Varicose veins is a medical condition where the veins become large and swollen and begin to appear so especially on the legs and feet though any vein can become varicose. This happens when the valves do not function properly and allow the blood to flow in the opposite direction or to pool. Due to this, the veins enlarge, and they begin to appear blue or dark purple on the skin. Legs and feet are the most commonly affected areas because standing or walking increases the pressure on the veins in the lower part of the body.

Symptoms of Varicose Veins
Apart from the twisted and bulging appearance like cords in blue and dark purple, varicose veins may include other painful symptoms as well such as-

Throbbing feeling and aching, heavy feeling in the legs.
Muscle cramping and swelling in the legs.
Severe pain after sitting or standing for a long period of time.
Bleeding varicose pains.
Treatment for Varicose Veins
In severe cases, varicose veins may rupture and form varicose ulcers on the skin. To avoid complications, it is best to get varicose veins treated before it worsens. Varicose veins can be treated in two ways- either by surgeries or by non-surgical methods, that is, by home remedies, medicines or non-invasive methods.

Surgical methods to treat Varicose Veins
Vein Stripping - Under general anesthesia, two cuts are made one below the groin and one behind the knee joint. The affected vein is then tied or clamped off at the top incision using a technique called vein ligation
Phlebotomy is another method where smaller incisions are made along the vein and using surgical instruments, the vein is pulled out.
Though treating varicose veins by surgeries is the most effective method, it involves several risks. Patients take a longer time to recover from surgeries than non-surgical methods. The sedation may cause complications. Chances of nerve injuries cannot be negated which may lead to fatal conditions such as deep vein thrombosis.

Non-surgical methods to treat Varicose Veins

Radiofrequency ablation is a method in which heat generated electromagnetic waves are used to close off the veins.
Endogenous laser ablation- in this case, lasers are used to close off veins.
Sclerotherapy is another method where a liquid or foam is injected into the affected vein to close it off.
Although big veins cannot be treated by these methods or additional treatments may be required, these methods are not only effective but also free from cuts and stitches or anesthesia. Performance of these treatments need not always take place in hospitals, special clinics can cure varicose veins using these methods. It is always advisable to consult doctors for treating varicose veins who can suggest the best treatment needed to cure varicose veins.


Surgical & Non-Surgical Treatment Options For Varicose Veins - Which Is Better?

Varicose veins are superficial, swollen, enlarged and twisting veins, often appearing dark purple or blue on the feet and legs. The condition occurs when blood through the veins flow in the wrong direction and starts accumulating.

Although varicose veins is not a serious condition, you should seek treatment if it causes symptoms like swelling and pain in the extremities. In severe cases, where a varicose vein ruptures or develops to form skin ulcers, your doctor may recommend laser treatment.

Can laser treatment cure varicose veins?

Laser surgery can effectively treat varicose veins. The procedure involves using a high-intensity beam of light to reduce enlarged, bulging veins that are observed usually on the calves or thighs.

How does the procedure work?

The heat emitted from the laser damages a vein, which causes scar tissues to form. This scar tissue shrinks and closes the vein. A closed vein gradually loses its source of blood and dies. After some time, usually in a year or two, the vein disappears on its own.

Two types of laser surgery are performed, namely  

  Simple Laser Treatment   This is done on the outer layers of your skin. It can cure small varicose veins and spider veins under the skin surface. Normally, more than one session, scheduled every 6-12 weeks is needed.
  Endovenous Laser Treatment   This particular procedure is used to cure large varicose veins that appear on the legs.
The steps of the procedure are as follows  
  Your healthcare provider will administer local anaesthesia to numb the area. You may be provided with an eyeglass to protect your eyes
  The surgeon will make a small incision on the skin and pass a laser fibre through a catheter into the veins while closely monitoring the vein on a screen
  As he/she pulls out the catheter, the length of the vein will heat up and shrink, and eventually close

This outpatient procedure is less painful than stripping and litigation. It has a shorter recovery period and can be performed under local anaesthesia or mild sedatives.

What to Expect

After the laser treatment, you can walk around without much complication. The recovery period is typically brief. You can expect to return to your daily activities following simple laser surgery. However, you might need to wear a compression stocking for a week or so after the endovenous laser procedure.
You may notice redness, bruising or burns on the skin after the treatment. That is only normal, so you need not worry. Do follow up with your doctor to see if the vein has closed.


Laser Treatment For Varicose Veins!

Blood flows through the tubes called as blood vessels. There are two networks of blood vessels   the arteries and the veins. The arteries carry pure or oxygenated blood from the heart to the various parts of the body. The veins, on the other hand, collect impure blood from all over the body and reach it to the heart. Blood flow in the veins is controlled via valves, which ensure blood does not flow in the reverse direction (against its desired direction of flow). The veins in the legs, which are farther from the heart, are quite thick and exert extra pressure to pump blood into the heart. They need to transport blood against gravity and so in people who are prone to stand for long hours, they can become thicker, swollen, twisted, and engorged. In severe cases, there could even lead to bleeding.

Some common causes for varicose veins are:

Damaged valves which are not able to control the flow of blood in the required direction.
Veins with a thin wall that are unable to control blood flow.
Risk factors: Though these are the suspected causes, there are specific risk factors which aggravate the condition of varicose veins.

Family history
Smoking
Occupations which require prolonged standing (construction jobs, painters, etc.)
Pregnancy
Obesity
Age, which reduces the elasticity of the veins
Surgery in the leg, which could have hampered the values or veins
There are quite a few symptoms of varicose veins. These are quite distinct and present as:

Swollen, ropy leg veins which can be blue
Pain, especially with prolonged standing
Tenderness on touching the veins
Itching and heaviness along the veins
Skin changes like scaling and dryness
Night cramps around the area
Susceptibility to bleed from these veins
While varicose veins are easy to diagnose given their distinct clinical presentation, some additional testing can involve the following:

Doppler ultrasound
Scanning
MRI
As said, prevention is better than cure; here are some preventive measures that can be really helpful:

Elevate legs as much as possible. When working, take short breaks to reduce stagnation and promote blood circulation
Quit smoking
Avoiding alcohol, as it causes venous dilation
Weight management
Avoid tight clothing and sitting with cross-legs for prolonged periods as they put a lot of pressure on the veins and valves
Follow a regular exercise regimen to improve blood flow in the legs, like walking or running
Starting from the least invasive to the most, this condition can be treated by:

Compression stocking (Ted hose or Jobst stocking) which improves circulation and reducing pain
Surgical options include sclerotherapy, laser treatment, and stripping off the vein. These are done in very severe cases, but quite rare.

Varicose Veins - How Best It Can Diagnosed?

Varicose veins are a painful swelling of the veins of the legs. The raised veins just under the top layer of the skin appear to be purplish blue. It is a common affliction and affects nearly 25% of the adult population all across the world and 10 million people in India are diagnosed with it every year.

What are varicose veins?

Varicose veins are enlarged veins that typically develop in the legs and the feet. This condition is triggered when there is something wrong with the valves of the veins. When the valves do not function properly, blood flow to all parts of the body is disrupted. Since the legs are the farthest part of the body from the heart, gravity makes it difficult for blood to flow up to the heart.

Varicose veins are common in people who are:

  Above 50 years of age
  Lead a lifestyle that requires them to be on their feet for long stretches of time
  Pregnant
  Menopausal
  Obese

If someone in your family has a history of varicose veins, you are quite likely to get it too.

What are the symptoms of varicose veins?

Varicose veins are characterized by the following symptoms-

  The most obvious symptom is the large twisty veins
  Pain all down the length of your legs
  Discolouration of the skin of the legs and feet

Diagnosis of varicose veins:

The doctor usually diagnoses varicose veins by a physical examination. She/he may also suggest an ultrasound to determine if your flow of blood is affected. It is a non-invasive procedure and is done with the help of high-frequency sound waves.

You may even have to undergo a venogram. The doctor injects a coloured dye into your veins and X-rays them. The dye gives an indication of how well your blood is flowing through the veins.

Treatment of varicose veins:

There are several treatment options for varicose veins-

  Compression socks: these socks exert pressure on the swollen veins and make it easy for blood to flow upwards. They also bring down the swelling.

Vascular surgery:

When the other methods do not work, doctors prescribe vascular surgery.

  Ligation and stripping: Through this surgery, the surgeon ties up the vein to prevent pooling of blood in the veins and sometimes the vein itself is removed.
  Sclerotherapy: The doctor injects a chemical right into the varicose vein which closes it.
  Radiofrequency ablation: The doctor uses radiofrequency to heat the varicose vein up, which makes the walls collapse

Lifestyle changes:

A few changes to your lifestyle can help you avoid the menace of varicose veins-

  If your job requires you to stand for extended periods, squeeze out a few minutes so that you can sit down, that allows blood to flow normally up to your legs.

  If you are overweight, lose weight immediately.

  Exercise regularly because that keeps your heart healthy and improves blood circulation.

Varicose veins are a painful condition that can be avoided if you implemented a few changes to how you live your life and even if you do get them, there are ways to cure them.

Varicose Veins - How Does Vascular Surgery Help?

Formation of blood clots in the arteries of the lungs, heart or legs can actually kill a person. In such a case, the immediate medical action is necessary and the only way to deal with blood clots is thrombolysis.
Thrombolysis or thrombolytic therapy is a medical process that dissolves blood clots and facilitates blood flow to all parts of the body. Thus, it protects tissues and muscles from damage.

What are the causes of blood clots in the body?

  Poor blood circulation
  Conditions such as Deep Venous Thrombosis and atrial fibrillation
  Blood clots can also be formed because of dialysis catheters and by-pass grafts

How can you tell if you have blood clots?

  Swelling in one or more legs
  Cramp and tenderness in the legs
  Breathing trouble might indicate that blood clots have travelled to the lungs
  Sweating and frequent chest pain may suggest that blood clots have travelled to the heart

How is Thrombolysis performed?

Thrombolytic drugs are injected into the body intravenously. They make their way to where the blood clots exist and dissolve them. If there is a medical emergency, the drugs are delivered to the exact location of the blood clots and immediately start dissolving them. Another method is inserting a device into the blood clot infested region to break the clots up. The drugs which on entering the body dissolve blood clots are called thrombolytics. There are many varieties of thrombolytics such as the following-

  Streptokinase - It is a kind of enzyme. It is used when a person has just suffered a heart attack or pulmonary embolism. Doctors do not usually prescribe the second usage of this drug. It is injected into a vein and can be administered to pregnant women.

  Tenecteplase - Also an enzyme, it is a plasminogen activator. When it binds to the surface of the blood clot, it makes the clot degenerate.

  Reteplase - It is actually extracted from E-Coli. It is a sterile intravenous bolus injection

The leading cause of heart attacks and ischemic heart disorder is the formation of blood clots in the arteries that connect the heart and the brain. Thrombolysis is often employed as an emergency treatment for this purpose. Thrombolysis is also effective against blood clots formed in the lungs (which lead to acute pulmonary embolism). Sometimes blood clots are formed in the legs, upper extremities of the body, the pelvic region (deep vein thrombosis). These clots may travel to the lungs and heart.

Consult your doctor before undergoing the treatment.

Thrombolysis - Causes, Symptoms & Treatment Of It!

Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

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