Varix Treatment

Varissiz bacaklar

If you are experiencing pain and heaviness especially in the evenings, if you have capillary vessel formations in your leg area, purple spots and swelling on your ankles, dry skin, redness and itching in your skin, if you have subcutaneous hemorrhage, which take a long time to recover, you should definitely consult a cardiovascular specialist.

What is a varix?

There are one-way valves in your veins that allow blood to flow into your heart. If these valves are damaged or weak, they cannot do their job well and the increased amount of blood will collect in your veins.

This causes the vessels to swell and can cause varicose veins. Varix is defined as a condition in which leg veins become enlarged, elongated and twisted.

What causes varix?

  • Hereditary predisposition
  • Regularly standing for long periods
  • Pregnancy, contraceptive pills, hormonal reasons
  • Severe obesity
  • Damage to the legs due to surgery or accident
  • Presence of other diseases (diseases that increase intra-abdominal pressure, tumors and the like)

What are the symptoms of varix?

  • Pain, fatigue and sense of weight in legs, especially in the evening and after exertion.
  • Formation of capillary vessels in the skin
  • Swelling and purple spots on the ankles
  • Redness, itching and dryness in the skin, referred to as stasis dermatitis or venous eczema
  • Subcutaneous bleeding that occurs spontaneously or even after minor impacts occasionally.
  • In some patients, collapse in the skin of ankle due to hardening of the fat layer under the skin
  • Restless leg syndrome in addition to existing presentation in some patients

Types of varix

Stages of Varicose Illustration

There are 4 types of varix;

Spider web

These vessels, called telangiectasia, are located on the surface of the skin. They are 1 mm or less in diameter. They are not palpable. They are mostly reddish in color. Regionally, they are common linear formations similar to star or spider web and can cover the entire leg.

Reticular Varices

They are bluish varices less than 4 mm in diameter, which slightly bulge from the skin and can be hardly figured out with touch.

Large Vein Varices (Saphenous vein varices)

They are larger than 3 mm in diameter. They are varices which form large wide folds across small and large saphenous veins and which are easily noticeable by touch and sight. They are located under the skin so they usually change the skin color but they reflect the greenish color of the vessel. They are raised from the skin and become prominent by standing. They disappear when you lie down and raise your legs.

Large Vessel Varices in Deep

These veins are located in the deep layer of the leg. Therefore, varices are not visible from the outside, but can cause edema and circulatory disorders in the leg.

How is a varix diagnosed?

The patient is examined first. A person-specific varix map, which allows making a diagnosis of up to 99% with the help of manual Doppler examination that works based on the principle of sound waves and color duplex ultrasonography, is prepared.
Examinations performed reveal very important information about veins and deep veins, such as diameters, functions of valves in them, movements of passing blood.

How is varix treatment performed?

Varix Treatment by Sclerotherapy Method

It is popularly known as needle therapy. This method, which has been applied for more than 80 years, involves injection of sclerosant (usually sodium chloride) into the vein using needles with very fine tips. This material damages the inner surface of the vein and allows its walls to adhere.

As blood no longer passes through the adherent walls, the vein becomes invisible and is absorbed and destroyed by the body over time.

The question is whether or not destroying these veins is harmful to our body. Since these veins should not be normally present in humans and have no function, it's not harmful to destroy them.

Sclerotherapy sessions last for 10-15 minutes and are usually applied 1 week apart. The proportion of veins destroyed in each session varies according to their diameter, amount of the medication and general condition of the individual.

After the treatment, the patient should wear a pair of special low compression stockings and walk for 15-20 minutes. S/he should wear the special stockings for 3 days continuously, except while having a bath.

Immediately after treatment, swelling of the corresponding veins is seen. Later on, bruises that will gradually diminish and disappear and crusting, in rare cases, might occur.

With sclerotherapy, 60-80% of unwanted vascular formations can be destroyed. Capillaries disappear within 3-6 weeks and large veins disappear within 3-4 months. Only 10 percent of patients may not respond to treatment and it might be necessary to repeat treatment in these people.

Varix treatment by radiofrequency

With this method, a needle is introduced into the vein at the patient's knee level and the vein causing the complaint is dried inside the body without making any incision. In this technique, a catheter (wire) is introduced into large veins to burn using radiofrequency energy.

In addition, capillary varicose veins are burned with radiofrequency energy over the skin. Even very thin capillaries that are not suitable for sclerotherapy can be destroyed by this method.

Varix operation with laser

In this method, which is applied using laser, a catheter which gives high heat is introduced into the superficial vein with the help of a needle. In this way, the vein is burned from the inside and closed. No incision is required.

Conventional varix surgery

In conventional surgical treatment (Stripping), superficial vein is removed entirely using the incisions made in the ankle and groin. In general, enlarged side branches (packs) in the lower knee area are also removed using individual incisions.

The operation is performed under general anesthesia and takes about 45 minutes. The patient usually stays in the hospital overnight. S/he can stand up and walk the same day. Strenuous activity should be avoided for one week.

How to prevent varicose veins?

Measures such as exercising, lifting your legs or wearing varicose stockings may help before formation of or in the early stage of varicose veins. However, if you are concerned about the appearance of your veins and your sensation, you should definitely consult a specialist.

Some precautions against development of varicose veins:

  • Avoiding standing for long periods
  • Wearing protective varix stockings during pregnancy
  • Walking regularly
  • Raising your legs half an hour in the evening
  • Avoiding extreme heat
  • Washing your legs with cold water
  • Avoiding hormone drugs
  • Not gaining too much weight

Which problems do varices cause?

Most varicose veins are usually benign. Severe varicose veins can lead to serious problems due to the poor circulation through the affected leg.

They cause pain, fatigue, inability to walk or stand for long hours, thus causing a decrease in work force and quality of life.

Serious bleeding may occur, even with minor impacts, especially in later years. They can cause clots to form in the veins called thrombophlebitis. This is often seen in superficial veins, but if deep veins are affected, it can have serious consequences such as lung embolism.

The resulting ulcers might cause infection, which in turn results in impaired quality of life. Although seen in very rare cases, ulcers may cause development of cancer.

Frequently Asked Questions

What are the stages of varicose veins?

The stages of varicose veins by the examination findings, changes in the skin and structural disorder of the vein are as follows:

  • There is no visible condition on the skin but there are complaints
  • Capillaries with appearance of spider veins
  • Varicose veins bulging on the skin surface
  • Swelling and edema in the lower half of the leg
  • Changes in the skin and color, eczema
  • Varix wounds that can heal
  • Open varix wound that heals with difficulty, active ulcers

Why is it more common in women?

Varicose veins are more common in women due to the effect of hormones and pregnancy. Hormonal changes during pregnancy, increased fluid amount and the pressure exerted by the baby into the abdomen increases the pressure in the veins, causing varicose veins. Contraceptive pills could also cause clot formation in the veins.

Do men have varix too?

The general belief is that varicose veins are a female condition. However, although less common than in women, this condition also occurs in men. Genetic predisposition, sedentary life and being overweight are the leading causes of varicose veins.

Are varicose veins likely to relapse after treatment?

Due to the structural nature of the disease, new formations may occur outside the treated area, particularly in the case of varicose capillaries. In treatment of main superficial veins, if affected veins are exactly identified by ultrasonography before surgery, treated and followed up appropriately, varicose veins will highly unlikely to relapse.

What are compression stockings?

When used correctly, compression stockings will slow down progression of existing varicose veins and contribute to faster and permanent healing of varicose veins treated. You should wear your compression stockings if you will be standing for a long time due to your work or social life. These special socks reduce your complaints induced by varicose veins and increase your quality of life.

Today, compression stockings made of a variety of fabrics are available for use according to season and those balancing air circulation, which do not cause perspiration, are also available.