Unveiling Varicose Veins: Understanding Causes and Treatments

Host: Hello and Welcome to PACE Hospitals Podcast, today we're diving into a topic that affects countless individual’s worldwide – varicose veins. These enlarged, twisted veins not only pose cosmetic concerns but can also lead to discomfort and potentially serious health complications if left untreated.

Joining us today Dr. C Lakshmi Kumar - Senior Interventional Radiologist and Abdominal Imaging Specialist having wide expertise in treating and managing varicose veins. In today's episode, he would like to delve into what varicose veins are, what causes them, the symptoms they present, and the available treatment options.

Dr. Lakshmi Kumar thank you for joining us at PACE Hospitals, Hitech City.

Doctor: Thank you for inviting me today; I would like to explore this common yet often misunderstood vascular condition with you today. Varicose veins affect millions of people worldwide, and by delving into their causes, symptoms, and treatment options, we hope to provide valuable insights that empower you to take control of your vascular health. So, let's dive in and unravel the mysteries of varicose veins together.

Host: Dr. Lakshmi Kumar, thank you for joining us. Let's understand exactly what are varicose vein, what are the types of visible veins and where are they commonly visible veins?

Doctor:  The tubular channels which bring blood back from the body to the heart. So when these winds became swollen and twisted, these are called varicose winds, commonly seen in the legs, spider winds and reticular veins. 

Spider veins and reticular veins are different from varicose veins. These are smaller compared to varicose veins and they are closer to the skin surface. These are red or blue in color, these are commonly seen in legs and face.

Host: How do varicose veins develop?

Doctor:  Blood from the legs is normally pushed slowly towards the heart by the cough muscle activity and this blood which is being pushed into in the veins, this is prevented from sliding back downwards with the help of cup shaped membranes called valves.

When these valves are not functioning properly, this leads to bulging of the veins and development of varicose veins. People with obesity, prolonged sitting or standing habits, pregnancy, prolonged usage of oral contraceptive pills or hormonal replacement therapy, old age, family history, so these are all the predisposing factors for the development of varicose veins.

Host: What are the symptoms of varicose veins?

Doctor:  They are usually seen in legs, you can see dilated veins or swelling in the legs, pigmentation of the skin, that is discoloration of skin or heaviness or pain, itching, burning sensation. If these are complicated, you can get redness or warmth, increased temperature in the leg or open skin, sore or wound.

Host:  What are the risk and complications of varicose veins?

Doctor:  If the varicose veins are neglected, these can lead to some complications like bleeding from the veins, clotting inside the veins, infection of these veins. Infection of these veins leads to increased swelling at that site with redness and increased temperature at the local site.

Also, the clots formed in the varicose veins can migrate into the lung, which is medically called as pulmonary embolism. This can be life threatening.

Host:  When do varicose veins need treatment?

Doctor:  The patients with the varicose veins who develop the symptoms like swelling in the legs, discoloration of the skin, eczema, hardness of skin, itching, pain in the legs or ulcer in the legs.

These are all the patients who need treatment for the varicose veins. If he or she is experiencing bleeding from the varicose vein, then it is an emergency indication for the treatment.

Host:  Who are the patients requiring varicose vein treatment? 

Doctor:  The patients with ulcer or increased pain which is not relieving with conservative measures or patients with bleeding or clots in the veins or infection in the veins. These are the patients who definitely will require the treatment for the varicose veins.

Host:  What are the conservative treatments for varicose veins?

Doctor:  Varicose veins patients need definitive treatment for the effective relief of the symptoms and decrease in size of the veins. But some patients they are not fit for the definitive treatment. For those patients alone, we'll offer conservative measures like stockings, lifestyle changes and some medicines.

Host:  What are the other treatment options for varicose veins?

Doctor:  The varicose veins can be treated using surgery or minimally invasive techniques. Surgery is ligating and stripping the affected veins and the minimally invasive techniques. We have a plethora of techniques nowadays like ablation of the affected veins using laser or radio frequency waves, sclerotherapy, mocha, varithina, injecting superglue, steam, et cetera. Out of these, the most commonly used techniques are ablation of the veins with the help of laser or radio frequency and sclerotherapy.

Host:  How is the ablation of varicose vein done?

Doctor:  This is done by introducing a catheter which is a thin tube with the help of a needle into the affected vein. Then the heat is generated from this tube from this tube which helps in closure of the affected vein. When the affected vein is closed, the blood flow in the normal veins increases, this is how the ablation is done.

Host:  What is sclerotherapy for varicose vein?

Doctor: sclerotherapy in sclerotherapy we introduce a chemical called scleroscent with the help of a needle into the affected vein. The sclerosant is a chemical which damages the inner lining of the vein, leads to scarring and closure of the affected vein.

Host:  How are the spider veins or reticular veins treated?

Doctor: These are treated with the help of a micro sclerotherapy. In this, a very thin needle is introduced into the reticular or spider vein followed by injection of a liquid sclerosis, which helps in eradication of all the reticular and spider veins.

Host:  How long does it take to treat varicose veins?

Doctor:  It depends upon the severity of the disease and for an ideal patient, we can treat within 30 minutes. For very complicated patients with severe disease, it can take up to 1 hour.

Host:  What is the duration of a hospital stay?

Doctor:  For a varicose vein procedure, it is performed as a day care procedure. For an ideal patient, after the procedure we can discharge him in 2 hours, but most of the patients we can discharge within one day. The procedure can be done as a completely painless procedure if we perform this under spinal or general anesthesia.

The procedure can also be done under local anesthesia or nerve block, which is little bit painful, which requires insertion of some needles. So this will be somewhat painful compared to the spinal or general anesthesia.

Host:  How to prevent varicose veins? 

Doctor:  The varicose veins can be prevented by maintaining a healthy weight. Lifestyle changes like regular exercise, which is, walking or cycling for 30 minutes and for at least five days in a week, also avoiding smoking, avoiding prolonged sitting and standing, avoiding cross legging, avoiding tight clothes and avoiding high heels, these are all the measures to improve the blood flow through the veins that can prevent varicose veins.

Host:  What are the post-procedure precautions for varicose veins?

Doctor:  After varicose veins treatment, you will be prescribed compression stockings for a period of two months. Also, you need to avoid strenuous exercises for one month and we will advise lifestyle changes like avoiding prolonged sitting or standing, reduction of weight and you will be given some medicines for a period of five days.

Host:  What are the advantages of minimally invasive surgery over traditional surgery?

Doctor:  In varicose vein treatment, the minimally invasive techniques are less complicated compared to the surgical techniques. When you undergo the procedure in the hands of an experienced doctor with proper training, this will be very safe.

The complications are seen in less than 5% of the cases compared to the surgery, which has complications up to 20% to 30% cases. 

The recurrence rate in minimally invasive techniques is significantly less, which is three to 5% compared to the surgical techniques which have a recurrence rate of 40% to 50%. Also, the postoperative pain the recovery time is significantly less in minimal invasive techniques compared to the surgery. Also, the complications and side effects are lower compared to the surgery.

Host:  Can varicose veins be cured?

Doctor:  The varicose veins cannot be cured completely, but the size of the varicose veins can be significantly decreased with the help of our treatment and the symptoms related to the varicose veins can be effectively relieved with our treatment.

Host:  Can varicose vein be cured on their own?

Doctor:  No, the varicose veins cannot be relieved on their own. It needs some kind of treatment, either conservative measures to prevent progression or a definitive treatment.

Host:  Are varicose veins hereditary? 

Doctor: Yes, family history of varicose veins is a known risk factor for the occurrence of varicose veins in a: patient.

Host : Thank you Dr. Lakshmi Kumar for sharing crucial information regarding the varicose veins to our listeners.

Doctor:  I hope this information can be valuable for the listeners and remember that knowledge is power when it comes to managing your vascular health. Whether you're seeking treatment for existing varicose veins or taking preventive measures to avoid them, your proactive approach can make a significant difference.

Host:  If any of you have any further questions regarding varicose veins please don’t hesitate to consult an Interventional Radiologist and remember that seeking early evaluation and treatment can help alleviate symptoms and prevent complications.

We will see you soon on PACE Hospitals Podcast with another episode until next time, wishing your health and wellness stay informed, stay proactive, and take care of your vascular health.