Varicose Veins

Varicose veins are part of the penalty we pay for adoption of erect posture. A vein is stated to be varicose when it is dilated and tortuous. In humans, the return of venous blood from the lower limbs to the heart requires a pump equipped with non return valves. The pumping action is provided by the muscles. With contraction of the muscles blood is squeezed in the direction insisted by the valves i.e. towards the heart. Therefore a congenital paucity of valves, muscle weakness or stretching of deep fascia will impair the function of the pump. On prolonged standing, the whole weight of the column of blood from the leg to the heart is exerted on the valve. The main valve affected in this way is situated at the groin and at the back of the knee. When these valves become incompetent there is a leakage of blood in the superficial veins and they become varicose and expand as they are not supported by muscles or deep fascia. Continued leakage may further manifest as thread veins which are very thin veins and become visible as red streaks. During pregnancy and any other condition increasing pressure in the side, the abdomen will also be predisposed to varicose veins.

TREATMENT

Early varicose veins can be helped by wearing support stockings, elevation of the feet and suitable exercises.

Varicose veins not associated with weakness of valves can be treated with injections or a sclerosent solution into the vein. Literally, the sclerosent acts as a glue which is injected into an empty vein which is then compressed for six weeks for the glue to set, by means of a bandage. Following this treatment patients are instructed to walk between 4-5KM daily. The same technique can be used in the treatment of thread veins which may not require prolonged bandaging. Instructions vary in individual situations i.e. the face, when the specialist will advise accordingly. Diathermy and lasers are also used in treatment of thread veins which involves the destruction of the source of blood leakage by using heat. People on oral contraceptives, or with very obese legs, any inability to walk well or any known allergies to sodium tetradectyl are not suitable candidates for sclerosent treatment.

Surgical treatment for varicose veins may involve a cut in the groin and multiple small cuts over varicose veins. These procedures can be carried out under general/regional or local anaesthesia as a day case or overnight stay. After the operation, the patient wears a compression stocking for 1-2 weeks and is encouraged to walk. Surgical treatment will require a follow up visit.

Even when the outcome of varicose vein treatment is good, they have a tendency to return some years later. Your specialist will be pleased to discuss this with you. Like any medical/surgical procedure, treatment will vary in individual situations and our specialist will discuss this in detail with you as you may require one or even a combination of treatments.