Varicose veins

Varicose veins are enlarged veins under skin surface. Usually they are located under the knee, but they may appear on the thigh too. Legs with varicose veins look rather cosmetically unappealing. But unfortunately this is not the only cause of concern.

What are varicose veins?

Varicose veins are pathologically enlarged veins that at their overwhelming majority are connected to one of the main superficial veins of the leg, which is insufficient too. This means that the valves located at their lumen have suffered irreparable damage, and consequently during the blood circulation it refluxes back into the legs instead of moving towards the heart. The blood quantity that refluxes is important – it has been calculated that in some cases it can exceed the 30% of the blood volume flowing in the leg per minute.

Consequently, varicose veins on the legs, apart from the esthetic problem, are also connected to major changes in blood circulation. The blood flow inside the varicose veins is much slower than normal and the venous pressure is rather increased.

What are the symptoms of varicose veins?

The symptoms usually caused by varicose veins are leg heaviness, burning, itching, night cramps, pain and swelling.

It is typical that there is no correlation between the symptoms and the severity of the varicose veins. This means that in some cases varicose veins are extremely enlarged, occupy large surface areas of the shank and the thigh and nevertheless they do not cause any symptoms. Certainly, this does not contradict the severity of the problem, since increased venous pressure exists and so do all its negative consequences.

The symptoms caused by varicose veins are not specific. Many other diseases, such as orthopedic, rheumatic diseases etc. may also cause similar symptoms. The symptoms are very possible to be due to varicose veins if they get worse during the day and are relieved when the patient wears elastic compression stockings or when he/she places the legs in an elevated position (high).

Diagnosis of varicose veins

Varicose veins are visible on the patients’ legs. Nevertheless, a careful clinical examination of the legs may prove the severity of the venous insufficiency.

A proof of the severity of varicose veins and of the venous insufficiency is the presence of intense spider veins on the ankle, swelling, hyperchromia and skin hardness at the inner area of the shank over the ankle, as well as the presence of inflammation in the same area. Certainly, the presence of ulcer on the skin is a sign of serious venous insufficiency.

The proper and complete diagnosis of varicose veins is accomplished with the use of ultrasound examination and more specifically with color duplex – also known as triplex. Triplex is a painless and innocuous examination performed at the doctor’s office during the first visit, which allows the creation of a “map” of the leg’s venous system suffering from varicose veins. This procedure is called mapping and is determinative for the selection of the proper treatments where applicable, in order to achieve a complete and long-term varicose veins treatment.

Varicose veins complications

Varicose veins, regardless of the severity and whether they cause symptoms or not, are possible to cause complications, some of which may be very serious.

One of the most serious complications of the varicose veins is thrombosis. When a blood clot forms in a varicose vein, this specific area will be painful and hard and the skin will become red. This complication is called superficial thrombophlebitis and is really important that every patient suffering from this problem seeks for specialized help from his/her vascular surgeon. The blood clot may be extended and move into a deep vein of the leg, causing deep venous thrombosis and increasing the danger of pulmonary embolism.

Moreover, there is major risk of bleeding after a perforation on the skin which covers the varicose vein, in other words of being caused variceal bleeding.

Treatment of varicose veins

The conservative treatment of varicose veins includes the use of elastic compression stockings, with or without the oral administration of concomitant drugs. This treatment does not solve radically the problem; however it reduces the risk of complications and decelerates the natural progression of the varicose veins.

The most reliable treatment of varicose veins is the endovenous laser treatment. This is a modern, safe and efficient treatment, which does not require general anesthesia, while the hospital stay after the operation lasts less than two hours and the patient is allowed to resume his everyday activities and his work even the following day.

Endovenous laser treatment of varicose veins combined with microphlebectomies of varicose veins guarantees, among other benefits, an excellent cosmetic result.

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