Varicose Veins in India
What is Varicose Veins ?
Varicose Veins are twisted and bulgy veins that protrude on the surface of the skin. Spider veins are similar, but less obvious. These blue and red tattoo like lines on the skin, as well as the varicose veins are commonly found in the legs and occur primarily due to enlarged and weakened vein walls and faulty valves. This leads to a painful and problematic condition that sometimes necessitates spider/varicose vein treatment. Vascular defects and poor blood circulation are also important reasons for these vein disorders.
Apart from vascular defects, some of the other causes for varicose/spider veins are heredity, obesity, prolonged standing, and lifestyle changes. These are typical reasons requiring varicose vein treatment, of the upwardly mobile residing in metros like Mumbai or Delhi who spend a lot of standing hours commuting, added to a fast paced life, and no time for exercises.
Varicose veins are veins that have become enlarged and twisted. The term commonly refers to the veins on the leg, although varicose veins can occur elsewhere. Veins have pairs of leaflet valves to prevent blood from flowing backwards (retrograde flow or venous reflux).
Leg muscles pump the veins to return blood to the heart (the skeletal-muscle pump), against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves do not work (valvular incompetence). This allows blood to flow backwards and they enlarge even more. Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides being a cosmetic problem, varicose veins can be painful, especially when standing. Severe long-standing varicose veins can lead to leg swelling, venous eczema, skin thickening (lipodermatosclerosis) and ulceration. Although life-threatening complications are uncommon, varicose veins may be confused with deep vein thrombosis, which may be life-threatening.
Signs and symptoms
Aching, heavy legs (often worse at night and after exercise).
Appearance of spider veins (telangiectasia) in the affected leg.
Ankle swelling, especially in the evening.
A brownish-yellow shiny skin discoloration near the affected veins.
Redness, dryness, and itchiness of areas of skin, termed stasis dermatitis or venous eczema, because of waste products building up in the leg.
Cramps may develop especially when making a sudden move as standing up.
Complications
Most varicose veins are reasonably benign, but severe varicosities can lead to major complications, due to the poor circulation through the affected limb.
Pain, tenderness, heaviness, inability to walk or stand for long hours, thus hindering work
Skin conditions / Dermatitis which could predispose skin loss
Skin ulcers especially near the ankle, usually referred to as venous ulcers.
Development of carcinoma or sarcoma in longstanding venous ulcers. Over 100 reported cases of malignant transformation have been reported at a rate reported as 0.4% to 1%
Severe bleeding from minor trauma, of particular concern in the elderly.
Blood clotting within affected veins, termed superficial thrombophlebitis. These are frequently isolated to the superficial veins, but can extend into deep veins, becoming a more serious problem.
Acute fat necrosis can occur, especially at the ankle of overweight patients with varicose veins. Females are more frequently affected than males.
Varicose Veins
The symptoms of varicose veins are:
Appearance of spider veins or bulging veins
Pain, heaviness and fatigue in the legs
Swollen ankles and calves
Burning or itching of the skin
Muscle cramping
Leg throbbing
Causes
Varicose veins are more common in women than in men, and are linked with heredity. Other related factors are pregnancy, obesity, menopause, aging, prolonged standing, leg injury and abdominal straining. Varicose veins are unlikely to be caused by crossing the legs or ankles.Less commonly, but not exceptionally, varicose veins can be due to other causes, as post phlebitic obstruction or incontinence, venous and arteriovenous malformations.
Varicose veins could also be caused by hyperhomocysteinemia in the body, which can degrade and inhibit the formation of the three main structural components of the artery: collagen, elastin and the proteoglycans. Homocysteine permanently degrades cysteine disulfide bridges and lysine amino acid residues in proteins, gradually affecting function and structure.
Treatment
Treatment can be either conservative or active. Active treatments can be divided into surgical and non-surgical treatments. Newer methods including endovenous laser treatment, radiofrequency ablation and foam sclerotherapy appear to work as well as surgery for varices of the greater saphenous vein.