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Varicose Veins

Varicose veins most commonly appear in the legs and affect mostly women and mainly occur after age 50. In fact, it’s estimated that nearly half of women and about 45 percent of men have some form of varicose conditions.

Varicose veins are enlarged, twisted and painful superficial veins that result from poorly functioning valves.In normal veins, valves in the veins keep blood moving forward toward the heart. With varicose veins, the valves do not function properly, allowing blood to remain in the vein.It’s this pooling of blood in a vein that causes it to enlarge.

There are several things that may cause varicose veins, including congenitally defective valves, thrombophlebitis (vein inflammation related to a blood clot) and pregnancy. The condition may be aggravated by prolonged standing and increased pressure within the abdomen.

Symptoms of varicose veins may include:

  • Pain, fullness, heaviness or aching in the legs
  • Visible, enlarged veins
  • Mild swelling of the ankles
  • Discoloration of the skin around the ankles
  • Skin ulcers near the ankles

Treatment

Since varicose veins tend to worsen over time, it’s important that patients seek treatment from their physician.In some cases, non-treatment may result in phlebitis (chronic inflammation of the vein), formation of leg ulcers or rupture of a varicose vein.

Treatment for varicose veins may begin with exercise, elevating your legs when you are resting and not crossing your legs when sitting. You also may want to wear loose clothing and avoid long periods of standing.

If conservative treatments aren’t effective, your doctor may recommend one of these treatment options:

Sclerotherapy. This procedure involves injections into the affected veins in order to produce scars that will close the veins. The treated veins should begin fading a few weeks after treatment. Sclerotherapy works best on small- or medium-sized veins.

Laser Treatments. Laser surgery can be used to make the vein slowly fade away. With this treatment, your doctor uses a laser that emits bursts of light that seal the vein. This type of procedure doesn’t require incisions or needles.

Endovenous Laser Ablation: Endovenous laser ablation is a minimally invasive technique used to treat varicose veins. Ablations use targeted heat to shut down the vein. Laser ablations offer a quick treatment with no scars and local anesthesia.

Thermal Ablation. Your doctor will insert a thin catheter into the affected vein. After the catheter is inside the vein, the tip begins to heat. Then the catheter is pulled from the vein. The heat causes the vein to collapse and seal. This procedure works best for larger varicose veins.

Endovenous Radio Frequency Ablation. Endovenous radio frequency ablation has an up to 98 percent success rate. For the treatment of varicose veins, endovenous radio frequency ablation uses targeted heat, through radio frequency, to shut down large long veins. After the vein is closed, healthy veins flourish and reestablish normal blood flow.

Vein Stripping. Your doctor will make small incisions and remove the affected vein. Vein stripping is usually done as an outpatient procedure.

Ambulatory Phlebectomy. Smaller veins can be removed through small skin punctures. This also is done as an outpatient procedure and requires local anesthesia. It generally causes minimal scarring.

Endoscopic Vein Surgery. If you have advanced vein ulcers, your doctor may recommend endoscopic surgery. With this procedure, a surgeon inserts a catheter equipped with a small video camera into the leg. This helps the surgeon see the varicose veins so that they can be surgically closed. The affected veins can be removed through small incisions.

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