Varicose Veins – Definition, Causes, and Prevention.

Definition

Varicose veins are rope-like veins that typically form on the legs. These veins are usually the result of a weak vein valve that is allowing blood to collect in the vein. It can very noticeable due to their blue or purple color and their bulging from the skin. There are several factors that can contribute to one’s risk of developing spider veins. Genetics can play a factor in whether or not you will develop varicose veins in your lifetime. Being pregnant can sometimes cause it because of the hormonal changes and the pressure put on the veins. Varicose veins are increasingly common as you age and being overweight also increases the risk of developing them. In order to prevent varicose veins, it is also important not to sit or stand for long periods at a time.

Epidemiology

• Prevalence estimates vary based on population, selection criteria, disease definition, and imaging techniques. Generally, prevalence rates are higher in industrialized countries and in more developed regions.
• Prevalence of visible varicose veins in the Western population over 15 years of age is 10% to 15% for men and 20% to 25% in women. Prevalence rates in the US are 15% (range from 7% to 40%) in men and 27.7% (25% to 32%) in women. Visible varicose veins are more prevalent in Hispanic people (26.3%) and less prevalent in Asian people (18.7%).
• The prevalence of varicose veins increases with age. In one study, 40-year-olds had a prevalence of 22%, 50-year-olds a prevalence of 35%, and 60-year-olds a prevalence of 41%.
• A genetic link has been suggested. The risk of varicose veins developing if both parents are affected is 90%; 62% risk if 1 parent is affected and female offspring; 25% risk if 1 parent is affected and male offspring; and if no parent is affected, the risk is 20%.

Types

Greater saphenous varicose veins

Lower extremities veins consist of deep veins and superficial veins and most of the blood flow in legs goes back to the heart through deep veins. It is formed in superficial veins that cover about 10% of the blood flow in legs. Among the superficial veins in legs, the one that forms varicose veins most frequently is greater saphenous veins. The greater saphenous vein is the superficial vein that goes up from inside of the ankle and is connected to the femoral vein at the inguinal region. It is formed on the main duct and the main branches of the greater saphenous vein is greater saphenous varicose veins. The area of the outset of varicose vein is lower legs, inside of the thigh, outside of lower extremities and the back of the thigh.

Lesser saphenous varicose veins

The lesser saphenous varicose vein is often seen next to the greater saphenous varicose vein. Lesser saphenous vein runs up from the outside of Achilles tendon and is connected to the deep vein at the back of the knees. The area of the outset of the lesser saphenous varicose vein is at the back of ankle or knees.

Branch type varicose vein

It is an enlarged segmental vein that is ramified from the main saphenous vein. Mainly it is seen below knees and sometimes solitary. Its feature is slightly narrower than a saphenous varicose vein.

Genital area varicose vein

It occurs due to the blood that backflows from the vein around the ovary and womb. Accordingly, the condition worsens when the flow of the blood into the ovary and womb increases during the menstrual period. When bumpy blood vessel meanders diagonally from the groin at the back of femur and spreads through lower extremity, genital area varicose vein is suspected.

Reticular type and Web type (spider veins) varicose vein

The reticular type is the swollen fine subcutaneous veins in the size of 2-3mm in diameter that spread like a mesh. The web type varicose vein is dilated capillary veins that are finer than reticular type in the size of less than 1mm in diameter that exist just below the skin. Web type varicose veins are not bumpy like saphenous varicose veins.

Risk factors

These factors increase your risk of developing:

Hormonal Changes: Women are more likely to develop the condition. Hormonal changes during pregnancy, pre-menstruation or menopause may be a factor because female hormones tend to relax vein walls. Taking hormone replacement therapy or 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.

Being overweight puts added pressure on your veins.

Standing or sitting for long periods of time: Your blood doesn’t flow as well if you’re in the same position for long periods.

Causes of varicose veins

In normal veins, valves in the vein keep blood moving forward toward the heart. With varicose veins, the valves do not function properly, allowing blood to remain in the vein. Pooling of blood in a vein causes it to enlarge.

This process usually occurs in the veins of the legs, although it may occur elsewhere. It is common, affecting mostly women.

Causes include:

• Defective valves from birth (congenitally defective valves)
• Superficial Venous Thrombophlebitis
• Trauma
• Standing for a long time

Having increased pressure in the abdomen may make you more likely to develop varicose veins, or may make the condition worse. This may be caused by:

• Pregnancy
• Obesity

Primary varicose veins occur because of congenitally defective valves, or without a known cause. Secondary varicose veins occur because of another condition, such as when a pregnant woman develops it.

Symptoms

It occur close to the surface of the skin and anywhere throughout the leg. Symptoms typically include:

• A feeling of fullness, heaviness, aching, and tiredness in the legs, especially at the end of the day or after periods of prolonged standing.
• Visible, enlarged veins.
• Swelling of the feet and ankles (due to stagnant blood leaking through the walls of the veins into surrounding tissues).
• Changes in skin color.
• Frequent itching of the skin.
• In more severe cases, the development of non-healing skin ulcers.

Symptoms of varicose vein

Complications of varicose veins

Complications although rare, can include:

Ulcers: Extremely painful ulcers may form on the skin near varicose veins, particularly near the ankles. Ulcers are caused by long-term fluid buildup in these tissues, caused by increased pressure of blood within affected veins. A discolored spot on the skin usually begins before an ulcer forms. See your doctor immediately if you suspect you’ve developed an ulcer.

Blood clots: Occasionally, veins deep within the legs become enlarged. In such cases, the affected leg may swell considerably. Any sudden leg swelling warrants urgent medical attention because it may indicate a blood clot — a condition known medically as thrombophlebitis.

Bleeding: Occasionally, veins very close to the skin may burst. This usually causes only minor bleeding. But, any bleeding warrants medical attention because there’s a high risk it can happen again.

Diagnosis and test

A physical examination, mainly visual, by a doctor will decide whether or not a patient has varicose veins. The patient will be asked to stand while the doctor checks for signs of swelling.

The following diagnostic tests are sometimes ordered:

Doppler test: An ultrasound scan to check the direction of blood flow in the veins. This test also checks for blood clots or obstructions in the veins.

Color duplex ultrasound scan: This provides color images of the structure of veins, which helps the doctor identify any abnormalities. It can also measure the speed of blood flow.

The patient may also be asked questions about the symptoms. In some cases, a doctor might refer the patient to a vascular specialist.

Treatment of varicose veins

If treatment is necessary, your doctor may first recommend up to 6 months of using compression stockings, taking regular exercise and elevating the affected area when resting.

If it is still causing you pain or discomfort, or they cause complications, they can be treated in several ways.

The most common treatment options include:

• Endothermal ablation – where heat is used to seal affected veins
• Sclerotherapy – this uses a special foam to close the veins
• Ligation and stripping – the affected veins are surgically removed

If you do feel you require treatment, it might help if you print out treatment options for varicose veins to discuss with your GP.

Prevention of varicose veins

There’s no way to completely prevent varicose veins. But improving your circulation and muscle tone can reduce your risk of developing it or getting additional ones. The same measures you can take to treat the discomfort from varicose veins at home can help prevent it, including:

• Exercising
• Watching your weight
• Eating a high-fiber, low-salt diet
• Avoiding high heels and tight hosiery
• Elevating your legs
• Changing your sitting or standing position regularly