Varicose Veins
Normal Circulation and Varicose Veins
Blood is carried away from the heart by arteries and is returned to the heart by veins (which have one-way valves). There are many networks of veins in the legs which return blood to the heart. The deep veins in the legs carry 90% of the blood to the heart. These veins do not become varicose because the muscle layers, which surround them, protect the walls of these veins. The surface or superficial veins carry 10% of the blood returning to the heart. If the valves in these veins do not function well, blood doesn't flow efficiently. The veins become enlarged because they are congested with blood. These enlarged veins are commonly called spider veins or varicose veins depending on their size. Spider veins are small red, blue or purple veins on the surface of the skin. Varicose veins are larger distended veins that are located somewhat deeper than spider veins. Varicose veins are no longer able to function properly and other normal veins have taken over for them.
Varicose veins are a hindrance to the circulation. Treatment of varicose veins aims at improving the circulation.
Vein disorders are not always visible; diagnostic techniques are important tools in determining the cause and severity of the problem. In addition to a physical examination, non-invasive ultrasound is often used.
Leg Pain and Varicose Veins
Varicose veins are the leading cause of leg pain in an otherwise healthy adult population. Varicose veins are more painful while they are forming because the walls of these veins are stretching. The pain can often be a burning sensation. The pain can subside for several years once the walls of the veins have stretched beyond their elasticity. At this time, heaviness rather than pain can be felt. Female hormones have an effect on varicose veins resulting in some women experiencing greater pain before and during menstruation and during pregnancy. Other forms of discomfort experienced with varicose veins can be night cramps, "restless legs", which cause the individual to shift leg positions frequently, and pain while standing or walking. Symptoms, often made worse by prolonged standing, include feelings of fatigue, heaviness, aching, burning, throbbing, itching, cramping. Leg swelling can occur. Severe varicose veins can compromise the nutrition of the skin and lead to eczema, inflammation or even ulceration of the lower leg.
Spider Veins (Telangiectasias)
Spider veins are tiny, thread-like purplish-blue or red veins seen close to the surface of the skin. Spider veins are usually the result of larger underlying veins, are generally painless and do not lead to medical complications.
Reticular Veins
Reticular veins are turquoise-blue veins seen through the skin in areas of stretch (knees, etc.). When they become varicose they can cause sharp pains which can be pinpointed on the legs. Reticular veins cannot lead to medical complications.
Collateral Veins
Collateral veins are large veins. When they become varicose they can pool a large volume of blood. They are often the cause of heaviness in the legs. Collateral (or truncular) varices lead, in time, to medical complications.
Causes of Varicose Veins
Heredity: 90% of varices are inherited from direct relatives.Acquired: 10% of varicose veins are caused by an injury, an inflammation or from a deep venous thrombosis (blood clot). Women are more likely to suffer from abnormal leg veins. Hormonal factors including puberty, pregnancy, menopause, the use of birth control pills, estrogen, and progesterone affect the disease. It is very common for pregnant women to develop varicose veins during the first trimester. Pregnancy causes increases in hormone levels and blood volume which in turn cause veins to enlarge. In addition, the enlarged uterus causes increased pressure on the veins. Varicose veins due to pregnancy often improve within 3 months after delivery. However, with successive pregnancies, abnormal veins are more likely to remain. Other factors which can indirectly induce the formation of varicose veins are obesity, old age, excessive heat including prolonged exposure to the sun, prolonged standing, constricting clothing and girdles, and disorder of the lower limbs and feet. These factors should be controlled to prevent varicose formation.
Will veins return?
Unfortunately, vein disease (both varicose and spider/cosmetic) is a dynamic disease. By this we mean that there is a perpetual change over time. For some people there are very few recurrence over time of their vein problems. For others, it simply means that they need more treatments on a regular basis. Our experience has demonstrated that regular follow up is very important for vein disease regardless of the type of treatment given.
Our experience...
Since 1850 or so, we have not yet found a way to "repair" varicose veins. By this I mean that the faulty valves in the veins can not be replaced at this time. We therefore have "learned" to remove or eliminate the diseased section of the vein involved. This is why in my opinion, we should do the least invasive treatment to satisfy the patient in eliminating the problematic veins. More importantly, regardless of the treatment given for the "diseased vein", treating the diseased vein does not affect the rest of the other veins in the leg, or possible future disease of other veins. Proper follow up, and timely treatments have been showned to be the best care in the long term.
Sclerotherapy
Injection treatment of spider and varicose veins
Advantages
- Non-surgical
- Minimal discomfort
- No down time
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- Cosmetic improvement
- Relieves leg pains, swelling, and tired legs
- Affordable
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For a list of FREQUENTLY ASKED QUESTIONS about Sclerotherapy,
CLICK HERE.
Recommendations for Best Results
- DO NOT apply oil or cream to your legs for 24 hours before your treatment (our tapes will not stick).
- DO NOT shave or wax your legs 24 hours before treatment (it will sensitize your skin)
- DO NOT suntan 24 hours before and 48 hours after your treatment (and always avoid sunburn).
- DO NOT take excessively hot baths or whirlpools (it will dilate your veins).
- DO NOT wear girdles or constrictive clothing (they will impair your circulation).
- DO NOT wear support hose immediately before your treatment, wear them after.
- DO continue your routine exercise (walking, swimming, aerobics, etc.) as usual after 48 hours post treatment.
- DO watch your weight.
- DO wear support stockings as often as possible.
- DO wear low-healed shoes, especially if standing for long periods. High heels impair the venous return from your feet.
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Echosclerotherapy |
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WHAT IS ECHOSCLEROTHERAPY?
- Echosclerotherapy is an ultrasound guided injection technique for the treatment of varicose veins. The purpose of echosclerotherapy is to sclerose (close) the veins near their site of origin. The goal of the treatment is to drastically reduce or eliminate the need of vein surgeries. Although the percentage rate of success is high, in some cases, patients may require surgical intervention despite this treatment. As a rule we inject a vessel twice (on two separate occasions, at least 6 weeks apart). If the outcome is unsuccessful, than surgery may be the last option. Echosclerotherapy is not a benefit of MSP.
Vein surgeries
All of our vein surgeriies are done under local anaesthesia. Minor incisions are done after ultrasound guidance over key areas to access the veins. Dr. Malo will go over this procedure in details if it is required for yourself. Varicose vein surgery is a benefit of MSP in BC. |
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