MetroHealth Heart & Vascular Center
Varicose Vein Excision
What are varicose veins?
Varicose veins are swollen veins that can be
seen through the skin. They occur in the superficial veins in the legs and often look blue, bulging, and twisted.
Large varicose veins can cause aching and fatigue as well as skin changes like rashes, redness, and sores. Left
untreated, varicose veins may worsen over time.
As many as 40 million Americans, most of them women, have
varicose veins. They usually affect people between the ages of 30 and 70.
Pregnant women have an increased risk of developing varicose veins, but the veins
often return to normal within 1 year after childbirth. Women who have multiple
pregnancies may develop permanent varicose veins.
You have t wo kinds of veins in your legs.
- Superficial veins lie close to your skin.
- Deep veins lie in groups of muscles and lead
to the vena cava, your body's largest vein, which runs directly to your heart.
- Perforating veins connect superficial veins to deep veins.
Veins return oxygen-poor blood back to your heart. The
blood in your leg veins must work against gravity to return blood to your heart.
To help move blood back to your heart, your leg muscles squeeze the deep veins
of your legs and feet. One-way flaps ,called valves, keep blood flowing in the right
direction. When your leg muscles contract, the valves open. When your legs relax, the valves
close. This prevents blood from flowing backward.
The entire process of sending blood back to the heart is
called the venous pump . When you walk and your leg
muscles squeeze, the venous pump works well. But when you sit or stand, especially for
a long time, the blood in your leg veins can pool and increase the pressure in
Deep veins and perforating veins are usually able to
withstand short periods of increased pressures. However, if you are a
susceptible individual, your veins can stretch if you repeatedly sit or stand for
a long time. This stretching can sometimes weaken the walls of
your veins and damage your vein valves. Varicose veins or spider veins may result.
Spider veins are
mild varicose veins that look like a nest of red or blue lines just under
your skin. They are not a
serious medical problem, but can be a cosmetic concern to some people.
What are the symptoms?
Standing or sitting for too long may worsen symptoms of varicose veins. These symptoms include:
- a heavy, burning, tired, restless, or achy feeling in your legs
- leg cramps at
- small clusters of veins in a winding
pattern on your leg, or soft, slightly tender knots of veins.
- skin changes including discoloration, irritation, and the
formation of sores.
If you have severe varicose veins, you have
a slightly increased chance of developing deep vein thrombosis (DVT), a
serious medical condition that may cause sudden and severe
leg swelling. DVT requires immediate medical attention.
What causes varicose veins?
High blood pressure inside your superficial leg veins
causes varicose veins. Factors that can increase your risk for varicose
- having a family history of varicose veins
- being overweight
- lack of exercise
- smoking, standing, or sitting for long periods of
- having DVT
What tests will I need?
Your physician will need to know information
concering your general health, medical history, and symptoms. He wil
examine the texture and color of any prominent veins and may apply a tourniquet
or direct hand pressure to observe how your veins fill with blood. To confirm
a diagnosis of varicose veins, your physician may order a duplex
Duplex ultrasound uses high-frequency
waves to measure the speed of blood flow and to see the structure of your leg
veins. The test can take approximately 20 minutes for each leg. Besides
showing varicose veins, duplex ultrasound can help determine whether your varicose veins are
related to some other medical condition.
How are varicose veins treated?
Your physician will recommend methods to relieve
your symptoms. If you have mild to moderate varicose veins, elevating your legs
can help reduce leg swelling and alleviate other symptoms. Your physician
may instruct you to prop your feet up above the level of your heart 3 or 4 times
a day for about 15 minutes at a time. When you must stand for a long
period of time, flex your legs occasionally to keep blood circulating.
For more severe varicose veins, your physician may
prescribe compression stockings Compression stockings are elastic stockings that
squeeze your veins and stop excess blood from flowing backward. They can
also help heal skin sores and prevent them from returning. For many,
compressions stocking effectively treat varicose veins, relieving pain and swelling and preventing
When noninvasive treatments do not relieve your symptoms, you
may require a surgical or minimally invasive treatment, depending upon the
extent and severity of the varicose veins.
To perform vein stripping, your physician disconnects and
ties off all varicose veins associated with the saphenous vein, the main
superficial vein in your leg. Your physician then removes this vein
from your leg. A procedure, called small incision avulsion, can be done
alone or together with vein stripping. Small incision avulsion allows your physician to remove varicose veins
from your leg using hooks passed through small incisions.