VARICOSE VEIN TREATMENT

---

Varicose veins usually announce themselves as bulging, bluish cords running just beneath the surface of your skin. They almost always affect legs and feet. Visible swollen and twisted veins -- sometimes surrounded by patches of flooded capillaries known as spider veins -- are considered superficial varicose veins.  Although they can be painful and disfiguring, they are usually harmless. When inflamed, they become tender to the touch and can hinder circulation to the point of causing swollen ankles, itchy skin, and aching in the affected limb.

Besides a surface network of veins, your legs have an interior, or deep, venous network. On rare occasions, an interior leg vein becomes varicose. Such deep varicose veins are usually not visible, but they can cause swelling or aching throughout the leg and may be sites where blood clots can form.

Varicose veins are a relatively common condition, and for many people they are a family trait. Women are at least twice as likely as men to develop them.  In the U.S. alone, they affect about 23% of all Americans.  

Veins are blood vessels that carry blood back to the heart. In order to keep blood flowing upward when we are on our feet, we have hundreds of sets of leaflets within our leg veins that act as one-way check valves to keep the blood flowing upwards against the pull of gravity. These valves can become faulty in certain veins underneath the skin surface. When this happens the blood flows backwards into the skin surface causing an elevated pressure in the veins. Since veins are normally low pressure blood vessels that are not made to withstand the abnormal increase in pressure, they start to dilate and elongate, curving back and forth on themselves.  The development  of large varicose veins in your legs has now started.  When valves in the veins under the skin surface become faulty they do not repair themselves.  The progressive worsening of varicose veins through time coupled with the effects of gravity is almost always  a certainty. 

Common causes of varicose veins can include:

• Age: As you get older, your veins can lose elasticity, causing them to stretch. The valves in your veins may become weak, allowing blood that should be moving toward your heart to flow backward.
  Blood pools in your veins, and your veins enlarge and become varicose. The veins appear blue because they contain deoxygenated blood, which is in the process of being recirculated through the lungs.
• Pregnancy: Some pregnant women develop varicose veins. Pregnancy increases the volume of blood in your body, but decreases the flow of blood from your legs to your pelvis. This circulatory change is designed to support the growing fetus, but it can produce an unfortunate side effect — enlarged veins in your legs.
  Varicose veins may surface for the first time or may worsen during late pregnancy, when your uterus exerts greater pressure on the veins in your legs. Changes in your hormones during pregnancy also may play a role. Varicose veins that develop during pregnancy generally improve without medical treatment three to 12 months after delivery.
• Gender: Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor because female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.
• Family history. If other family members had varicose veins, there's a greater chance you will too.
• Obesity: Being overweight puts added pressure on your veins.
• Standing or sitting for long periods of time: Your blood doesn't flow as well if you're in the same position for long periods.

Once valves become faulty in a vein under the skin surface, this underlying cause of your varicose veins needs to be addressed first. Following a thorough medical history and physical examination of your legs, an ultrasound evaluation needs to be performed to help determine where, if any, of the valves have become incompetent. After the faulty valves are identified, a varicose vein treatment plan is formed. All health and medical concerns are considered before deciding which vein treatment option is best for you.

Today, the best way to treat incompetent  veins under the skin surface is to close them with an FDA approved procedure called Endovenous Laser Ablation (EVLT). The procedure was approved by the FDA in 2002 for treating patients with large varicose veins. A thin flexible laser fiber is inserted into the abnormal vein. The vein is anesthetized and the vein wall is then heated with thermal energy. Subsequently, the body’s natural healing allows the non-functioning vein under the skin surface to close, relieving the abnormal pressure in the visible veins on the leg. These visible veins are then eliminated with sclerotherapy.

Endovenous Laser Ablation (EVLT) is a minimally invasive office-based procedure which eliminates the need for surgery in the vast majority of patients. During the EVLT procedure, there is no need for general anesthesia or sedation. In experienced hands of our Radiologists the EVLT procedure is well tolerated by patients and allows for immediate resumption of most day-to-day activities.     

Sclerotherapy is a popular and effective method of eradicating large varicose veins to very small spider veins. It involves micro-injections of an FDA approved medication into the abnormal veins. The medication irritates the lining of the vein and the vein wall. The veins are then compressed with a graduated compression stocking which promotes closing of the abnormal veins. Ultrasound is sometimes used to place injections under the skin surface precisely where they will be of the most benefit. Walking each day promotes healing. The veins are such thin walled vessels that once they are closed you cannot see them. The legs feel better because the blood is no longer allowed to pool and stagnate within the abnormal veins. We use only FDA approved sclerosing medication. To find out which vein treatments are appropriate for you, contact Valley Imaging Consultants at (630)898-4515.