Varicose veins are twisted, enlarged veins near the surface of the skin. They commonly develop in the legs and ankles.
Normally, the one-way valves in these veins keep the blood flowing efficiently against gravity up towards the heart. Varicose veins develop when you have faulty valves in your veins and weakened vein walls. When these valves do not function properly, blood pools and pressure build up, hence the veins are weakened, enlarged and twisted.
Varicose veins are common and usually will not cause serious medical problem. However, in some cases, varicose veins can signal a blockage in the deeper veins that requires evaluation and possibly treatment. People with leg skin changes associated with varicose veins may develop chronic sores which are difficult to heal (as shown in Fig. B).
Your doctor will examine your legs and feet. Varicose veins are easy
to see, especially when you are standing. If a problem with the deep
veins or complications are suspected based on your symptoms and
examination, an ultrasound study may be required.
Patients often feel no discomfort but may be concerned about the
appearance of the veins. Varicose veins are visible through the skin and
appear dark blue, swollen and twisted. Some may experience distending
discomfort, tiredness, swelling and pain in the leg. Symptoms may
worsen after standing or sitting for long periods of time. Varicose veins
can also cause darkening of skin, dry, thickened skin, open sores
(ulcerations), inflammation (thrombophlebitis) or bleeding.
The goals are to reduce symptoms and prevent long term complications.
Litigation is done at the main junction between deep and superficial
vein with a faulty valve. Small incisions are then made over the
varicose vein to remove them. If several valves along the vein are
heavily damaged, the whole vein is usually removed by stripping.
EVLT and RFA are both done under local anesthesia. It works by
using laser or radiofrequency energy to heat the vein from inside
which causes it to seal shut and disappear.
Vein litigation and stripping are done as day surgery under regional or
general anesthesia. EVLT/RFA can be done under local anesthesia. The
leg will be bandaged with crepe and stockings for two weeks after the
operation. Most often, you can return to work within a few days. After
two weeks, you can resume normal leisure and recreational activities.