Veins are blood vessels that bring blood back to the heart to be cleaned and oxygenated. Veins have valves, or flaps, that open and close to allow blood to move toward the heart instead of down to the legs and feet due to gravity.
What are varicose veins and when should they be treated?
Varicose veins are twisted, enlarged veins near the surface of the skin with weak or damaged valves that allow the blood to flow backward into the lower extremities. This results in swelling, bulging, pain, itching, redness, and possibly wounds or venous ulcers in the legs.
“We usually see this happen in the lower extremities, like the legs, because these veins receive the highest amount of pressure due to gravity,” explains Lindsey Haga, MD. Dr. Haga is a vascular surgeon who sees patients at UPMC East, UPMC McKeesport, and the new UPMC Outpatient Center on Clairton Boulevard in West Mifflin.
What are symptoms of varicose veins?
“Varicose veins pose a problem because, as they become enlarged, the valves start to lose their ability to keep pushing the blood flow in the right direction. If you have a lot of fluid going in the wrong direction, that can eventually cause swelling and inflammation in the leg, which are the main symptoms we see with patients who have varicose veins,” says Dr. Haga.
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In addition to swelling and inflammation, other symptoms of varicose veins include:
- Bulging appearance on the legs
- Fatigue at the end of the day
- Tenderness over or near the veins
- Wounds, mainly on the foot/ankle area
What should I do if I have varicose veins?
If you are worried you may be suffering from varicose veins, Dr. Haga recommends first making an appointment with a doctor. This can be your primary care provider (PCP) or a vascular surgeon in your area.
“Patient history and examination are the most important factors when it comes to assessing your symptoms,” says Dr. Haga. “Being able to evaluate you in person helps give us a good idea of the cause of these symptoms.”
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Once your doctor evaluates you, there’s a good chance you will be referred for an ultrasound. This process uses gel and special equipment with sound waves to look at the blood vessels in question. Using ultrasound, the vascular surgeon assesses the veins to determine their size and the amount of time the blood flow goes in the wrong direction. With that information, the surgeon can recommend the best course of treatment for you.
What treatments are available for varicose veins?
Treatment for varicose veins varies, but it typically starts with conservative management. You can:
- Exercise to improve blood flow in your legs
- Lose weight if needed
- Prop up your legs when sitting or lying down to reduce the extra pressure caused by gravity
- Wear compression stockings
“A lot of times conservative management is enough,” explains Dr. Haga. “It’s definitely enough to help prevent wounds, if that’s a concern for you.”
When conservative management is not enough, other options are available.
Minimally invasive procedures include:
- Laser treatment: Heat from the laser damages the vein and causes scar tissue to form, which closes the vein. Lasers may be used:
- On the outside of the skin (external laser) to close off small veins near the surface.
- Inside a vein (endovenous laser) to close large veins. The doctor places a thin tube called a catheter into the vein through a small cut in the skin.
- Phlebectomy: Also called microphlebectomy or stab avulsion, it is usually done alongside another surgery to treat varicose veins. Several tiny cuts are made in the skin and the veins are removed through these cuts. Stitches usually aren’t needed.
- Radiofrequency closure: This procedure uses a type of energy different from the laser to close off large varicose veins in the legs. A small cut is made in the vein and the energy is directed through a thin tube placed in the cut.
- Sclerotherapy: A chemical is injected into the varicose vein to damage and scar the inside of the vein. This closes the vein.
As with any procedure, varicose vein treatment can carry some risk. Make sure to talk with your PCP or vascular surgeon about the risks before moving forward.
Varicose veins are treated by Dr. Haga, Natalie Domenick Sridharan, MD, and other vascular specialists in the South Hills, including at the new UPMC Outpatient Center on Clairton Boulevard. Schedule an appointment online or call 412-802-3333.
The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.