Varicose veins can evolve into other more serious pathologies if not treated correctly

Dr. Morales is a specialist in Varicose Veins Surgery and Phlebology in Murcia who talks in this article about the importance of treating varicose veins correctly and on time so that they do not develop more serious pathologies.

Varicose veins are a disease with a large genetic component on which act environmental factors that accelerate or delay their evolution. Therefore, a healthy lifestyle can delay their appearance and avoid complications.

Location of varicose veins in the legs

With each heartbeat, arterial blood is propelled towards the rest of the body. In addition, the arteries, with their thick muscular wall, also help to propel the blood. Once the tissues have been oxygenated, the blood must return to the heart, but since the cardiac impulse has been exhausted, other mechanisms must act. In addition, it must do so through the veins, which, unlike the arteries, have a thin wall, with no muscle that can contract, and are easily dilated if the pressure increases.

This situation is critical at the level of the legs, where the venous blood must also overcome the force of gravity. In fact, varicose veins are an exclusively human disease, not suffered by other four-legged mammals.

Therefore, it is highly advisable for people who spend long days in the same position (either standing or sitting) to move their calf muscles regularly, as well as to wear elastic compression stockings to prevent venous dilatation.

Stages and pathologies associated with varicose veins

Varicose veins have been classified with several stages, according to phlebology specialists.

The first stage (CEAP 1) is the least severe and appears in the early stages of the disease. Small veins (varicose veins and telangiectasias) appear on the back of the knee (popliteal fossa) and on the outer thighs. In this first stage, symptoms such as leg heaviness, itching, cramps and even pain may appear, especially in the last hours of the day and during the hottest periods of the day.

The next stage (CEAP 2) is characterized by the appearance of the typical varicose veins that stand out on the skin. Symptoms are usually almost daily.

A patient is considered to have CEAP stage 3 when swelling of the ankles appears in the evening (the typical mark of socks or stockings when we take them off at night). It may or may not be accompanied by visible varicose veins, so it may be the first symptom of the disease, which is already at a relatively advanced stage.

The next stage or CEAP stage 4, which is characterized by the appearance of skin lesions on the inner aspect of the leg, just above the ankle. This location is very typical as it coincides with the area of highest venous pressure. These skin lesions can range from redness to dark spots and skin atrophy. Once they appear they are usually irreversible.

CEAP stages 5 and 6 are the natural evolution of stage 5 if the disease is not treated, and consist of the appearance of an ulcer at this level. When the ulcer manages to close it is considered a stage 5, and when it remains open it is a CEAP stage 6.

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As can be seen, varicose veins are not just an aesthetic disease as many people consider, but a chronic and progressive disease that affects the quality of life of people who suffer from them and can lead to serious situations that require hospitalization.

In addition, the existence of varicose veins in the leg can cause thrombi that reach the lung and can be life-threatening.

Techniques to treat varicose veins

First of all, it is necessary to know that there are multiple treatments, since being a chronic disease with different evolutionary stages, the treatment indicated in a particular patient may be different from that of another patient. For example, treating a young woman with small veins in the thigh is not the same as treating a man with thick varicose veins and a leg ulcer.

The most important thing is that the treating physician makes a good individualized diagnosis by means of a color Doppler ultrasound and applies the indicated treatment. The problem is that not all physicians who treat varicose veins are able to make an individualized diagnosis, nor are they familiar with all the techniques. Generally, if they are surgeons, they only know stripping or stripping of the saphenous vein, and this is the one they apply in all cases. On the other hand, if they are not surgeons, they usually try to treat all cases with sclerosis, which is not always possible.

Secondly, we must insist on the importance of ultrasound management of the patient. In a leg there are multiple veins that can be the cause of varicose veins, and the success of the treatment is to treat the diseased vein and respect the healthy ones, for which it is essential that they have been previously studied by the phlebologist himself. In addition, most of the more advanced treatments must be performed under ultrasound control. Whether or not the doctor who is going to treat a patient with varicose veins handles a Doppler ultrasound scanner can be a good reference for the patient to choose the most suitable professional.

The techniques from which the patient can choose, always under the advice of his phlebologist, are liquid or foam sclerosis and surgical techniques, among which we must distinguish techniques that remove the veins (stripping), and those that close the veins but do not remove them (ultrasound-guided foam sclerosis as the only treatment, or associated with radiofrequency or endolaser).

Advice for a patient with varicose veins

If you have a family history of varicose veins, you should try to take care of yourself and avoid risk factors, especially being overweight and taking hormones. Consider wearing a knee-high sock during working hours. When the first symptoms or varicose veins appear, the patient should look for experienced professionals (preferably dedicated to varicose veins), with a broad vision and mastery of more than one strategy, since in medicine one thing has never worked for everything or everyone.