What is “Varicose Vein”?

Varicose veins are twisted, enlarged veins. Any superficial vein may become varicose, but the veins most commonly affected are those in your legs.  It happens because of defective valves in the vein that cause reflux and pooling of blood towards the direction of gravity.  

For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more serious problems.

Symptoms

When painful signs and symptoms occur, they may include:

• An achy or heavy feeling in your legs, burning, throbbing, muscle cramping and swelling in your lower legs
• Worsened pain after sitting or standing for a long time
• Itching around one or more of your veins
• Skin discoloration (blackening), thickening, dryness and loss of hair.
• Leg ulcers and bleeding

Spider veins are similar to varicose veins, but they're smaller. Spider veins are found closer to the skin's surface and are often red or blue. They vary in size and often look like a spider's web.

When to visit a doctor

Self-care, such as exercise, leg elevation, or compression stockings, can help you from getting worse. But if you're concerned that the cosmesis or self-care measures are not sufficient to prevent getting worse, see your doctor.

Causes

Weak or damaged valves can lead to varicose veins. Arteries carry blood from your heart to the rest of your tissues, and veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity.

Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart, then close to stop blood from flowing backward. If these valves are weak or damaged, blood can flow backward and pool in the vein, causing the vein to stretch or twist.

Risk factors

• Age: Due to loss of vein elasticity some blood flows back into your veins where it collects instead of flowing up to your heart.
• Sex: Women are more likely to develop this because hormonal changes during pregnancy, premenstruation, or menopause tend to relax vein walls and allow the development of varicose veins. Also, birth control pills may increase your risk of varicose veins.
• Family history: If other family members had varicose veins, there's a greater chance you will too.
• Obesity: It puts additional pressure on your veins.
• Standing or sitting for long periods of time: Jobs involving prolonged standing and a sedentary lifestyle. 

Complications

• Ulcers: Painful ulcers, particularly near the ankles. A discoloured spot on the skin usually forms before an ulcer. Needs urgent consultation.
• Blood clots (DVT): Any persistent leg pain or swelling warrants medical attention because it may indicate a blood clot within deep veins (DVT).
• Bleeding: This happens because of increased pressure.

Prevention

• There is no way to completely prevent, but improving your circulation and muscle tone may reduce the risk of developing varicose veins or getting additional ones. 
• Exercising with weight control
• Eating a high-fibre, low-salt diet
• Avoiding high heels and tight hosiery
• Elevating your legs
• Changing your sitting or standing position regularly

What is EVLT

Endovenous laser ablation therapy (EVLT) is a minimally invasive procedure that makes use of catheters, lasers, and ultrasound to treat varicose veins. The EVLT procedure begins with an Interventional Radiologist inserting a catheter into the varicose vein. Using ultrasound to see inside the patient, the doctor guides the catheter through the vein. A laser at the end of the catheter heats the walls of the vein, which closes it. This causes blood to stop flowing through the vein.

As the body recovers after the procedure, circulation becomes more efficient since blood is not flowing through a faulty vein and the problem vein shrinks and fades. Blood then flows through other nearby veins instead.

WHY EVLT

• Outpatient procedure(walk-in - walk-out). Can resume normal activities immediately
• Quick and easy to perform
• Minimally invasive and less traumatic
• No scarring
• Excellent clinical result
• Better result than open surgery
• Reduced procedure cost

What happens after endovenous laser varicose vein surgery?

You will be encouraged to walk right after the procedure, for about 30 to 60 minutes.
Your leg may have some bruising. The bruises should go away in about 2 weeks.
You’ll need to have someone drive you home after the procedure.

Follow-up to the procedure

Follow up within one week, followed by the next follow-up after 1 month.
You will be advised to use stockings for 2 months.