When the veins under the skin become enlarged, dilated and tortuous, it is labeled as Varicose Vein. There is thinning of walls of veins, due to the failure of valves within, which results in pooling of blood leading to engorged, dilated and tortuous veins. This may or may not be visible.
- It is mostly hereditary and runs in families
- Females are more commonly affected than males
- Multiple pregnancies
- Deep vein thrombosis
- Occupations demanding prolonged standing.
- Swelling of legs
- Burning, throbbing or cramping in the legs
- Brownish-grey discoloration around the ankle
- Achy or heavy feeling in the legs
- Itching skin over the varicose vein
- Non-healing skin ulcers around the ankle (later stages)
Diagnosis is by clinical and Ultrasound examination of the leg. Self-help measures which help in alleviating the discomfort and slowing the progression of existing varicose veins:
- Do not sit or stand for prolonged periods of time
- Maintain a healthy weight
- Exercise regularly
- Wear compression stockings
- Avoid tight clothing and high heels
Conservative management with the use of elastic compression stockings is commonly used in early cases along with lifestyle modification. More symptomatic patients need ablation of the problematic veins. Previously more invasive surgical procedures were applied, with the requirement of anesthesia and admission in hospitals. With technological upgradation and introduction of newer minimally invasive modalities, like the Endovenous Laser Ablation, the procedure is done under local anaesthesia on a day care basis. Chemical ablation in the form of Foam Sclerotherapy is being used in combination with laser therapy.
Endovenous Laser Ablation
Under ultrasound guidance Diode Laser Fiber is placed inside the vein and is ablated. The procedure takes 10-15 minutes only, and the patient is discharged within a few hours of the procedure. Excellent results have been demonstrated with this procedure and have been shown to be superior to the conventional surgical stripping procedure, both in terms of patient comfort and cosmesis.
This article was written by Dr. Pinak Dasgupta, MBBS, MS, FNB (Minimal Access), FACRSI for Narayana Superspeciality Hospital, Guwahati .