Introduction to Varicose Veins Treatment
VARICOSE VEINS: PATIENT INFORMATION
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Program Excerpts
Nearly 25% of women and 15% of men suffer from lower extremity venous insufficiency and associated visible varicose veins.1 Most of these patients have long-standing leg symptoms which compromise their daily routines, with symptoms worsening during the day while they are on the job or simply living their lives. If left untreated, these symptoms can progress to a life-style limiting condition.
The traditional treatment for venous reflux and varicose veins has been surgical ligation and stripping, an open surgical procedure that usually requires general anesthesia and can be associated with perioperative morbidity such as pain, bruising, scarring, and nerve injury. Other treatments, such as high ligation alone, injection sclerotherapy, and phlebectomy, that treat only visible varicosities without addressing the source of the problem (venous hypertension from reflux within the superficial venous system) have a high rate of recurrence. Now, there are newer, minimially-invasive endovenous ablation treatments that not only improve the appearance of varicose veins, but also provide relief from the accompanying symptoms.
Varicose veins (and sometimes spider veins) are usually a symptom of venous hypertension secondary to superficial venous reflux, a disease that causes blood to flow backward in the veins, making them bulge and twist down the leg. This venous reflux (or incompetence) can develop into chronic venous insufficiency. Venous insufficiency can occur throughout the venous system, but occurs most frequently in the great saphenous vein, small saphenous vein, and other truncal veins of the superficial venous system.
Other symptoms of venous insufficiency may include:
- Leg heaviness and aching
- Hyperpigmentation
- Pain and/or restless legs
- Lipodermatosclerosis
- Induration
- Ulceration
Conservative treatment (such as weight loss, leg elevation, compression stockings) may slow the progression of symptoms, but does not treat the underlying cause of the disease. As a result, varicose veins will usually become more pronounced over time. As the disease progresses, legs and feet may begin to swell and sensations of pain, heaviness, burning, or tenderness may occur.
Left untreated, the symptoms of venous insufficiency often progress to more serious complications, including:
- Inflammation (phlebitis)
- Skin discoloration
- Skin ulceration
- Bleeding
Most clinicians (and their patients) believe the only option for curative treatment of varicose veins is surgery (ligation & stripping), a hospital-based treatment (often performed under general anesthesia) with recognized morbidity. Therefore, many choose to delay treatment in favor of conservative therapies, again only treating the symptoms and not the underlying cause of the problem.
1Callam MJ. Epidemiology of varicose veins. Br J Surg 1994; 81:167-173.
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