Varicose Veins Treatment
There are mainly three types of blood vessels in human body. Arteries, Capillaries & Veins. Arteries are blood vessels which carry fresh oxygenated blood from the heart to the whole body. Veins are blood vessels which does the reverse work i.e. transport blood from body back to the heart. Capillaries essentially the connection between arteries and veins.
Simply put, Veins are blood vessels that transport blood from various body parts to the heart for re-circulation.
What are Varicose Veins?
Varicose vein is a clinical condition in which the normal veins do not function the way they are supposed to. Let’s understand it in detail:
Arteries carry oxygenated blood from pumping heart to various body parts (for e.g. legs) with pressure.
While transporting blood back to heart, most pressure from heart pumping is lost and veins do not have similar support of pressure to transport blood to heart.
To overcome the reduced pressure, inside your veins are very small valves that open and close to help keep blood flowing in one direction – back towards the heart.
Sometimes, these tiny valves begin to malfunction, allowing blood to back up and “pool” behind the valves. Over time, the vein walls become weak and veins begin to bulge, causing the raised, welt (swollen vein) like appearance we see as varicose veins. Spider Veins are similar but smaller.
Varicose veins are normally swollen and enlarged. They often are lumpy, bulging or twisted and sometimes may be red, blue/purple.
To understand simply, imagine a road where traffic lights control movement of traffic in one direction. However, when traffic lights malfunction, a traffic jam happens. Similarly, when valve in the veins do not work properly, blood movement is obstructed which many a times result into Varicose veins.
What Causes Varicose Veins?
Mostly Varicose veins occur with age; however, they also can be caused by significant weight gain. Also some professions that require you to stand or sit for a long time each day also exert more than normal pressure on the veins which leads to onset of Varicose veins.
Genetics can also play a role in varicose vein development, and women are more likely to have them than men. Smoking and taking oral contraceptives or hormone replacements also increase your risk of developing varicose veins.
Number of factors which increase probability of having varicose veins:
- Professions or Occupations which require a lot of standing like Security guards, Professors, Airhostess, Factory workers, Nurses etc.
- Obese people that is people with BMI greater than 30 (>30) are more likely to get vein problem.
- Pregnancy, puberty, and menopause leads to hormonal changes and they may influence occurrence of varicose vein. Postmenopausal hormonal replacement also have been considered as cause of varicose vein issue.
- Birth control pills usage also leads to hormonal changes which again may increase probability.
- Heredity: Genetics are known to play a role in onset of vascular conditions and Varicose vein is no exception.
- Blood clot history.
- Conditions that lead to more than normal pressure in the abdomen such as constipation, tumors, garments like girdles etc.
- Research has identified some other causes like injury/trauma to the skin, history of vein surgery, ultraviolet rays exposure
Is Varicose Veins a Serious Health Problem?
Varicose Veins is a medical condition and in itself may not be a serious problem unless you experience:
- Heavy & uncomfortable legs with aching
- Mild to heavy swelling
- Throbbing and burning sensations in legs
- Muscle cramps in legs
- Dryness and itchiness over the vein
- Slow healing sores, dark patches
- Thickening of skin around calves or ankles
As informed while varicose vein may themselves be not a very critical condition, ignoring them will certainly lead to some serious medical issues and certainly will adversely affect quality of life. An early identification of such condition not only will lead to early relief from symptoms but also restricts development of any serious medical problem.
If you experience any or a combination of the above symptoms, it is advised to get treatment done as negligence may lead to development of:
- Extremely painful ulcers
- Blood clots which may develop into Deep Vein Thrombosis (DVT) and pulmonary embolism which are serious health problems
- Bleeding in the veins requiring medical attention
To avoid any future serious health complication as described above you should see doctors and avail medical guidance preferably from an expert like interventional radiologist.
How is Varicose Veins Diagnosed?
Diagnosis and early treatment of varicose veins is inexpensive and easy.
While primary evaluation for varicose vein is done by confirming the symptoms and physical inspection of the legs by medical professional.
However clinically every patient is required to have a full and detailed duplex ultrasound scan carried out by specialist doctor i.e. an interventional radiologist.
It is necessary with ultrasound for varicose veins that the medical professional examines each vein in the leg including smaller perforator veins. It has been found that a non-specialist medical professional may overlook the minor veins which may be the real cause of varicose vein and hence we recommend consulting an interventional radiologist.
In certain specific conditions wherein varicose veins are thought to be originating from Pelvis, more specific tests are required.
What Doctor to see for Varicose Vein?
You should consult an expert as he only can assess your problem and advise if you need to avail dedicated treatment. If you have symptoms as described above, you may meet any of the following set of doctors:
- A phlebologist who is a vein specialist. We should note that such distinct specialty is not identified in Indian medical education system.
- A vascular medicine doctor, who focuses on the system of blood flow.
- An interventional radiologist, who specializes in using imaging tools to see inside the body and do treatments with little or no cutting.
It is important to see the right expert because it is equally important to know when to start the treatment.
As per guidelines by National Institute for Health & Care Excellence, United Kingdom interventional procedures by an interventional radiologist should be attempted first before reviewing any other treatment option.
In early disease, depending on the clinical examination and a good doppler study, the expert will usually recommend appropriate stockings for prevention.
It is also necessary to know the right time to proceed to intervening into definite treatment to prevent complications.
The technique used by Interventional radiologists are some of the most advanced and have proven to have given best results to the patient.
Interventional radiologists are specially trained to perform all treatment procedures related to varicose veins. Most treatments performed by them provide immediate relief to the patient and enable resuming normal life with minimal rest period.
You can connect with us for getting a free online doctor advise for your problem. We will be happy to provide you guidance for the problem.
Types of Treatment Offered for Varicose Veins
Thermal Treatment Options:
The below options in this category use mild heat as catalyst for the treatment. These are well tested and statistically proven methodologies for effective treatment of varicose veins.
Endo-Venous Laser Ablation Treatment (EVLA/EVLT):
A minimally invasive treatment, EVLT uses heat to close off challenging veins and release the symptoms they lead to. Imaging guidance (guided by x-ray images) is used by the interventional radiologist to thread a thin laser fiber inside the problem vein using a tiny needle. After that, the radiologist numbs the vein to minimize uneasiness during the heating process. At the end, the heat due to the laser causes the vein to close. As the delinquent vein is closed, blood flows via the remaining healthy veins. While patient rests easily during the complete EVLT process, the patient can return to most of the routine activities instantly.
With insertion of a small catheter into the vein, radiofrequency energy is transported to the vein wall, initiating it to heat, collapse and close shut. It is mostly done on an outpatient basis and very few times under local anesthesia.
Also, some non-thermal treatment choices are available for varicose veins. Under these options different types of medically approved substances are used to enable closure of problematic vein. These treatments include:
The latest medical technology available for treatment of varicose veins. In the short span of 5 years, the treatment option is getting fast popularity among doctors and patients alike.
In this mesmerizing technique a specially formulated medical glue is injected into the problematic vein and with little external pressure the vein is sealed. With no requirement for local anesthesia in most cases and relative ease of technique, VenaSeal is fast becoming preferred choice of treatment.
A small rotating catheter, which is a small, flexible tube, is used to inject in the vein a chemical solution which causes complete closure.
Similar to the above too, insertion is made in the vein. However under Varithena, a foam like material is used to improve conditions & appearance.
The benefit of all of these techniques is that multiple needle sticks for local anesthesia is totally avoided. Also, there is reduced risk for potential nerve damage that may happen with burns.
clerotherapy (Spider Vein Treatment):
Under Sclerotherapy a chemical irritant is directly injected into a vein to near to the vessel. Variety of medically approved materials can be used to irritate the vein lining causing it to shrink & close. The solution is injected through a very small needle.
Also, this technique is frequently used to treat spider veins (telangiectasia) which are essentially smaller veins.
Sclerotherapy normally shall be carried out as side procedure with main procedure for the tiny veins.
Which treatment option specifically should be adopted depends on various factors and your specialist doctor should be able to help you make correct choice.
FAQ's you should know about Varciose veins
What steps does a vein specialist takes to treat varicose veins?
In case of varicose veins, the vein specialist shall preferably be an interventional radiologist. Normally, a doctor diagnoses varicose veins by physical clinical examination. Confirmatory detailed ultrasound is also done by doctor to conclusively diagnose the condition.
Treatment of patient, if EVLT/VenaSeal is suitable, is done on out-patient basis and patient returns home same day. In a day patient can resume normal activities. Patient should have symptomatic relief immediately. It’s a good practice to have a follow up check-up with doctor.
Patient may be advised to wear compression stockings for some time.
This is a normal routine and treatment plan for a patient can only be decided by doctor after check -up.
Can varicose return even after treatment?
The treatments offered presently for varicose veins and spider veins have very high success rates when compared to traditional surgical options.
However, with time more abnormal veins may develop as there is no medically approved cure for weak vein valves.
Diagnostics like ultrasound are used to identify the level of leakage in the valves (venous insufficiency). Medication under guidance can help contain this issue for the patients.
Will one procedure eliminate my varicose veins?
While the current treatments offered for varicose vein like EVLT are well tested and observe high success rates at good institutions, with time there is chance of development of more abnormal vein. It depends on various factors of patient condition.
Patient should consult doctor if experience symptoms. Mostly the patients may avoid serious redevelopment of varicose vein if timely consult doctor and practice some exercise/precautions.
How laser treatment is different from other varicose veins treatment options?
Laser treatment (Popularly referred as EVLT) has very high success rate, it is non – surgical with fast results and in most cases does not requires admission. There is no use of any chemicals and if patient condition permits anaesthesia may also not be administered. However, each patient needs to get evaluated for EVLT to formalize treatment plan. Please consult with your specialist doctor, an interventional radiologist.
How long do I need to stay out of normal activities after the procedure?
EVLT procedure is mostly an outpatient procedure unless patient condition requires admission. Mostly no anaesthesia is administered hence patient returns to home within few hours. Depending on condition, patient may be advised to rest for a day before resuming any strenuous routine. Normal routine can be taken up same day or next day.
When to seek medical advice for varicose veins?
Varicose Vein is a medical condition which may largely effect quality of life of patient in its initial stages. If a patient experiences discomfort & pain in legs with mild to heavy swelling, leg muscle cramps, throbbing & burning feeling in legs, development of dark patches, slow healing sores etc. it is good to get evaluated by a specialist before the problem increases.
What can happen if I don’t treat my varicose veins?
Varicose vein in itself may not be life threatening condition, but it may significantly hamper patient quality of life and in extreme cases leads to development of more serious medical condition which may be fatal.
Are compression stockings actually an effective treatment?
Compression stockings are not treatment but may provide symptomatic relief to the patient. Varicose veins is a medical condition with respect to blood flow in veins and compression stockings help relieve some of the symptoms for patients. It is not treatment.
Does my insurance cover laser treatment for varicose veins? Yes. While coverage depends on type of medical policy, in most policies varicose vein treatment like EVLT shall be covered.
Will removing varicose veins affect the blood flow?
Under EVLT, affected vein in the leg is not removed but incapacitated and closed. Blood flow in our body does not depend on one vein and closure doesn’t affect normal blood flow. In any case, at endovascular clinic patient is fully evaluated before the procedure to identify any other medical condition. Patients should ask their treating doctors about the procedure and make an informed decision.
If a varicosed vein is blocked or removed, will it be bad for circulation?
No. Varicose veins are already malfunctioning, so that means they're already interfering with healthy, normal circulation.
By preventing blood from flowing through these diseased veins and rerouting it naturally through healthy neighboring veins, normal circulation can be restored.
Why should I choose Endovascular Clinic for my varicose veins treatment?
Endovascular clinic is a doctor driven institution with dedicated team for vein related procedures. We help patient understand the condition & recommend the patient with optimum treatment plan as per the condition.
The specialist, Dr. Bhavesh Popat is recognized and highly experienced interventional radiologist who provides information to patient in most convenient manner so that patient takes a fully informed decision.
Patients can connect us for second opinion also and we shall be happy to provide information. Decision is always patients.
One thing which supposedly has shown result in slowing the development of new varicose veins is to wear gradient compression support stockings as much as possible during the day.