Varicose Veins: Unattractive, and Potentially Dangerous

I’d be willing to guess that most everybody has heard of varicose veins. No one really likes them, since they have a reputation of being unattractive, but most people don’t realize they can also cause serious health issues.

What are Varicose Veins?

“Spider” veins—small blue, bluish or purple vessels (technically called telangiectasia)—are a manifestation of this disease as well, if they form in the legs and feet. They can also create significant troubles if located in certain vulnerable areas of the lower extremities—by rupturing and bleeding, for example. Such bleeding is always painless and usually very hard to stop, so it’s fairly dangerous, especially since it has the tendency to happen at night, during sleep.

Once venous insufficiency progresses, complications can develop, like thrombophlebitis, trophic ulcers, reperfusion cellulitis, swelling of an extreme degree called anasarca, progressive infections called phlegmasia, and even skin cancer. Other, less common problems include chronic pelvic pain and orthostatic hypotension.

What’s really going wrong in these veins? It all starts in the small folds on the inside lining. In a vein of a normal diameter, the folds located on opposite walls can reach each other to form a valve, allowing blood to move only in one direction: upstream. Such veins are called “competent” or “sufficient.” In even slightly enlarged veins, those folds do not meet. The blood, therefore, can go either direction. The abnormal valves are appropriately called “incompetent,” and the vein is called “insufficient.” Normally, blood in our legs moves against gravity to reach the heart; in an insufficient vein, however, the blood will be directed vertically down, toward the feet.

Health Consequences

Insufficient veins can have many detrimental consequences. The ones most people know about are mechanical—such as dilated, varicose veins; and swollen legs and feet. However, many people don’t realize the biochemical consequences, like increased toxins in the blood.

The blood flowing through our veins is “used” blood. It doesn’t contain oxygen or nutrients, and it’s loaded with carbon dioxide and other end products of metabolism. These waste materials need to be filtered through the kidneys, liver, gastro-intestinal tract, and lungs, and eventually, expelled from the body. Typically, the body is efficient in getting rid of these toxins, so they don’t hang around long enough to cause trouble. In insufficient veins, however, such blood is being forcefully injected back into peripheral tissues, poisoning them and depriving them from the fresh blood normally brought in by the arteries.

How is it Treated?

How do we treat this problem? Regardless of the signs and symptoms, treatment should be directed at the cause—poor circulation. First, we need to identify the veins with incompetent valves. Second, we need to stop the blood from flowing through them. Any treatment not directed at improving circulation is not efficient, at best, and is often detrimental, with the potential of accelerating the disease or leading to further complications.

In the old days, surgeons made a large, entire-leg incision and removed the affected veins during an operation. Not only was it disfiguring, invasive, and requiring of general anesthesia—with long recovery consisting of multiple limitations and complications—“looking for it” with our eyes was a crude way to find an insufficient vein.

Today, we find abnormal veins with an ultrasound machine using specific sophisticated criteria, measurements and calculations. It’s precise, painless, and takes about 10 minutes. Once the vein is identified, there are several modalities of treatment designed to seal the vein from the inside, as opposed to surgical removal. Endovenous laser therapy is the most advantageous approach. Upon treatment, the vein not only remains closed, but in the majority of cases, it slowly disintegrates while being digested by surrounding soft tissues. Consequently, the question of recurrence due to re-opening of the treated vein does not exist anymore: the vein is gone.

In U.S. Vein Clinics, physicians with high qualifications in vascular pathology— specializing exclusively in management of venous insufficiency and its complications—conduct meticulous evaluations, perform indicated testing, and administer appropriate treatment on a case-by-case basis. In our centers, the relationship between doctor and patient doesn’t stop upon completion of treatment; we always follow our patients to ensure perfect results and full satisfaction.