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: Used to treat small varicose veins, sclerotherapy is a chemical treatment injected directly into the affected vein, causing the vein to close. The vein turns to scar tissue and fades from view. Patients are instructed to wear an ACE ™ wrap after treatment. Results are immediate there are no activity restrictions following sclerotherapy.
• Endovenous Laser Ablation Therapy (EVLT): EVLT is a minimally invasive laser procedure that shrinks or scars the vein that runs alongside the inner thigh and calf, called the greater saphenous vein. With the patient under mild sedation, the surgeon makes a small incision near the knee and guides a fine, wire catheter into the saphenous vein. The undesired vein is ablated, or “burned,” causing the body to reabsorb and redirect blood flow. The procedure takes about an hour. Patients are instructed to wear compression garments for a week after EVLT to prevent blood clots. It is also very important for patients to walk frequently to keep the blood flowing. Most patients should be able to return to work the next day, and a follow-up ultrasound is performed at the Vein Clinic one week after treatment.
• Surgical Vein Removal: For varicose veins that are too complex or advanced to treat with other procedures, we offer two types of surgery: ambulatory phlebectomy and saphenous vein stripping. These surgeries are not performed at the Northridge clinic. Both procedures involve anesthesia, one or more incisions and direct removal of the undesired vein(s). Patients are instructed to wear compression garments for 48 hours after surgery (or as directed) and must return to the clinic in one month for a follow-up exam. Patients may require time off work during recovery.