SIU Division of Vascular Surgery 
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Varicose Veins

Anatomy of Veins

Veins carry blood back to the heart. All veins have one way valves or “dams” that prevent blood from sinking back to your feet when you stand up. When you walk, the calf muscles squeeze to move the blood forward to the heart.
There are three types of veins. The surface veins, also called the saphenous veins, lie just below the skin. The deep veins are located near the bones of the leg and are surrounded by muscle. Connector veins join the surface veins to the deep veins. click image for larger view

 

 

 

What are Varicose Veins?

Varicose veinsVaricose veins develop when the valves or “dams” no longer work properly. The surface veins begin to develop increased pressure from blood that sinks back toward the feet. The vein walls become thin. Over time, this increased pressure forces the veins to expand into long, twisted and unsightly varicose veins.
There are different classifications of varicose veins. Typical varicose veins are the large, ropy veins greater than 1/8 of an inch. Spider veins are tiny dilated veins that you can not feel and are located in the skin surface. Veins that are larger than spider veins but not bigger than 1/8 of an inch are called reticular veins.

 

What Are The Symptoms of Varicose Veins?

It is important to remember that varicose veins of all sizes can cause symptoms. Large veins are not more problematic than small ones. Symptoms of varicose veins are often very vague. These can include leg or ankle swelling, leg heaviness, leg aching, restlessness and itching. For patients with varicose veins that do not cause symptoms, there are generally no health problems associated with the varicose veins. Symptoms from varicose veins can develop into permanent skin changes, bleeding and the development of ulcers or open sores.

Diagnosis of Varicose Veins

The diagnosis of varicose veins is made by having your legs examined by a specialist trained in the treatment of varicose veins. If you are found to have a varicose vein, a test called a venous reflux study may be ordered to check that the valves or “dams” in the veins are working properly. The test requires the patient to stand for a period of time. A technologist applies a blood pressure cuff to the leg being evaluated. Then an ultrasound device looks at the veins to evaluate the function of the valves.

Prevention of Varicose Veins

compression stockingsCompression stockings can decrease the symptoms of varicose veins and slow their progression. Prescription compression stocking provide standard compression and are more effective in preventing varicose veins than over-the-counter stockings purchased at supermarkets or stores. Like compression stockings, leg elevation and exercise decrease the amount of blood that pools in the lower leg of people prone to developing varicose veins.

 

 

 

Treatment of Varicose Veins

The treatment of varicose veins varies from compression hose to surgery. Minimally invasive treatment for spider veins can be with either sclerotherapy or a laser. Both of these procedures are performed on an outpatient basis in the clinic.

Sclerotherapy, or injections, use a small need to inject a chemical solution into the small varicose veins. This causes the vein to become irritated and no longer function. In addition a laser may be used on the skin surface to irritate the small varicose veins. While each treatment can improve the appearance of varicose veins, they may require multiple treatment sessions. Most patients see improvement over the course of several months.

Stab phlebectomies, or avulsions, are minimally invasive procedures performed under local anesthesia in the clinic. Varicose veins are removed with small instruments through tiny skin incisions. These tiny incisions do not usually require stitches and are often pulled together with fine paper tape. Recovery is brief and uneventful.
If the long surface vein, the saphenous vein, has valves or “dams” that no longer work, there are two procedures used to treat this problem. A minimally invasive procedure involves using a laser to make the vein no longer function. This is called an endovenous laser ablation. A catheter is placed into the saphenous vein in the calf through a small cut. The tip of the laser is advanced up to the groin. The laser seals the vein shut with heat. This technique avoids the open surgery of a saphenous vein stripping.

Vein stripping is the standard treatment for varicose veins involving the saphenous vein. Usually the thigh part of the saphenous vein is removed through cuts made at the ankle and in the groin. After the stripping procedure, multiple tiny cuts are made along the course of the vein to remove the branching veins. This technique can result in more scarring than the laser procedure. For many patients, multiple treatments are combined to effectively treat all of their varicose veins.

The Varicose Vein Clinic offers less invasive procedures to reduce scarring and improve cosmetic results. Treatment of varicose veins is covered by many insurance companies.

Call 217-545-8000 to schedule your evaluation today. SIU Varicose Vein Clinic national excellence locally owned.