Varicose

Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the veins on the leg, although varicose veins can occur elsewhere. Veins have pairs of leaflet valves to prevent blood from flowing backwards (retrograde flow or venous reflux). Leg muscles pump the veins to return blood to the heart (the skeletal-muscle pump), against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves do not work (valvular incompetence). This allows blood to flow backwards and the veins enlarge even more. Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides being a cosmetic problem, varicose veins can be painful, especially when standing. Severe long-standing varicose veins can lead to leg swelling, venous eczema, skin thickening (lipodermatosclerosis) and ulceration. Although life-threatening complications are uncommon, varicose veins may be confused with deep vein thrombosis, which may be life-threatening.

Causes

Varicose veins are more common in women than in men and are linked with heredity. Other related factors are pregnancy, obesity, menopause, aging, prolonged standing, leg injury and abdominal straining. Varicose veins are unlikely to be caused by crossing the legs or ankles. Less commonly, but not exceptionally, varicose veins can be due to other causes, as post-phlebitic obstruction or incontinence, venous and arteriovenous malformations.

Signs and Symptoms

In most cases, there is a simple cosmetic concern. In some cases, varicose veins cause aching pain and discomfort. Sometimes the condition leads to more serious problems. Varicose veins may also signal a higher risk of other circulatory problems. Symptoms of varicose veins can include aching legs, swollen ankles, and spider veins. People with varicose veins are more prone to leg ulcers.

Treatment

Treatment options for varicose veins can be both surgical and non-surgical. Non-surgical treatments include sclerotherapy, elastic stockings, leg elevation and exercise. The traditional surgical treatment has been vein stripping to remove the affected veins. Newer, less invasive treatments which seal the main leaking vein are available. Alternative techniques, such as ultrasound-guided foam sclerotherapy, radiofrequency ablation and endovenous laser treatment, are available as well.

See Also

• Deep vein thrombosis
• Spider veins
• Sclerotherapy
• Radiofrequency ablation
• Endovenous laser treatment

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