Eliminating Discomfort
and Pain, Improving Appearance
Varicose
veins are enlarged veins that are visible through the skin and can appear as
blue or purple, twisted, knot-like cords. Varicose veins can occur anywhere in
the body but are more commonly found on the legs. This condition is caused by
increased blood pressure inside the superficial leg veins.
When veins are healthy and
working properly, they return blood to the heart for re-oxygenation, but when
valves in the veins fail – or become damaged or leak – some of the blood flows
backward rather than toward the heart, accumulating in the veins and causing
them to thicken, elongate, and sometimes bulge.
Left untreated, varicose
veins can cause serious health issues such as venous leg ulcers, skin
discolorations, or blood clots. They
affect about 20 percent of the U.S. adult population and half of those age 50
and older.
For many
patients, procedures to correct varicose veins are necessary to decrease or
eliminate discomfort, aches, and pains. For others, treating varicose and
spider veins is important for cosmetic reasons.
Symptoms of
Varicose Veins
Varicose
veins are common in patients with a family history of the condition and in women
during or immediately following pregnancy. Symptoms include:
- Discomfort
- Achiness, heaviness, and fatigue in the affected area
- Itchiness or numbness
- Swelling
Progression
of varicose veins can lead to:
- Skin discoloration
- Leg ulcers
- Blood clots
Treating
varicose veins early – with minimally invasive, nonsurgical procedures – can
prevent these progressive symptoms.
Diagnosis
Physicians might request a combination of
diagnostic procedures to confirm varicose veins. Some of these procedures include:
- Duplex
ultrasound:
A type of vascular ultrasound procedure used
to assess blood flow and the structure of the leg veins. Duplex means that two
modes of ultrasound are used – Doppler and B-mode. The B-mode transducer (like
a microphone) obtains an image of the vessel being studied. The Doppler probe
within the transducer evaluates the velocity and direction of blood flow in the
vessel.
- Color-flow
imaging: Also called triplex
ultrasound, this procedure is similar to duplex ultrasound but uses color to
highlight the direction of blood flow. Vessels in which blood is flowing are
colored red for flow in one direction and blue for flow in the other direction,
with a color scale that reflects the speed of the flow.
- Magnetic
resonance venography (MRV): A
diagnostic procedure that uses a combination of a large magnet,
radiofrequencies, and a computer to produce detailed images of organs and
structures within the body. An MRV uses magnetic resonance technology and
intravenous (IV) contrast dye to visualize the veins. Contrast dye causes the
blood vessels to appear opaque on the X-ray image, allowing the physician to
visualize the blood vessels being evaluated. MRV is useful in some cases
because it can help detect causes of leg pain other than vein problems.
Treatments for Varicose Veins
At UT Southwestern, our vascular specialists and
interventional radiologists offer surgical and nonsurgical treatment for
varicose veins.
Nonsurgical
Methods
- Ablation: Involves the insertion of a thin, flexible
tube called a catheter into a varicose vein. The tip of the catheter heats the
walls of the varicose vein and destroys the vein tissue. Once destroyed, the
vein is no longer able to carry blood and is absorbed by the body.
- Compression
stockings: These elastic stockings
squeeze or compress the veins and prevent blood from flowing backward.
Compression stockings can help with healing of skin sores and prevention of
additional sores. They are effective in treating varicose veins if worn daily
and can prevent the need for more invasive treatment.
- Elevation
of the legs:
Elevating the feet above the heart three or
four times a day for about 15 minutes at a time can help. Flexing (bending) the
legs occasionally can also help keep blood circulating.
- Laser treatment: Until recently, laser treatment was mainly
used to treat spider veins on the face. However, newer laser technology can now
effectively treat varicose veins as well. The physician inserts a tiny
fiber into a varicose vein through a catheter. The fiber sends out laser energy
that destroys the diseased portion of the varicose vein. The vein closes and the
body eventually absorbs it.
- Sclerotherapy: The most common treatment for both spider
and varicose veins, this procedure involves injecting a saline or chemical
solution into the varicose veins, causing them to harden so they no longer fill
with blood. Blood that would normally return to the heart through these veins
returns to the heart by way of other veins. The veins that received the
injection will eventually shrivel and disappear. The body absorbs the scar
tissue. It can be performed as a standalone procedure or as a complement to
ablation therapy.
- Microphlebectomy: This minimally invasive procedure removes
the varicose vein via a tiny nick made with a special set of tools.
Surgical Methods
- Small
incision avulsion: This
procedure involves passing hooks through small incisions and can be done alone
or together with vein stripping.
- Transilluminated-powered
phlebectomy: This vein-removal procedure
uses a bright light to illuminate the vein. A device is passed through a tiny
incision and removes the vein with suction.
- Vein
stripping: This procedure involves
tying off all varicose veins associated with the leg's main superficial vein
and removing it from the leg. Removing veins from the leg will not affect blood
circulation in the leg because deeper veins take care of the increased blood
circulation.