Varicose Veins
Varicose veins are blood vessels that are abnormally dilated which appear swollen, twisted and can be painful. Varicose veins can form anywhere in the body, but they are usually seen in the back of the calf or on the inside of the leg. They occur when the valves in the veins do not function properly and the blood leaks down and collects in the veins. This causes the veins to enlarge. Women are more likely to get varicose veins than men. Puberty, hormonal changes, weight gain, lack of physical activity, pregnancy, birth control pills, sitting or standing for a long time are some of the factors that causes varicose veins. Varicose veins appear as blue, purple, or red veins and look twisted and bulging.
Treatment
The non-surgical treatment options for varicose veins include:
Sclerotherapy: It is one of the common treatments for varicose veins. A sclerosing/irritant solution is injected to the target site where the varicose veins are present. The sclerosing solution irritates the lining of the blood vessel causing the vein to swell and stick together. Over time, the venous blemishes turn into scar tissue and may disappear. The number of veins treated in one session will be decided by your dermatologist based on the size and location of the veins. There will be a two week interval between first and second treatments and then a 1-month period to assess response.
In micro-injection sclerotherapy, tiny needles are used to inject a sclerosing solution into the abnormal tiny veins to close off the vein.
Sclerotherapy slowly clears leg veins and may be completely resolved in two to six months, depending on the vessel size.
Endovenous Laser Treatment: Endovenous laser method is a minimally invasive method where a laser fibre is guided into the vein till it reaches the site of abnormality. On reaching the site of treatment the fibre is made to emit the laser energy which produces heat near the blood vessel which causes blood to clot in the vessel and thus destroys the blood vessel. The damaged blood vessels will collapse, shrink and finally disappears. This procedure is often performed for larger varicose veins and the procedure can be performed in out-patient setting which may require about 30 minutes.
Ultrasound guided sclerotherapy: Ultrasound guided sclerotherapy technique involves injecting a sclerosing substance, a mild detergent solution, directly into the varicose vein using a very fine needle. The procedure takes about 15 to 30 minutes. An ultrasound is used to track the foam which makes sure that foam enters the varicose veins and not normal veins. The target veins are compressed by bandage and a surgical stocking is placed over this bandage. The sclerosing solution irritates the lining of the blood vessel causing the vein to swell and stick together. Over time, the venous blemishes turn into scar tissue and may disappear. The advantages of using Ultrasound guided sclerotherapy is that it requires no incision, less time for recovery, no scar formation and does not require an overnight stay in the hospital.
Other conventional methods for treatment of Spider Veins would include:
Lifestyle changes:
- Avoid sitting or standing for long hours without taking break.
- Physical activity should be included in your daily routine. This will help improve circulation in the veins.
- Obesity will increase the risk of pressure being exerted on the blood walls. Lose weight if you are obese.
- Avoid wearing tight clothes which may interrupt the circulation.
- Avoid wearing high heeled shoes. Calf muscles put in a lot of energy when you try to walk in heels. Thus when the calf muscles are at rest the circulation will be improved.
Surgery
Vein stripping, surgery to remove the veins is the last resort of treatment. Vein stripping is generally done for removing the thickened and hardened saphenous vein (the large vein in the leg). Varicose veins are usually removed under general anaesthesia or spinal anaesthesia. The surgeon makes two small incisions, one in the groin at the top of the affected vein and the other either in your calf or ankle. The surgeon then advances a thin, flexible plastic wire through the vein from the groin incision to the incision in ankle or calf. This flexible wire is tied to the saphenous vein and pulled out bringing the entire vein with it. For other damaged veins, tiny incisions are made over the damaged veins, and the veins are removed or tied off. The incisions are closed with sutures.
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