins can lead to blood clots and sudden death from pulmonary embolism, especially if confined on a long plane or car trip: https://venousdisease.com/travelers.html. Injury to the skin will result in stasis dermatitis, pigment changes, thickened skin and possibly, leg ulcers. In addition, venous hypertension can cause pain, fatigue and swelling of the legs.
Are all varicose veins visible from the outside?
No. Varicose veins may be deep enough that they are not visible. A duplex ultrasound evaluation of your legs will be able to detect all varicose veins.
Can varicose veins develop in one leg and not the other?
Most patients develop varicose veins in both legs. However, the severity of the varicosities will differ. Some may require surgery, while others may only require compression therapy.
What treatments are available for varicose veins?
A new procedure called endovenous laser ablation, or EVLA, has been available to treat varicose veins for about five years now. EVLA involves a simple, in-office surgical procedure in which a laser is inserted into the damaged vein which permanently seals it using heat. The blood that normally flowed through that vein is redirected into normal veins which carry it back to the heart. EVLA is performed under local anesthesia while you are awake and is very comfortable. Most people return to work the next day.
Another way to treat varicose veins is called foam sclerotherapy. For this treatment, no anesthesia is required and a small butterfly needle is used to deliver a sclerosant chemical to the veins. They immediately shrink and are cleared by the body's metabolism over several weeks to months.
Vein stripping surgery is not performed very often nowadays since these newer procedures are so safe and effective.
Do these treatments cure varicose veins?
After all diseased veins are treated, most people have a remission of symptoms, leg swelling improves and the skin begins to heal, including leg ulcers. Many patients do not have problems again for years. Due to many factors including heredity, however, some people are predisposed to future problems. Since there is no way to prevent other veins from becoming damaged, varicose veins may be an ongoing challenge for some patients.
Will my varicose vein surgery be very painful?
The degree of pain that a patient experiences during varicose vein surgery varies from patient to patient. The survey we conducted indicated that most patients thought the procedure to be pain-free, while a few reported experiencing a great deal of pain. The amount of pain is dependent on several variables, such as age, sex, weight, and tolerance level.
Are there any side effects of the treatments?
As with any invasive procedure, risks of surgery include allergic reaction to one of the medications, bleeding, postoperative pain, infection, blood clots or nerve damage. If any of these side effects occur, they are usually temporary if promptly treated.
How long after surgery will I be able to return to my normal routine?
Most patients return to their normal routine the next day, however, you should not resume aerobics, heavy exercise routines, running, sports or travel for at least a month after your surgery. It's very important to walk at least thirty minutes each day after the surgery to prevent blood clots from forming in the veins. Walking on a treadmill is fine.
Does insurance cover the procedures?
Yes. These are medically necessary procedures.Without treatment, you may be at risk for worsening symptoms of pain, blood clots, and skin changes including leg ulcers.
If you have a question that is not found on this page, click the link to submit a question to Dr. Fleck
