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Varicose veins

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What are varicose veins?

Valves inside the veins stop the blood from flowing downwards towards the gravity. With the help of calf muscles veins move the blood up to the heart. Varicose veins are the result of chronic venous insufficiency which causes the malfunction of the valves inside the veins. Apart from the visual disturbance by varicose veins chronic venous insufficiency can cause pain and swelling after long periods of standing, skin changes and ulcers.

Usually varicose veins are just the top of an iceberg and the extent of the diseased veins needs to be thoroughly examined. Therefore, the visible varicose vein is not the only vein affected by the disease – the cause is usually an insufficient perforator or an incompetent vein trunk.

What causes varicose veins?

Varicose veins are a common problem in the western population, affecting approximately every fourth person. The incidence rises with age. Approximately 8 % of women under 30 years of age have varicose veins. The incidence rises up to 41% for women in their fifth decade. Men are affected somewhat less but have a similar incidence pattern.

Risk factors of varicose veins

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Heredity

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Pregnancy

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Overweight

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Female sex

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Smoking

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Standing

What symptoms may be caused by varicose veins?

In milder cases varicose veins can be asymptomatic. As the disease develops pain and swelling after long periods of standing may follow. In cases of vast varicose veins, a painful inflammation may complicate the disease – this is called thrombophlebitis. In chronic cases the disease starts to affect the skin of the legs causing pigmentation and lipodermatosclerosis. A chronic venous ulcer may develop which itself is although in rare cases a risk factor for skin cancer. Chronic venous insufficiency is graded by the CEAP classification.

CEAP classification. C1 – telangiectasias, C2 – varicose veins, C3 – edema, C4 – skin changes, C5 – healed ulcer, C6 – chronic venous ulcer

How are varicose veins treated?

Modern treatment methods include radiofrequency ablation (RFA, ClosureFast procedure), endvenous laser ablation (EVLA, EVLT) and VenaSeal adhesive. In addition, depending on the need sclerotherapy and miniphlebectomy may also be used. Open surgery is no longer the method of choice for varicose vein treatment.


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