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Varicose VeinsVaricose veins, also called "varicoceles," result when the valves that control the flow of blood in and out of veins fail to work properly and the pull of gravity causes blood to pool in the legs or elsewhere. Varicoceles in the scrotum may cause infertility in men. Varicoceles in the veins of the ovaries may cause chronic pelvic pain in some women. When valves fail in the legs, the superficial veins become enlarged and twisted, where they appear as twisted, dark blue vessels just under the skin’s surface. Smaller varicose veins are sometimes called spider veins. Obesity, pregnancy, constriction of the veins with garters or tight clothing, and an inherited tendency are among the contributing causes of varicose veins. Usually, there are no symptoms. Varicose veins are diagnosed by physical examination. Venous insufficiency is an abnormal circulatory condition with decreased return of blood from the leg veins up to the heart, with pooling of blood in the veins. Normally, stop valves in the vein close to keep blood from flowing downward with gravity. When the valves in the vein become weak and don’t close properly, they allow blood to flow backward, or reflux. Facts:Women between the ages of 30 and 70 are most often affected by varicose veins. In the United States, 10 percent of men and 20 percent of women have varicose or spider veins. Treatment usually is not required. While most treatment is sought for cosmetic reasons – to improve the appearance of the veins in the legs – some varicose veins are painful and require treatment for medical reasons. Chronic venous disease of the legs is one of the most common conditions affecting people. Approximately half of the U.S. population has venous disease—50 to 55% of women and 40 to 45% of men. Of these, 20 to 25% of the women and 10 to 15% of men will have visible varicose veins. Varicose veins affect 1 out of 2 people age50 and older, and 15-25% of all adults. People without visible varicose veins can still have symptoms. The symptoms can arise from spider veins as well as from varicose veins, because, in both cases, the symptoms are caused by pressure on nerves by dilated veins. Risk Factors:
Symptoms:Most varicose veins have no symptoms other than the appearance of purplish, knotted veins on the surface of the skin. A physician should be consulted and treatment may be required if there is:
Symptoms caused by venous insufficiency and varicose veins include aching pain, easy leg fatigue, and leg heaviness, all of which worsen as the day progresses. Many people find they need to sit down in the afternoon and elevate their legs to relieve these symptoms. In more severe cases, venous insufficiency and reflux can cause skin discoloration and ulceration which may be very difficult to treat. One percent of adults over age 60 have chronic ulceration. Diagnosis:The presence of varicose veins is most often confirmed by ultrasound. This is a painless procedure in which a radiologist or technician moves an instrument (transducer/receiver) about the size and shape of a computer mouse across the outside surface of the skin. Sound waves are transmitted through the skin and allow the technician to "see" the size, shape and texture of the patient’s veins. A picture is displayed on a computer screen as the radiologist or technician takes the ultrasound. Your VIA Interventional Radiologist will use ultrasound to assess the venous anatomy, vein valve function, and venous blood flow changes, which can assist in diagnosing venous insufficiency. The doctor will map the greater saphenous vein and examine the deep and superficial venous systems to determine if the veins are open and to pinpoint any reflux. The saphenous vein, which runs the length of the thigh, is one of the major veins of the leg.
Treatment Options:Varicose Vein Ablation is an outpatient procedure performed using imaging guidance. After applying local anesthetic to the vein, the interventional radiologist inserts a thin catheter, about the size of a strand of spaghetti, into the vein and guides it up the greater saphenous vein in the thigh. Then laser or radiofrequency (RF) energy is applied to the inside of the vein. This heats the vein and seals the vein closed.
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