What are varicose veins and how do they appear?
Varicose veins are a disease of the veins of the lower extremities. Our veins, under normal conditions, carry blood poorer in oxygen back to the heart to be led to the lungs and cleaned. The veins of the lower extremities, due to our upright walking, are burdened with returning a large volume of blood to the heart. In several people, a weakening of the vein wall in the lower extremities is observed, which results in the gradual dysfunction of the venous valves . Consequently, the blood flow slowly changes direction (towards the periphery and not the other way around as is normal) and its volume and the pressure exerted on the superficial venous system of the lower extremities increase. This causes the veins under the skin in the subcutaneous fat to become elongated and dilated, and venous blood pools in them. These visible, twisted and dilated veins are varicose veins . They are divided into large varicose veins (over 3mm in diameter) and spider veins. Spider veins – also known as “ broken vessels” or arachnoid veins – are further divided into telangiectasias , which are purple-colored intradermal veins (up to 1mm wide) and reticular veniectasias , which are blue-colored subcutaneous veins (1-3mm wide).
What are the factors most associated with the appearance of varicose veins?
Varicose veins are a more common condition in women than in men. Today, one in three women and one in five men suffer from varicose veins to some extent. In women, the percentage of varicose veins reaches 80%. The different hormonal profile of women compared to men seems to favor the appearance of the disease. Pregnancy is also a period when venous diseases worsen or appear for the first time. In addition, heredity , as does prolonged standing (mainly professional) . Finally, aggravating factors include obesity, a sedentary lifestyle and a pre-existing deep vein thrombosis in the lower extremities.
What are the symptoms of varicose veins?
Many times varicose veins remain asymptomatic for a long time. In fact, in patients with varicose veins, the problem is only aesthetic and as such concerns the patient who seeks the vascular surgeon. However, with the passage of time and the worsening of the disease, patients begin to complain of a feeling of heaviness and swelling in the lower extremities , mainly after prolonged standing or sitting, especially when high temperatures prevail such as in summer. In a second phase, pain and/or cramps in the calves are added to the symptom profile. When the disease remains untreated for years, then trophic disorders appear in the skin – mainly in the area of the inner ankle – and there is a risk of skin atrophy that can develop into hyperpigmentation, eczema or even a chronic ulcer.
What are the complications of varicose veins?
The most common complication of varicose veins is the so-called thrombophlebitis, i.e. thrombosis of pathological veins accompanied by a picture of inflammation along the thrombosed vein. This particular complication is not generally considered serious, but must be treated because it is associated with a relatively increased risk of concomitant thrombosis of the deep veins of the limb with a further risk of pulmonary embolism. Another common complication is bleeding from superficial varicose veins, usually after injury. Although it is frightening when it occurs because the bleeding is usually extensive, it is easily treated by compressing the bleeding vein and immediately bandaging the limb. Finally, prolonged and untreated chronic venous insufficiency can develop into chronic edema, white atrophy and ultimately the very serious condition that is the "open wound" or venous ulcer .
How are varicose veins diagnosed?
Apart from a detailed clinical examination of the patient, the basic and almost always only necessary examination for the diagnosis of varicose veins is ultrasound, the well-known triplex. With this method, all pathological venous branches can also be mapped, which is essential before any surgery.
What is the treatment for varicose veins?
Vascular surgery currently offers many possible treatments for the treatment of varicose veins. In addition to sclerotherapy in the case of the aesthetic problem of varicose veins, the advanced stages of the disease are treated with both classical surgical methods and modern bloodless endovascular methods . The vascular surgeon will advise and inform the patient about all methods with their respective advantages and disadvantages, so that the best possible method with the fewest complications and the best possible long-term results can be selected.