Leg Varices

 

In the past decade, revolutionary developments in the diagnosis and treatment of venous conditions and ailments have brought venous procedures from in-hospital setting to the out-patient/office setting. The changes brought tremendous benefits to all. The diagnosis and treatment modalities become more available and versatile, cost effective and affordable.

 

Leg varices (cord like) is the term commonly used to described bulging veins in the legs, in fact it is not uncommon to see varices in the pelvic floor, and the external hemorrhoids is also a form of varices. The venous system bring the blood circulation back to the heart. In the legs, the venous blood has to travel up against the gravitational force, more so in the tall person, and longer legs.

 

Various mechanisms we know take place to help propel the venous blood back to the heart. The veins have smooth muscle. The limb muscle and kinetics are essential to venous circulation. The veins have uni-directional valves to keep the blood from falling back or going in reverse.

 

In the legs, we have the deep vein system which carries more than 90% of the venous blood back to the heart, the superficial vein system and the skin vein system. These systems communicate with each other via the bridge system called the Perforator veins. The different systems maintain the correct venous blood pressure in the venous system.

 

Many factors contribute to the failure of the venous systems in the legs. These include thrombosis or blood clot formation, systemic hypertension, vascular disease, Diabetes, other connective tissue disease, obesity, multiple pregnancies, leg injuries/trauma and infection. With any of the above insults, the venous blood pressure is elevated. The goal is to keep the venous blood pressure as stable as possible in the deep system, therefore the venous blood pressure in access must be released to the wide ranging superficial venous system. Over some times, the pressure build-up in the superficial system eventually caused superficial venous dilatation and failure, hence the development of Leg Varices. Apparently, the likelihood for a failure of the superficial veins resulting in the vessel dilatation and a failure of the venous valves resulting in the venous blood reversal, are somewhat determined genetically and probably related to Estrogen and Progesterone.

 

Our treatment of the leg varices will be targeted to the superficial venous system. The goal is to abolish the dysfunctional veins using laser and/or sclerotherapy. The vein consultations would also address the causal/risk factors such as poorly controlled hypertension and weight management, healthy diet and exercise.

 

We could not discuss leg varices without also discussing spider veins. These are the smallest skin veins that may appear red or blue. Spider veins may stand as a solitary cosmetic matter, but more commonly they relate to leg varices. In our Vein Center, we have a special Laser Skin Pulse to rid off the spider veins.

 

In closing, the leg varices is commonly caused by chronic (long term) venous insufficiency. Just as with any chronic condition, the goal of the treatment is to control the condition. The venous system unlike the arterial system is reproducible in some forms or other. Without appropriate control and follow up the leg varices will likely recur.  More clinical information on the leg varices could be found in our vein center website:  

 

 

Arizona Heart and Vascular