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Visible veins

Abraham Eisenstein, M.D. |
Since 20 to 30 percent of adults will develop varicose veins later in life, new techniques are developed continuously and one very promising just hit the hospitals around the world.

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Blood vessels transport blood all over the body and veins are a group of them responsible for moving blood forward toward the heart which pumps it back to body organs. Veins have valves which prevent blood to flow in the opposite direction from the heart and those valves are under great pressure. Since humans stand on their two feet, gravity pulls blood toward the ground and if heart is just a bit weaker, blood flows slower, which means a great pressure on veins' walls. With time, veins become wider and wider, up to the point when they are clearly visible, especially on legs. We call those veins "visible veins", "spider veins" or "varicose vein".

Varicose veins are common condition and they affect mostly women. The most usual causes are defective heart valves, thrombophlebitis (in plain English: vein inflammation because of a thrombus), and pregnancy. Although we don't know all causes of visible veins, we do know that prolonged standing and higher pressure in the abdomen can increase susceptibility to the development of visible veins.

There are two types of varicose veins: primary occurs because of defective valves or without known cause, and secondary occurs because of some other condition such as pregnancy. Visible veins are followed by pain and heaviness in the legs, enlarged veins, swelling of ankles and skin ulcers around the ankles.

The name visible veins implies that the diagnosis is based on the visual appearance of the legs. The veins are checked when the patient is standing, and for the confirmation the doctor may order an ultrasound exam to check the blood flow. In very rare cases an angiography (an X-ray examination of the blood vessels) of the legs may be performed, that's the case when the doctor suspects that some disease caused visible veins.

There are several types of treatments and a doctor will usually suggest a conservative one and tell the patient to avoid standing, elevate the legs when resting and when sleeping, and to wear elastic support hose. In some cases a surgery may be of great help.

The most-known methods are removal of the varicose vein and sclerotherapy, a procedure during which a liquid that causes the closure of the vein is injected into it. The vein then becomes non-functional, but since spider veins are non-functional anyway, no harm done. The smaller veins will then carry the burden of blood transport. Veins removal treatment is reserved for patients who are experiencing a lot of pain because that is a very invasive procedure.

Since 20 to 30 percent of adults will develop varicose veins later in life, new techniques are developed continuously and one very promising just hit the hospitals around the world.

It is true that sclerotherapy has some advantages over vein removal (it can be done under local anaesthetic, it leaves one small scar in the groin, the patient can return to usually daily activities in one week), but in the case of very developed veins that's not enough. The new approach is using a foam instead of a liquid, that procedure is called microfoam sclerotherapy.

Injectable foam is made of a sclerosant, a material that causes damage to the vein wall and subsequent scarring. So, the vein becomes a scar invisible under the skin. The foam is a better option because it is not diluted after injection, it remains in the vein for longer than a liquid and doctor needs less foam than liquid - a single injection treats a half metre of the vein.

The foam pushes the blood out of the way, makes a better contact with vein walls, there's no side effects like leaking outside the vein, and complications are milder. During the procedure, the doctor is using an ultrasound and he can see where the foam is in every individual vein. It must be noted that foam therapy is relatively new for the larger veins (in small it is used since 1979), in everyday procedure for that last five years, but it sounds very promising.


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