03.30.16 Dr. Garth Rosenberg Varicose Veins

How Do You Develop Varicose Veins?

Varicose veins are prominent surface leg veins that become enlarged, sometimes elongated and twisted, and cause symptoms of aching, heaviness, itching and fatigue. Untreated, these veins can lead to permanent skin discoloration, ulceration and blood clots.

To understand why varicose veins develop, it is first important to understand how normal leg veins function. Arteries bring blood down the leg, and veins return the blood up the leg against the constant pressure of gravity pushing downward. Fine valves in the leg veins propel the venous blood up the leg. If the valves become weakened or inadequate, blood flows downward, causing elevated pressures. These elevated pressures lead to aching, heaviness, swelling, and eventually enlargement of the skin veins.

Vein valve weakness can be due to hereditary factors, though the exact genetic transmission has not been resolved. Generally, elastin and collagen are proteins within the vein wall, and if your production or breakdown of these proteins is slightly abnormal, the veins weaken. As gravity is a constant downward force we all face, it is largely unavoidable.

The hormonal swings of pregnancy also play a role in vein integrity. Elevated estrogen and progesterone levels lead to vein weakness. Post partum, these hormone levels drop to near normal, but the veins do not always return to normal function. Multiple pregnancies add more stress to the veins.

Using medical support hose can help counter the elevated pressures within the veins, but the hose do not prevent the weakening of the vein walls and valves.

We evaluate varicose veins with duplex ultrasound, as this gives excellent information on which to base therapeutic decisions. Saphenous vein reflux is treated by endovenous ablation using either VNUS Closure, VenaSeal or Clarivein. Small side branch veins can be easily treated with microphlebectomy.

Varicose veins are a very common clinical condition. There is not much you can do to avoid their development, but be assured that treatment is highly effective, done under local anesthesia and allows immediate return to normal activity. As venous disease is a progressive problem, earlier evaluation and treatment can help avoid longer term complications.

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