Varicose Veins

Definition

Varicose veins are enlarged veins at least 3 mm in diameter that can be felt right below the skin's surface. Over time, they may become elongated, twisted and thickened. It's one of the most common health problems in America, according to the Vascular Disease Foundation; an estimated 20 million to 25 million Americans have varicose veins.

Causes

Varicose veins are usually caused by hereditary factors (something passed down through the family).

Risk

• Family history of varicose veins
• History of blood clots in the veins
• Female gender
• Inactivity
• Obesity (a Body Mass Index higher than 30)
  

Symptoms

Some people may have no symptoms. Common symptoms include:

• Leg and ankle swelling
• Leg heaviness, tension or fatigue
• Pain at the site of the varicose veins
• Aches
• Restlessness
• Cramps
• Itching

Diagnosis

• Physical examination: Most varicose veins are diagnosed through a physical exam by the doctor with the help of a Doppler device to listen to blood flow.
• Ultrasound: A painless test where a small ultrasound probe is held to the area of the leg where varicose veins may be located. The ultrasound's high-frequency sound waves provide the doctor with a picture of the blood flow in the arteries and whether varicose veins are present.

Treatment

Treatment will depend on the severity of the symptoms and the location of the varicose veins. Treatment options include:

• Compression stockings: The stockings may ease the symptoms and prevent leg swelling.
• Sclerotherapy: A chemical solution is injected to affected veins, scarring them and preventing them from filling with blood. Blood then flows through other, healthy veins.
• Ambulatory phlebectomy: In this minimally invasive procedure, varicose veins are removed with hooks inserted through small skin incisions that don't require stitches.
• Vein stripping: This procedure treats varicose veins in the great saphenous vein, the largest vein close to the skin's surface along the inner thigh and calf. Through a small incision in the groin, the thigh portion of the vein is removed and its vein branches are disconnected. Varicose veins are then removed through several small incisions. Alternatively, radiofrequency or laser energy delivered through a knee-inserted catheter may be used to close off the great saphenous vein, eliminating the need to surgical remove a portion of the vein.