Varicose veins are dilations and tortuosity of the superficial leg veins that appear as a result of progressive deterioration of the venous wall by the inability to establish an effective return of blood to the heart.
They usually appear in the territories of the internal and external saphenous veins.
They are a very common disorder and it is estimated that in our country there are more than 3 million people with the disease, most common in women in their second and third decades of life.
This process is related to genetic and hormonal factors (hormonal contraception, menopause) and aggravated by a sedentary lifestyle, prolonged work standing, pregnancy, obesity and exposure to heat.
The loss of elasticity of the vein wall results in the presence of reddish wires on the legs that furrow the skin and form fans or 1-2 mm spider veins (telangiectases) or dilated bluish veins deeper than 2-4 mm of caliber (reticular veins), both very unsightly and sometimes painful.
Telangiectases may also occur in the facial region.
The diagnosis must be based on clinical symptoms and physical examination. This is complemented by venous Doppler, Doppler ultrasound and venography studies, which test with an efficiency of 100% the incompetence of the saphenous and perforating veins and the patency of the deep venous system.
Treatment is designed to occlude vessels, improving the aesthetics of the area and symptomatology, if any, and is performed by:
- Ablative and hemodynamic surgical treatment, striping, phlebectomy, endovenous laser and CHIVA.
- Non-surgical treatments. Sclerosis, cryosclerosis and sclerosis with foam.Vascular sclerosis involves injection into a varicose vein of a sclerosing substance which causes irritation of the inner wall of the vein and subsequent fibrosis causing the gradual disappearance of the varix. The treatment is especially indicated to treat the veins of small and medium caliber, as the thick trunks often require surgical techniques.
The injection is performed with a very fine needle, which allows the technique without much discomfort to the patient. Often the subsequent application of a bandage over the treated area or compression stockings are needed. It is normal to have a slight discomfort in the sclerosed area for one or two days after the session.
Sessions are weekly or biweekly and their number depends on the number of veins, their size, and the particular individual patient response to treatment.
Hematomas may appear at first and they disappear with the application of iron chelators creams in no time.
Some patients may require a combination of other techniques to improve results. As the problem of varicose veins is chronic, once treatment has ended we must conduct regular checks in case you need to do some touch-up or new varices have appeared that will have to be treated.
- Physiological measures. Avoid a sedentary lifestyle, obesity control and liquid retention, application of discharge measures (elastic stockings and elevation of the lower limbs), venotonics …
- Laser treatment. Application of heat to the vein so that it necroses and its light closes. Effective, fast and safe procedure that is often combined with sclerosis treatments with or without foam. It provides a noninvasive non-surgical approach for the treatment of reticular veins and spider veins. The light produced by the laser is absorbed into the blood vessel by its “target” pigment, hemoglobin (pigment that gives blood its red color), and generates heat to destroy its walls without damaging adjacent tissues and structures. Therefore it eliminates most vascular lesions leaving intact skin and its pigment. Depending on the depth to which the vessel is it will be needed to find lasers with different wavelengths. Neodymium lasers will be used in the deeper veins and intense pulsed light in the most superficial.