Varicose Veins Treatment

Updated: Nov 29, 2021

Varicose veins are permanently enlarged veins. The venous wall or the valves that prevent the back flow of blood in it are affected by venous blood pressure and its structure is deteriorated. Varicose veins appear as blue, swollen, convoluted veins in the patient's leg. Capillary varices are formed by the permanent expansion of smaller diameter veins (venule) close to the skin. Untreated varicose veins cause fatigue and a feeling of heaviness in the legs. In advanced cases, it can cause edema in the ankle, scaling on the skin and sores called ulcers.

SYMPTOMS (FINDINGS) • Change in skin appearance on the leg or under the knee • Appearance of small vein clusters in the leg • Itching or feeling of heaviness in the leg • Burning sensation in the leg or foot • Constant feeling of tiredness (not being able to rest) in the leg; and • Night cramps Those with significant varicose veins have an increased risk of developing deep vein coagulation (DVT). In case of DVT development, sudden painful swelling in the leg should be treated immediately.

RISK FACTORS Those who are likely to develop varicose veins: • People between the ages of 30 and 70 • Pregnant • Those who have varicose disease in the family Varicose veins that occur during pregnancy usually disappear after 1 year. However, the risk of developing varicose veins increases in more than 1 pregnancies

DIAGNOSIS The diagnosis of the disease is made by the attending physician by questioning the patient's complaints and by examination and Doppler ultrasonography.

Treatment options: If left untreated, varicose veins will progress over time. As the initial treatment in patients with mild complaints and whose disease has not progressed;

Resting the leg during the day • Compression stockings are recommended.

Treatment options for patients with advanced disease:

• Sclerotherapy: Medicines are injected into the varicose veins, which scleros the vein from the inside and prevent it from filling with blood again. After sclerotherapy, varicose veins harden and disappear spontaneously over time (2-3 months). • Endovascular Ablation (with Laser or RF): It is the process of burning the vein wall from the inside with laser or RF after local anesthesia after inserting plastic tubes called catheters into the vein by entering through a 1-2 mm incision into the affected vein. After the procedure, the vein is no longer filled with blood and disappears completely over time. Laser therapy is a very less traumatic method compared to surgery. Patients do not need to be hospitalized. Although it is a new treatment, long-term success results are around 98%, better than traditional surgical methods. The procedure takes about 1 hour and is done under ultrasound guidance. It is a painless procedure, but there may be mild pain that usually starts on the 2nd and lasts for a few days. There may be tightness and slight bruises on the leg, which improves within 7-10 days after the procedure. Patients should wear compression stockings for 1 week after the procedure. They cannot drive immediately after the procedure.

Possible Complications: If it is performed by experienced physicians, no serious complications will develop, however; • Burn on the skin • Discoloration of the skin • Nerve damage • Coagulation may occur in deep veins. Surgical Treatments: • Vein Striping • Small incision avulsion • Transillumination-enhanced phlebectomy (TIPP) In our Interventional Radiology unit, varicose veins treatment is successfully performed under local anesthesia without the need for hospitalization.

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