Varicose Veins
What are varicose veins?
Varicose veins, large dark-colored veins visible below the surface of the skin, occur from an increase in pressure within the vein. They are the result of underlying venous disease and a sign of venous insufficiency. Venous insufficiencies range from mild forms that may be largely cosmetic and cause slight discomfort, to more severe forms that can cause venous ulcers or more serious health concerns.

What are the symptoms of varicose veins?
Symptoms of varicose veins include:

+ Bulging or stretching superficial leg veins
+ Aching or throbbing
+ Heavy, tired, itching or restless legs

What causes varicose veins?

In normal veins, blood flows to the heart, and valves prevent the blood from flowing backward. With varicose veins, the valves do not seal fully and allow blood to leak downward. Blood pools in the vein, increasing venous pressure and weakening the vein wall. The result is leg swelling and superficial vein distortion typical of this condition.

In some cases, varicose veins are a precursor of a potentially dangerous condition known as Deep Vein Thrombosis (DVT). Only a qualified medical professional such as Dr. Gideon Van Wyk can properly evaluate the venous disorder for each individual patient.

Many factors, such as age, gender, genetics, weight, and lifestyle can contribute to the development of venous disorders and varicose veins. Other common causes include certain hormones, such as progesterone, genetic deficiencies, pregnancy, obesity, hormone replacement therapy, female oral contraceptives, and occupations that require long periods of standing.

TREATMENT

If the patient has no symptoms or discomfort and is not bothered by the sight of the varicose veins, treatment might not be necessary. However, if there are symptoms, treatment may be required to reduce pain or discomfort, address complications, such as leg ulcers, skin discoloration, or swelling.

Some patients may also want treatment for cosmetic reasons – they want to get rid of the “ugly” varicose veins.
Surgery

If varicose veins are large, they may need to be removed surgically. This is usually done under general anesthetic. In most cases, the patient can go home the same day – if surgery is required on both legs, they may need to spend one night in hospital.

Laser treatments are often used to close off smaller veins, and also spider veins. Strong bursts of light are applied to the vein, which gradually fades and disappears.

Ligation and stripping

Two incisions are made, one near the patient’s groin at the top of the target vein, and the other is made further down the leg, either at the ankle or knee. The top of the vein is tied up and sealed. A thin, flexible wire is threaded through the bottom of the vein and then pulled out, taking the vein with it.

This procedure does not usually require a hospital stay. Ligation and stripping can sometimes result in bruising, bleeding, and pain. In extremely rare occasions, there may be deep vein thrombosis.

After surgery, most patients will need 1-3 weeks to recover before going back to work and other normal duties. During recovery time, compression stockings are worn.

Sclerotherapy

A chemical is injected into small and medium-sized varicose veins, which scars and closes them. A few weeks later, they should fade. A vein may need to be injected more than once.

Radiofrequency ablation

A small incision is made either above or below the knee, and with the help of an ultrasound scan; a narrow tube (catheter) is threaded into the vein.

The doctor inserts a probe into the catheter, which emits radiofrequency energy. The radiofrequency energy heats up the vein, causing its walls to collapse, effectively closing it and sealing it shut. This procedure is preferred for larger varicose veins. Radiofrequency ablation is usually done with a local anesthetic.

Endovenous laser treatment

A catheter is inserted into the patient’s vein. A small laser is threaded through the catheter and positioned at the top of the target vein; it delivers short energy bursts that heat up the vein, sealing it shut.

With the aid of an ultrasound scan, the doctor threads the laser all the way up the vein, gradually burning and sealing all of it. This procedure is done under local anesthetic. There may be some nerve injury, which is usually brief.