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Varicose Veins

What are Varicose Veins?

The venous system is made up of a network of veins which includes:

  • Superficial veins – veins located close to the surface of the skin.

  • Deep veins located in the leg.

  • Perforator veins – veins that connect the superficial veins to the deep veins.


Healthy leg veins contain valves that open and close to assist the return of blood to the heart. Venous Reflux Disease develops when the valves that keep blood flowing out of the legs and back to the heart become damaged or diseased. As a result, veins valves do not close properly, leading to symptoms like

  • Varicose Veins

  • Pains

  • Swollen limbs

  • Leg heaviness and fatigue

  • Skin changes and skin ulcers

varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet. That's because standing and walking upright increases the pressure in the veins of your lower body.

For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems.

Varicose veins may also signal a higher risk of other circulatory problems. Treatment may involve self-care measures or procedures by your doctor to close or remove veins.

What are the symptoms associated with a Varicose veins?

  • Ankle and leg swelling

  • Heaviness or tension

  • Aching pain

  • Restlessness in legs

  • Cramps

  • Itching

  • Skin pigmentation (usually rusty brown)

  • Loss of the soft texture of the skin and underlying tissue in the ankle area

What are the risk factors for varicose veins?

  • Heredity

  • Prolonged standing

  • Increasing age

  • Heavy lifting

  • Prior superficial or deep vein clots

  • Female gender

  • Multiple pregnancies

  • Less physical activity

  • Higher blood pressure

  • Obesity

What are the treatment options available for varicose veins?

Treatment of varicose veins is usually only necessary to:

  • ease symptoms – if your varicose veins are causing you pain or discomfort

  • treat complications – such as leg ulcers, swelling or skin discoloration

  • Cosmetic reasons

Conservative Management:

This may involve: 

  • using compression stockings

  • exercising regularly

  • avoiding standing up for long periods

  • elevating the affected area when resting


Compression stockings

Compression stockings are specially designed to steadily squeeze your legs to improve circulation. They're often tightest at the ankle and get gradually looser as they go further up your leg. This encourages blood to flow upwards towards your heart. They may help relieve the pain, discomfort and swelling in your legs caused by your varicose veins.

Endothermal ablation

One of the first treatments offered will usually be endothermal ablation.

This involves using energy either from high-frequency radio waves (radiofrequency ablation) or lasers (endovenous laser treatment) to seal the affected veins.

Radiofrequency Ablation

Radiofrequency ablation involves heating the wall of your varicose vein using radiofrequency energy. The vein is accessed through a small cut made just above or below the knee. A narrow tube called a catheter is guided into the vein using an ultrasound scan. A probe is inserted into the catheter that sends out radiofrequency energy.

This heats the vein until its walls collapse, closing it and sealing it shut. Once the vein has been sealed shut, your blood will naturally be redirected to one of your healthy veins. Radiofrequency ablation may be carried out under local anaesthetic (you are awake) or general anaesthetic where you're asleep.

Endovenous Laser Treatment

As with radiofrequency ablation, endovenous laser treatment involves having a catheter inserted into your vein and using an ultrasound scan to guide it into the correct position. A tiny laser is passed through the catheter and positioned at the top of your varicose vein. The laser delivers short bursts of energy that heat up the vein and seal it closed. The laser is slowly pulled along the vein using the ultrasound scan to guide it, allowing the entire length of the vein to be closed. Endovenous laser treatment is carried out under either local or general anaesthetic.

Ultrasound-guided foam sclerotherapy

If endothermal ablation treatment is unsuitable for you, you'll usually be offered a treatment called sclerotherapy instead. This treatment involves injecting special foam into your veins. The foam scars the veins, which seals them closed. This type of treatment may not be suitable if you've previously had deep vein thrombosisThe injection is guided to the vein using an ultrasound scan. It's possible to treat more than one vein in the same session. Foam sclerotherapy is usually carried out under local anaesthetia. After sclerotherapy, your varicose veins should begin to fade after a few weeks as stronger veins take over the role of the damaged vein, which is no longer filled with blood. You may require treatment more than once before the vein fades, and there's a chance the vein may reappear. You'll need to wear compression stockings or bandages for up to a week.


If endothermal ablation treatments and sclerotherapy are unsuitable for you, you'll usually be offered a surgical procedure called ligation and stripping to remove the affected veins. Varicose vein surgery is usually carried out under general anaesthetia

Ligation and stripping

A technique called ligation and stripping involves tying off the vein in the affected leg and then removing it. 2 small incisions are made. The first is made near your groin at the top of the varicose vein. The second, smaller cut is made further down your leg, usually around your knee. The top of the vein (near your groin) is tied up and sealed. A thin, flexible wire is passed through the bottom of the vein and then carefully pulled out and removed through the lower cut in your leg. The blood flow in your legs will not be affected by the surgery. This is because the veins deep within your legs will take over the role of the damaged veins. After the procedure, you may need up to 3 weeks to recover before returning to work, although this depends on your general health and the type of work you do.

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