Symptoms commonly seen with varicose veins include:
- Dull aching or pain
- Heaviness or the feeling of leg pressure
- Tiredness or fatigue
- Restless legs at night
- Nighttime cramping
- Itching or burning
Patients with chronic venous insufficiency (CVI) develop skin changes resulting from high pressures in the veins that then affect the fat and skin most often around the ankle. It is seen as chronic swelling, more severe skin changes of thickening or fibrosis (lipodermatosclerosis) or dark color changes called hyperpigmentation, or with the most severe condition, venous stasis.After having CVI for a long time, the skin of the lower leg becomes shiny, hard and has a darker color than the surrounding skin. The skin is fixed or anchored to the underlying tissues making the skin tenser and less flexible. They skin may be very dry (dermatitis). White scar tissue (atrophie blanche) may also be present.
The doctor will want to know of any other medical problems which might show how important or how likely your symptoms are due to venous disease. This includes:
- A history of blood clots or other vein problems
- Family history of blood clots or vein problems
- Previous vein surgery
- Your job and the need for standing for a long time
- Any issues you have with weight control and constipation
- A history of cancer, stroke, recent surgery illness
- Orthopedic surgery or any injury to the leg.
- When your symptoms happen and if they are getting worse
- The use of compression stockings
- Pregnancies or pregnancy complications
- Any condition which affects the movement of the foot, ankle or leg
Doppler ultrasound is necessary non-invasive test used to diagnoses “faulty veins”. This allows the physician to directly see the vein and hear blood flow in the vein. This test uses sound waves which can go in to the body, hit the vein and be bounced back to detecting part of the machine. The test usually begins with testing to look for deep vein thrombosis (DVT) or chronic injury resulting from a previous blood clotting. Then the veins are studied with the patient standing to look for reflux (downward flow of the blood) in all of the deep and superficial veins.
In some cases, you may need a CAT scan (computed axial tomography) or MRI (magnetic resonance imaging) to evaluate the veins and make sure there is nothing blocking the blood from getting out of the vein (outflow obstruction).
There is wide range of treatment options available and most are “key-hole surgery”. It will depend on the severity of patients venous disease and patients may choose from variety of options from open surgery to sclerotherapy. The modern and very efficient treatment for advanced venous disorders are clot dissolving, clot debulking, angioplasty or stent of the affected veins and laser surgery. Most are “day-case” treatment requiring NO hospital stay at all.
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