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What is varicose veins? Varicose Disease and Treatment

Updated: Sep 26, 2022


Varicose veins are defined as the enlargement, lengthening and twisting of the veins without an organic cause. It is derived from the Latin word 'varix' (curved vein).

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Varicose veins are an important health problem. Although its incidence in adults shows different geographical variations, it gradually increases with age. Leg varicose veins are the most common vascular disease. It affects 15-20% of the adult population. It is seen 2-4 times more in women than in men, and the familial transmission rate is more than 50%.

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What are the types of varicose veins?

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There are three types of varicose veins.

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Telangiectatic Varices



They show superficial localization on the skin. They are 1 mm or less in diameter. They are not palpable. They appear as blue or red linear color changes. Locally, they are star-shaped or spider web-like common linear formations and may envelop the entire leg.



Reticular Varices


They are blue colored varicose veins that are slightly raised from the skin, less than 4 mm in diameter, and can hardly be felt by hand.



Great Vein Varieties



They are varicose veins that can be easily noticed by hand and eye, forming large folds along the course of large and small veins (saphen veins). They are larger than 4 mm in diameter. Because they are under the skin, they usually do not change the color of the skin. The reflection of the vein's own greenish color is seen.



In addition to prominent varicose formations that have folded in one extremity, smaller telangiectatic, reticular formations may also be found. Although it varies from patient to patient, these formations can be located together or separately on one leg.



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Causes of varicose veins


Varices can be primary or secondary. Although there are various theories about the causes of primary varicose veins, the main causes are not certain. Today, the most accepted theory is hereditary, weakness in the venous wall and valve insufficiency in the vein, venous hypertension. Secondary or subsequent varicose veins occur as a result of damage to the vein valves due to trauma, clot formation (deep vein occlusion) or inflammation.

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Many factors that play a role in the formation of varicose veins have been suggested in epidemiological studies. In these studies, family history (heredity), risky lifestyle and smoking were shown as risk factors.



The risk of varicose veins is 4.4 times higher in patients with a positive family history.



Standing for a long time or sitting for a long time is a risk factor, and the risk of developing high-grade venous insufficiency is 2.7 times higher in those who stand for more than 4 hours a day.



To summarize the risk factors that cause varicose veins;



standing for a long time

Pregnancy

Obesity

sit down work

Inactivity

Senile

Medication use (Birth control pills, hormone replacement therapies used during menopause)





Common complaints


The most common complaints of the patients are deterioration of the appearance of their legs, leg pain after standing for a long time and a feeling of heaviness in the legs. Complaints may not be related to the degree of anatomical defect. Sometimes the patient can injure the varicose vein. In this case, significant bleeding can be seen.



A complication of leg varicose veins is superficial vein inflammation (thrombophlebitis); It can cause severe pain and limitation of movement.



Chronic ankle swelling, stasis dermatitis and leg ulcers may develop in long-term leg varicose veins. Prolonged standing or obesity cause all leg varicose veins to become more symptomatic.



Pain

Itching

swelling in the ankle

night cramps

Superficial thrombophlebitis

Venous ankle skin changes (pigmentation, eczema, lipodermatosclerosis and open wound)

Bleeding





Varicose veins diagnosis

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It is quite easy to diagnose varicose veins. Varicose veins are lesions that can be easily seen when viewed from the outside with the naked eye. What is important here is whether there is insufficiency in the main vein where varicose veins occur. The easiest and best way to show this insufficiency is color Doppler Ultrasonography applied to the leg with varicose veins. Ultrasonography gives detailed information about which vein the insufficiency is, the duration and degree of the insufficiency, the diameter and structure of the vein.





Methods used in the treatment of varicose veins


Medical treatment

Medicines

Compression Stockings *

Sclerotherapy / Foam sclerotherapy

thermocoagulation

Laser

Radiofrequency Ablation

Surgical Treatment - Phlebectomy



At the point we have reached today, all types of varicose veins can be treated. However, the treatment method to be chosen according to the type of varicose varies. The main goal is to eliminate the venous insufficiency that causes the formation of varicose veins. In this case due to valve insufficiency, the recommended treatment method is Laser, Radiofrequency ablation and/or foam sclerotherapy. Sclerotherapy / foam-sclerotherapy may be preferred for medium-sized and capillary varicose veins. In both methods, the aim is to destroy the inner wall of the vein and completely cover the vein.


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