Veins are the blood vessels that take deoxygenated blood back to the heart. Inside the veins, there are a series of one-way valves that keep blood from flowing backward. The valves are especially important in the lower limbs because gravity continually pulls venous blood in the opposite direction of the flow.
Varicose veins are swollen, twisted veins. They occur when the one-way valves become weak or damaged. As the blood seeps back, it pools in the area of the vein below the damaged valve. The vein stretches (swells) to accommodate the extra blood. Eventually, the weight of the blood in that section of vessel can put pressure on the next lower valve and cause that one to weaken also. The affected section of the vein bulges and thickens (varicose veins).
Valve damage can also occur in the smaller veins. In the capillaries (the tiniest blood vessels), the condition is called, spider veins. Spider veins typically occur on the legs and face. In another condition, telangiectasias, clusters of spider veins occur on the face.
According to the Society of Interventional Radiology, up to 25 percent of all adults have varicose veins. The condition is more common with age, affecting half of those 50 and older. Signs include: dark purple/blue veins, bulging or twisted veins on the surface of the legs, aching or heaviness in the legs; burning, cramping or swelling in the lower legs; leg pain after sitting or standing for a considerable time; skin itchiness, discoloration or ulceration in the area of the varicose vein. In severe cases, a blood clot can develop inside the swollen vein.
Treating Varicose Veins
Many people seek treatment for varicose veins because of the unsightly nature of the bulging, colored veins. However, treatment can also reduce the risk for development of ulcers or blood clots.
There are several different options for varicose vein treatment. Sometimes compression stockings and elevation of the legs can reduce symptoms. In sclerotherapy, a special solution is injected into the swollen section of the vein. The solution contains an irritant, which causes the walls of the vein to thicken and become “sticky.” The vein walls stick together, sealing the vessel shut in the target area. The closed vein is eventually absorbed by the body. Sclerotherapy may need to be repeated and works best for small to medium-sized veins.
Ambulatory phlebectomy is a procedure in which a small number of puncture incisions are made in the leg, following along the route of the target vein. The vein is removed, segment by segment, through the tiny incisions.
Varicose veins can be treated with lasers and radiofrequency energy. For larger veins, a catheter is inserted through an incision and into the vein. Laser or RF energy is aimed inside the swollen section of the vessel. The heat causes the vein to collapse and seal itself shut. For spider veins, a laser can sometimes be aimed at the vessel from outside the body.
A newer treatment for some types of spider veins is called the VeinGogh™ Ohmic Thermolysis System. The procedure uses electrical resistance to create heat, coagulate blood and cause the wall of the vein to collapse.
To use the VeinGogh system, the tip of the system’s probe is inserted just under the skin, into the wall of the target vein. Microbursts of high-frequency electrical energy are delivered into the vein. The heat collapses the walls of the vein and seals the vessel. Over time, the damaged vein will be absorbed by the body.
Steven Elias, M.D., Vascular Surgeon at Englewood Hospital in Englewood, NJ, explains that the procedure is done segment by segment, until the entire section of the damaged vessel has been treated. The entire process takes about 20 to 25 minutes. Patients have little to no pain and usually don’t need any kind of anesthesia during the treatment.
After the procedure, patients are generally free to go about normal activities. Although some results may be seen immediately, it takes several weeks for the vein to be reabsorbed by the body and the full effect to be seen. Generally, patients can expect about a 60 to 70 percent improvement in the look of their legs.
Elias advises using aloe vera gel on the skin over the treatment area. The skin may be a little sensitive for about a week, so sunscreen should be used for a week or two after the procedure. Most patients only need one treatment. However, further treatments may be needed if new varicose veins develop. VeinGogh may be used in conjunction with other treatment for larger varicose veins.
AUDIENCE INQUIRYFor information on VeinGogh™, or to find a local provider: http://veingogh.com
For general information on varicose veins or treatment for the condition:
American Academy of Dermatology, http://www.skincarephysicians.com
American Society for Dermatological Surgery, http://www.asds.net
National Heart, Lung and Blood Institute, http://www.nhlbi.nih.gov
Radiological Society of North America, http://www.radiologyinfo.org
Society of Interventional Radiology, http://www.scvir.org
BIBLIOGRAPHYAlmeida, J., and J. Raines, “Laser Ablation of Cutaneous Leg Veins,” Perspectives in Vascular Surgery and Endovascular Therapy, December 2008, Vol. 20, No. 4, pp. 358-366.
Hamel-Desnos, C., and F. Allaert, “Liquid Versus Foam Sclerotherapy,” Phlebology, December 2009, Vol. 24, No. 6, pp. 240-246.
Ravi, R., et al., “Endovascular Thermal Ablation of Superficial Venous Insufficiency of the Lower Extremity,” Journal of Endovascular Therapy, August 2009, Vol. 16, No. 4, pp. 500-505.
Van den Bos, R., et al., “Endovascular Therapies of Lower Extremity Varicosities,” Journal of Vascular Surgery, January 2009, Vol. 49, No. 1, pp. 230-239.