Treatments and aftercare
Visible, bumpy veins on your lower legs are likely varicose veins. A quarter of the Dutch people suffer from it; especially women. Many have the varicose veins removed because it doesn’t look nice, but the condition also has medical consequences.
Varicose veins almost always start with visible veins on the legs. Initially, these result in few complaints. In a later phase, varicose veins can lead to a feeling of heaviness in the legs, swollen ankles or ‘restless’ legs while sleeping. In severe cases, it even ends with eczema on the ankles, skin discolorations (pigmentations) on the lower legs and poorly healing wounds.
Malfunctioning valves
The veins in your legs can be divided into two groups. The superficial veins lie under the subcutaneous fat layer. The deep veins are located between the muscles. The deep veins play a role in pushing the blood upwards.
When walking or cycling, the calf muscles contract and become shorter and thicker. This flattens the veins and makes the blood flow upwards. The valves in the veins keep the blood from flowing down. If these valves do not work properly, the blood can flow downwards. This creates overpressure in the veins and capillaries.
When they expand, a varicose vein develops. Another vein then takes over the function of the vein with malfunctioning valves. This way the varicose vein can be removed without any problems.
Scan your veins
To examine the blood vessels in your legs and look for varicose veins, the doctor uses a duplex scan. The device emits sound waves that are reflected by the blood. This gives a picture of both the superficial and the deep veins. In this way, the doctor determines very accurately the nature and location of the varicose vein.
In addition, it shows the patency of the blood vessels, the direction of blood flow and the function of the valves. The examination with the duplex scan is not painful at all. You can compare it to making a sound echo.Causes
The main causes of varicose veins are heredity, standing a lot and pregnancy. Women who work in a standing position are therefore at greater risk.
Types of treatments
There are several ways to treat varicose veins. Today, treatments address not only the medical problem, but also the aesthetic one. Below you will find an overview.
Stripping
Stripping is actually an old-fashioned technique. The technique is only used for varicose veins that twist a lot. In this method, the varicose vein is completely removed under general anesthesia. This operation is quite taxing and drastic.
Endovenous Laser Therapy (EVLT)
Thanks to endovenous laser therapy, it is no longer necessary to pull the entire vein out of the leg. Using an ultrasound, the vein to be removed is marked on the leg. A thin wire of laser fiber is placed in the blood vessel through a small incision. The blood vessel is closed with the laser energy. This has no consequences for the blood circulation in the legs.
The blood naturally seeks another blood vessel in the vascular system, so that it can continue to flow in the direction of the heart. The remains of the closed blood vessel are broken down and cleaned up by the body. The treatment is done under local anaesthetic. The big advantage is that you are immediately mobile again. In addition, you will not be left with any scars and both your legs can be treated at the same time.
Müller technique
Another way to remove varicose veins is the Müller technique. Before the treatment, the varicose veins are first marked with a special marker. Then small incisions are made in the skin above the varicose veins. The veins are removed completely with tiny ‘crochet hooks’. With this technique, the scars are minimal. The treatment is done under local anaesthetic.Sclerocompression Therapy
This technique is better known as the injection of varicose veins. And is usually used for ‘smaller’ varicose veins or as a follow-up treatment for more serious procedures. Here too, the doctor first marks the areas to be treated. He injects a fat-dissolving liquid into the varicose vein every five centimeters. This makes the smooth vessel wall stiff and the blood clots a little.
The vessel walls partly adhere to each other, after which they shrivel and can no longer expand. To promote the latter, you should wear an elastic stocking and possibly a compression bandage. The blood will find another way into the circulatory system. Over time, the vein is not or hardly visible anymore.
Ultrasound-guided sclerocompression therapy
The basis of ultrasound-guided sclerosis compression therapy largely corresponds to ordinary sclerocompression therapy. In this case, however, the doctor has ‘frothed’ the liquid to be injected beforehand. This foam is thicker and therefore acts even better on the vessel wall.
The medium-sized veins can be treated with this method. After all, the foam can spread over a larger surface. During treatment, the duplex scan is used to check whether the foam is entering the vein to be treated.
Laser treatment of small vessels
Red or blue visible fine vessels (birch twigs) that appear as a network on the legs do not cause any medical problems. These unsightly vessels can be treated excellently with a laser.
If varicose veins are also present, the doctor will advise you to treat them first. This removes the pressure on the small veins. Laser therapy is therefore only recommended at the end of the treatment process.
Aftercare with elastic stockings
After the treatments for varicose veins, you should wear elastic stockings, except for the laser therapy. Aftercare is essential for the effectiveness of the treatment. The elastic stockings promote blood circulation and drainage of lymphatic fluid. In addition, the legs receive extra support. This prevents existing vascular problems from getting bigger.
