Varicose Vein

"Absence of pain does not mean absence of disease!"
Varicose Vein
Varicose Veins is a very common problem usually neglected by patients due to lack of pain in the initial stages of the disease. Pain appears in late stages when complications take place. Over last few years there is increasing awareness about Varicose Veins & availability of LASER treatment is reducing the complication rate.

About 30 to 40% of men & women suffer from varicose veins & the incidence seems to be increasing world over. So it is important for all of us to know about this disease.

There are two systems of blood vessels in body:
  1. Arterial System: These carry pure (oxygenated) blood from heart to all the body parts.
  2. Venous System: These carry impure (deoxygenated) blood from all over body to Heart to be sent to lungs for oxygenation.
    In legs there are two sets of veins:
    1. Superficial Veins: These are just below skin, superficial to muscles & may be visible in thin persons. These are the veins which become dilated i.e. Varicose Veins.
    2. Deep Veins: These veins are deep to muscles & are never visible from outside. There are small connecting channels between superficial & deep veins known as ‘Perforators’.

There are many interconnections between these leg veins & blood can flow through alternate channels.

Varicose Veins is the disease of mainly lower limb (Leg) veins. In this disease the veins of Legs become dilated & tortuous. This is because the Non-return valves present in these veins start leaking, leading to stagnation of impure (deoxygenated) blood in the leg veins.

Heart is a strong muscular pump that pushes pure (oxygenated) blood to all parts of body. This blood becomes darker in color as the body parts use oxygen & give away unwanted substances to be removed out of body. This impure blood comes back to heart through venous system. In lower limbs blood has to travel against gravity upwards to the heart. This becomes possible due to pumping action of calf muscles as well as the unidirectional non-return valves which direct blood flow below-upwards & prevent stagnation of impure blood in the legs.

Failure of these valves is known as Incompetence of valves. It leads to stagnation of blood in leg veins leading to various symptoms.
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Varicose Vein Treatment

Why Varicose Veins need to be treated?
It is important to recognize the problem of varicose veins & treat it at the earliest so as to avoid debility & complications arising due to untreated veins. Varicose Veins is a very slowly but definitely progressing disease. The symptoms are usually very mild to begin with but by the time symptoms become significant it may be beginning of complications, some of which can be difficult to treat. The damage to tissue around varicose veins & skin can be permanent & disabling. If treated in time, these changes can be totally reversible.

Methods of treatment: As soon as diagnosis of varicose veins is done, a thorough & detailed Colour Doppler Examination of entire leg needs to be done. It will give information about the valves as well as the superficial & deep veins. This information is very useful in planning treatment.

Various treatment modalities available today are as follows:
  1. Conservative Treatment: Conservative treatment in the form of Medicines, Exercise, Graded Pressure Venous Stockings, Weight Reduction & Lifestyle Modification etc. Conservative treatment is given to patients who are unfit for definitive ENDOVENOUS LASER TREATMENT or if there are contraindications like Deep Vein Thrombosis, Pregnancy, Internal Malignancy or Serious Medical problem. Conservative treatment doesn't cure varicose veins but may prevent or delay progress of this disease.
  2. ENDOVENOUS LASER TREATMENT (EVLT): This has become the Gold Standard of Varicose Vein Treatment. It is a MINIMALLY INVASIVE procedure with excellent success rate & very minimal complication rate. This Treatment modality will be discussed in detail in following pages.
  3. Surgical Removal of Varicose Veins: The procedure is known as Ligation & Stripping. In this surgery the diseased veins are ligated at various places & pulled out with the help of a stripper through small incisions made at various levels on the leg. World-over this procedure is being given up in favour of ENDOVENOUS LASER TREATMENT. It has more morbidity, prolonged hospital stay, & more recurrence or failure rate.
  4. Sclerotherapy: Injection of Sclerosing drugs in the veins is done mainly as adjuvant treatment for varicose veins. It gives good results in leftover veins & superficial small veins but may not be effective in bigger size veins.


Vishrambag Hospital

Vishrambag Hospital is a prominent hospital in Western Maharashtra having advanced modern equipment like Diomed Diode LASER from England, ERBE-VIO 300 Electrosurgical Unit from Germany, Richard Wolf, Scholly & Carl-Storz Laproscopy Equipment from Germany, MIPH–STAPLER for piles surgery from Ethicon - USA, Multipara monitors from Schiller - Switzerland etc.
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Varicose Vein Illustrated