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What are Varicose Veins?

Varicose veins are generally defined as the enlarged and twisted veins occurring, especially in the legs. Studies indicate that approximately 30% of adults have varicose veins.

They are more common in women and in the lower leg area.

The function of the veins is to carry deoxygenated blood to the heart. The veins in the legs can perform this transportation with the help of valves inside them. Valves act like check valves against gravity, pumping the blood upward. When these valves cannot function properly for various reasons, the blood starts to flow downward (Venous Reflux), accumulating in the veins and creating high pressure. This, over time, leads to the enlargement, twisting, and visible appearance of the veins on the skin.

Varicose veins are not only a cosmetic issue. If left untreated, it can cause symptoms such as pain, swelling, and burning sensations in the legs, significantly affecting daily life.

Some potential causes of varicose veins include:

Genetics, pregnancy, menopause, being over 50 years old, tobacco product use, prolonged standing or sitting, obesity, birth control pills, gender (more common in women), and vascular injuries.

Types of Varicose Veins:


1- Telangiectasia Varicose Veins (Spider Veins):

Also known as spider veins, they are small clusters of blue or red veins visible on your face or legs. They are harmless and, unlike other varicose veins, remain below the surface of the skin. They are more common in women, especially during pregnancy and hormonal medication use.

These veins, which are about 1 mm in diameter and not felt by touch, are usually visible on the face or legs.

2- Reticular (Medium Size) Varicose Veins:

Reticular veins are slightly swollen and usually blue varicose veins. They are often seen around the ankle and behind the knee, making them difficult to feel by touch. These veins are generally smaller than four mm in diameter.

3- Large Varicose Veins (Thick or Internal):

Large varicose veins are generally visibly raised from the surface of the skin. Thick and distinct, they are often long and have an unpleasant appearance.They are the result of irregular functioning of the great saphenous vein and small saphenous vein.

These varicose veins are easily felt and seen by hand and eye, having a swollen and greenish appearance. They have a diameter greater than 3 mm and become more pronounced when standing.

Symptoms of Varicose Veins:

 

The primary symptoms of varicose veins are the irregular appearance of the legs. Additionally, there may be pain, swelling, and twitching around or in the vicinity of the enlarged veins.

In some cases, swelling and discoloration may develop. In advanced cases, veins can bleed significantly, and ulcers may form.

Although varicose vein symptoms can vary from person to person, they generally include:

  • Pain in the legs, especially cramps at night, a burning sensation, and swelling
  • Numbness and itching in the varicose area
  • Veins appearing green or purple and protruding
  • Chronic fatigue
  • Edema

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What are the Damages of Varicose Veins and What Happens If They Are Not Treated?

If varicose veins are left untreated, they can worsen over time. Unfortunately, this is true even if you make the necessary lifestyle changes to minimize symptoms and keep varicose veins under control. While they often do not lead to long-term medical issues, they can sometimes cause
severe complications in advanced cases.
In some rare instances, untreated varicose veins can lead to ulcers, wounds, blood clots, or chronic inflammation in the legs.
Although they generally do not cause serious medical problems, if you notice any of these
symptoms, you should consult your doctor immediately.

Rare but possible complications of varicose veins include:

  • Ulcers: Painful ulcers can form on the skin around previously existing varicose veins and ankles. The most recognizable sign of an ulcer is a colorless spot on the skin. If
    you suspect you have leg ulcers, it’s crucial to see a healthcare professional without delay.
  • Blood Clots: In some cases, veins deeper in the layers of the legs may loosen, causing leg pain and swelling. If you experience such symptoms, it is essential to seek medical attention promptly, as they could be indicative of a blood clot.

  • Bleeding: Occasionally, there may be bleeding from burst veins near the surface of the skin. Although these are usually minor bleeds, they require medical intervention.

    It is important to address any symptoms promptly and consult with a healthcare professional to avoid potential complications associated with untreated varicose veins.

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How to Diagnose Varicose Veins?

Examine

Varicose veins can be diagnosed through various methods, and modern technology allows for quick and accurate assessments.

Physical Examination:

  • A crucial step in diagnosing varicose veins is a physical examination performed by your doctor. During this examination, your doctor will assess your veins while you are sitting
    and standing. They will also inquire about any pain or symptoms you may be experiencing.

Color Doppler Ultrasonography:

  • The most effective and commonly used method for diagnosis is Color Doppler
    Ultrasonography. This non-invasive test utilizes sound waves to examine blood flow in the veins. Through this method, the overall structure of the veins can be examined, varicose
    veins can be identified, and any blood clots or valve abnormalities can be detected.

Venography:

  • Venography is another method used for diagnosis, especially when Color Doppler Ultrasonography is insufficient. In this procedure, a special contrast dye is injected into
    the veins, and X-rays are taken. The dye allows for a clear visualization of blood flow and irregularities in the veins.

Other Imaging Techniques:

  • Depending on the doctor’s discretion, other imaging techniques such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) may be used.

The combination of a thorough physical examination and advanced imaging techniques ensures an accurate diagnosis of varicose veins and provides valuable information for determining the
most suitable treatment plan.

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Color Doppler Ultrasonography

Color Doppler Ultrasonography is an advanced ultrasound imaging technique that utilizes high- frequency sound waves to detect blood flow in the vessels. By emitting sound waves that bounce back from blood cells, it provides real-time imaging of blood circulation.

It is widely used, even during pregnancy, as it does not involve radiation. Color Doppler
Ultrasonography allows real-time visualization in various parts of the body.

How Color Doppler Ultrasonography is Performed?

The Doppler ultrasound begins with the patient lying on the examination table. A layer of ultrasound gel is applied to allow the probe to move smoothly. The real-time display on the screen shows red and blue colors, indicating the speed and direction of blood flow in the vessels. This enables the identification of damaged veins causing varicose veins, and the condition of these
veins can be easily assessed. Therefore, Color Doppler Ultrasonography is crucial for diagnosing varicose veins.

Color Doppler Ultrasonography can help diagnose various conditions, including:

  •  Blood clots Malfunctioning valves causing the accumulation of blood or other fluids in leg veins (venous insufficiency)
  • Heart valve defects and congenital heart disease
  • Arterial blockages
  • Reduced blood circulation in the legs (peripheral artery disease)
  • Swollen arteries (aneurysms)
  • Narrowing of an artery, such as in the neck (carotid artery stenosis)

Varicose Vein Treatment

How are Varicose Veins Treated?

For varicose vein treatment, it is recommended to consult the Department of Cardiovascular Surgery.

Initially, varicose veins may only be aesthetically bothersome, but over time, they can lead to issues such as pain, itching, numbness, and wounds. Therefore, resolving the problem from the beginning is crucial for your quality of life.

While varicose veins can be treated surgically (with an operation), modern technology allows for non-surgical treatments. Traditional surgery involves removing the vein, and this method, with a
longer recovery period, is less commonly chosen today.

Non-surgical methods include Laser Treatment for Varicose Veins, Foam Treatment, Radiofrequency Ablation, Glue/Closure Treatment, and Sclerotherapy.
The choice of treatment depends on a detailed examination by the doctor, and after identifying the varicose veins, an assessment with Color Doppler Ultrasonography is crucial.

For detailed information on varicose vein treatment, click on the link. Varicose vein treatment…

FAQ About Varicose

Individuals with varicose vein complaints should be treated and diagnosed by a Cardiovascular Surgeon (Vascular Surgeon).

The main symptoms of varicose veins are:

  • Blue purple swellings on the legs,
  • Pain, aching and stinging sensation,
  • Feeling of heaviness in the legs,
  • Swelling and burning in the legs,
  • Numbness in legs.

Pregnancy-related varicose veins are a common issue among women. According to research, approximately 40% of pregnant women experience varicose vein problems. Taking certain precautions during this period can minimize the risk of varicose veins after childbirth. You can find information here on the precautions you should take during this process and details about varicose vein treatment during pregnancy.

During pregnancy, the volume of blood in your body increases, leading to an increased workload on your veins. The hormone progesterone, which prepares the body for pregnancy, also rises and relaxes the walls of your blood vessels. As the uterus grows, the pressure on the large vein on the right side of your body (inferior vena cava) increases, causing an increase in pressure in the leg veins. Varicose veins may increase during this period, growing more prominent as you progress in your pregnancy.

If varicose veins run in your family, your likelihood of having varicose veins is higher. They are more common in women than men, and if you already have them, the probability increases with each consecutive pregnancy and as you age. Being overweight, carrying twins or more, and prolonged periods of standing can also increase your chances of developing varicose veins.

The good news, especially if you didn’t have varicose veins before becoming pregnant, is that they may heal or disappear after giving birth. If they don’t improve, various treatment options are available after your baby is born.

You might also notice small blood vessels near the surface of your skin, especially around your ankles, legs, or face. These are called spider veins because they often appear in a pattern resembling a spider’s web or fine, non-linear lines. (Sometimes, they can resemble the branches of a tree or specific patterns without clear lines.)

These do not cause discomfort and typically disappear after childbirth.

In the following situations, you can prevent or minimize varicose veins during pregnancy:

Engage in daily exercises under your doctor’s supervision. Even a short, brisk walk can improve your circulation.

  • Pay attention to staying within the recommended weight range during your pregnancy.
  • Elevate your feet and legs as close to the level of your heart as possible. Extend your legs onto a chair and elevate them with pillows while sitting.
  • Avoid crossing your legs or ankles while sitting.
  • Avoid prolonged sitting or standing. Take regular breaks to rest.
  • If your doctor recommends, continue wearing compression stockings. These stockings come in various types and help regulate blood circulation in your legs.

Yes, it is possible to get rid of varicose veins. If the root cause of the problem is identified with the correct diagnosis and mapping in varicose vein treatment, you can eliminate your varicose veins with the most appropriate treatment, and the likelihood of recurrence is minimized.

Unfortunately, varicose vein problems can occur at a young age. One of the main reasons for this is genetic factors. If you have a genetic predisposition to varicose veins and, in addition, due to your occupation or lifestyle (standing for long periods, etc.), you are at a higher risk of experiencing varicose vein problems.

In summary:

The biggest reason is its hereditary nature.

Occupational disease (jobs that involve prolonged standing),

Obesity and lack of exercise,

Not moving much in your daily life,

Giving birth and having frequent or multiple births.

Excessive consumption of substances like tobacco and alcohol.

Another reason is the failure of individuals with vein occlusion to use blood thinners. This can lead to clot formation in the veins, and as a result, serious consequences, potentially leading to death.

The diagnosis of varicose veins is made through an examination conducted by a radiologist using color Doppler ultrasound. During the examination, the patient is raised to a standing position, and Doppler ultrasound is performed on the legs. The blood flow in the leg veins (venous) is thus detected, and the diagnosis is established.

The most successful diagnostic test used for a detailed diagnosis of varicose veins is color Doppler ultrasound. The condition of veins that cannot be seen through a normal examination is meticulously examined with Doppler ultrasound, and a vein map is created.

Once varicose veins appear, they do not heal on their own. Measures to slow down the progression may include:

Maintaining a healthy weight and engaging in regular walks of 20-30 minutes per day.

Reducing the duration of time spent in a fixed position, especially in a sitting or standing position, can be helpful. Transitioning between standing and sitting positions throughout the day can also reduce pressure in the veins.

Engaging in exercises to improve blood circulation. Wearing compression stockings if recommended by your doctor.

Compression stockings may be recommended to wear after treatment. These stockings apply sufficient pressure to your legs to facilitate easier blood flow to your heart and also help reduce swelling. They are a commonly used medical garment for patients with venous (varicose vein) insufficiency.