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?

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. 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. The raised veins just under the top layer of the skin appear to be purplish-blue.

Varicose veins are common in people who are -
  Above 50 years of age
  Long stretch sitting
  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
  Discoloration of the skin of the legs and feet

Diagnosis of varicose veins -
The doctor usually diagnoses varicose veins by a physical examination. An ultrasound may 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 colored 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-

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
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.

In Detail About Varicose Vein & Its Treatment!

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?

The veins are a type of blood vessels which collect impure blood from all parts of the body and return it to the heart. The veins in the legs especially are quite thick and need to exert extra pressure to pump blood against gravity towards the heart. In quite a few people, these veins could be engorged, swollen, and twisted, which are known medically as varicose veins.

Causes:
Defective or damaged valves in the blood vessels. Normally, the blood flow is controlled by valves which ensure blood flows in the desirable direction. When these valves are not able to control the flow of blood, then varicose veins can return
Thin vein walls can lead to improper flow of blood, resulting in varicose veins

Risk factors:

Prolonged standing
Obesity
Pregnancy
Smoking
Surgery in the leg, which could have hampered the values or veins
Age, as the elasticity of the vessels, reduces with age and can impede normal blood flow
Family history
Symptoms:

Blue, swollen veins in the legs which are thin and ropy
Pain with prolonged standing followed by pain and tenderness
Itching and heaviness in the legs
Cramping in the night
Blood clots in the superficial vessels
Severe varicose veins can cause bleeding
The area around the leg feels firm and/or hard
There could be skin changes like scaling, dryness, and color changes
Increased propensity to bleed in the affected leg
Diagnosis:

Usually easily diagnosed in clinical examination
The above-listed features are very characteristic and help in identifying them
Further testing may be done to identify the problematic valve, usually using a tourniquet
Doppler ultrasound, scanning, and MRI may be required to confirm diagnosis, which are quite rarely used
Prevention/Treatment:

Keep the legs elevated as much as possible. During working hours, take short breaks where you are able to elevate the legs
Even in prolonged journeys, try to take a break which will improve circulation
Quit smoking
Compression stocking (Ted hose or Jobst stocking) can be used to improve circulation. They also help in controlling pain and are very commonly recommended to treat varicose veins
Avoiding alcohol, which leads to venous dilation
Weight management, as being overweight is a big risk factor
Do not cross legs when sitting, as it puts constant pressure on the valves
Avoid tight clothing which can put pressure on the veins and/or valves
Keep a regular exercise regimen like walking to improve blood flow
Surgical treatment options include sclerotherapy, laser treatment, and stripping off the vein, but are not usually required.

Varicose Veins - 9 Signs You Are Suffering From It!

Coronary artery disease is characterized by accumulation of plaque in the coronary artery that chokes blood supply to the heart. This plaque buildup usually starts with cholesterol accumulation and gradually other particles such as calcium and lipoproteins get deposited as well. Over time, the plaque accumulates, making the blood vessels narrow and choking the supply of blood. In some cases, if the plaque ruptures, it may lead to formation of blood clots resulting in stroke.

The symptoms of coronary artery disease are:

1. Breathing difficulties: This disorder may lead to shortness of breath as the blood pumping mechanism of the heart is impaired; this usually results in fatigue and exertion. It is advised to avoid advanced cardio exercises such as the high intensity interval training.

2. Chest pain: Stress related activities may cause intense pressure or tightness in your chest, resulting in pain in the middle or left portion of your chest. If you discontinue the activity, the pain would usually subside. In some cases, you may feel the pain in the arm and the neck.

3. Heart attack: If the level of plaque accumulation is excessive, then it may result in a heart attack. It is characterized by breathing difficulties, pain, tightness in the chest and sweating. You may also experience pain in the neck and the jaw.

The causes of coronary artery disease are:
1. Smoking and alcohol consumption
2. Leading a sedentary lifestyle ups the risk of coronary artery disease
3. Hypertension
4. High cholesterol levels in the body
5. Blood sugar problems

Treatment
1. Get your blood pressure under control: If you suffer from high blood pressure, then it is recommended to get it under control to prevent coronary artery disease.
2. Quit smoking: If you are a habitual smoker, then it is time to nip the habit in the bud. Smoking is known to constrict blood vessels as it is a vasoconstrictor.
3. Eat healthy: Eat a well balanced diet consisting of vegetables and fruits so that your body receives the essential nutrients to function well.
4. Beat stress: You need to control your stress levels through exercise or meditation. Take time off work and do activities that make you happy.

Coronary Artery Disease: Causes and Treatment

It is said that if all the veins of the human body were laid out in a single line, it would stretch over 60000 miles. We don t usually think of our veins or notice them unless an intravenous injection is to be administered or the person suffers from varicose veins. These veins are usually benign and can be described as enlarged veins that rise to the surface, and become prominently visible. The varicose veins can usually be seen on the feet and calves. For most people, it is simply a cosmetic problem but for others it can be the cause of pain and discomfort. The good news is that in either case, varicose veins can be treated.

EVLT refers to Endovenous Laser Therapy, which is also known as EVLA or Endovenous Laser Ablation. This is a type of laser therapy that can be used to destroy veins from within. The procedure is performed while the patient is under local anesthesia and hospitalization is not required. Know the steps in which it is carried out:

The first stage involves mapping the veins and identifying the problem veins. A Duplex Ultrasound is usually used to create this map. It is important to note that this procedure cannot treat bulging veins on the surface of the skin. The veins that can be treated include the Great Saphenous Vein (GSV), Small Saphenous Vein (SSV) and their major tributaries.
Once the veins have been identified a needle is inserted into the vein near the ankle or knee with the help of ultrasound controls. A wire is then passed into the vein and a long sheath is then passed to the top, and positioned with the help of the ultrasound.
Ultrasound is again used to then inject local anesthetic into the area around the vein. This numbs the vein and surrounding tissue. The adrenaline in it also makes the vein contract, so as to fit the sheath perfectly. This technique is called  Tumescent anesthesia .
This is followed by passing a laser fiber inside the sheath and switching the laser on. The laser and sheath are then pulled back simultaneously so as to destroy the vein without damaging any of the surrounding tissues.
Once done, you should be able to get back to work and your normal lifestyle, the day after the surgery. But it is advisable to take good rest for few days, before you get back to your regular routine. Your doctor may advise you to wear compression stockings for up to 2 weeks. You should also avoid letting your legs come in contact with water. To avoid getting varicose veins in future, exercise regularly and have a balanced diet to control your weight.

EVLT Endovenous Laser Treatment For Varicose Veins!

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