Varicose Vein Center

The problem of varicose veins is as old as human history. Some Greek statues made 2,500 years ago prominently depict varicose veins. However, it was first described in written documents in the Ebers papyrus dating back to 1600 BC. Today, it is considered a very common societal condition affecting 5% to 40% of the population, which, although not usually life-threatening, can reduce the quality of life and create serious cosmetic issues.

The problem of varicose veins is as old as human history. Some Greek statues made 2,500 years ago prominently depict varicose veins. However, it was first described in written documents in the Ebers papyrus dating back to 1600 BC. Today, it is considered a very common societal condition affecting 5% to 40% of the population, which, although not usually life-threatening, can reduce the quality of life and create serious cosmetic issues.

It is evident that the estimate of at least 5 million people in our country having varicose veins of varying degrees is accurate. The clean blood flowing to our legs is pumped back to the lungs as a result of the contraction of our leg muscles, creating a pumping action in the veins, while the force of gravity works against the return of this blood back to our legs. The valves in the leg veins allow blood to flow only upward toward the heart and close to prevent gravity from reversing this flow. If these valves are damaged due to hereditary and acquired factors, the blood sent to the lungs can flow back (reflux) due to the effect of gravity and accumulate in the leg veins. Over the years, the increased pressure caused by the blood flowing back leads to swelling and widening of the leg veins, ultimately resulting in varicose veins.

What are Varicose Veins?

In its simplest definition, varicose veins are a condition characterized by the dilation, elongation, and twisting of veins, particularly in the legs, and it is unique to humans. This condition has not been observed in any other mammals. The cause of the enlargement in this system, which is responsible for carrying blood from the feet to the heart (from bottom to top), is the dysfunction of the valves in the leg veins (venous insufficiency)

Generally, there are three types of varicose veins based on their size and proximity to the skin:

Large Varicose Veins (Varicose Veins)
These are prominent veins that protrude from the skin with diameters ranging from 4 to 15 mm and are often formed due to valve insufficiency in a large superficial vein.

Medium-Sized Varicose Veins (Reticular Veins)
These are veins that slightly protrude from the skin, are green-red in color, and vary in width from 2 to 4 mm. They typically result from valve insufficiency in a smaller superficial vein.

Capillary Varicose Veins (Spider Veins)
These are red-purple colored veins that do not protrude from the skin and have diameters smaller than 1-2 mm. They usually occur as a result of valve insufficiency in one or more small superficial veins.

What are the Symptoms of Varicose Veins?

1. Swelling: Swelling often occurs in the ankles and calves. It typically develops after standing for long periods, especially noticeable in the evening and not present in the morning upon waking.
2. Pain: This is a dull, deep pain that feels heavy in the legs, often caused by prolonged standing. The pain usually improves when the leg is elevated or after lying down for a while.
3. Itching: Itching can occur around the ankles and nearby areas, especially when there is a color change, accompanied by a burning sensation and throbbing.
4. Night Cramps, Fatigue, and Tension: These symptoms, especially after standing for long periods or during long journeys, may indicate varicose vein problems, along with a feeling of restlessness and uncertainty about where to place the legs at night.
5. Thrombophlebitis: This condition arises when the enlarged venous structures clot after trauma or spontaneously, leading to inflammation on the surface. The skin may become red, warm to the touch, and overly sensitive. It can resolve spontaneously or with treatment but may recur.
6. Skin Changes: These can range from color changes to open, non-healing sores.
7. Bleeding: This is the only urgent situation that can occur. Due to high pressure, varicose vein bleeding can be severe but is usually controllable with adequate compression.

What is the Progression of Varicose Vein Disease?

Symptoms such as leg pain, increasing cramps throughout the day, tingling in the legs, swelling in the legs and ankles, a heavy feeling in the legs, and numbness and tingling tend to improve once treatment begins. However, delaying treatment can lead to more severe cases characterized by non-healing leg ulcers, thickening and hardening of the skin, bleeding, inflammation (phlebitis), and increasingly severe pain and swelling, along with growing and darkening spots, making treatment more difficult, and symptoms may not completely resolve despite treatment.

How is Varicose Veins Diagnosed?

Clinical indicators of chronic venous disease, such as edema (swelling), skin color changes, and the presence of venous ulcers, are generally sufficient to diagnose venous hypertension without additional diagnostic methods. However, in some suspicious cases, diagnostic methods are used to confirm the diagnosis, determine the exact cause (such as reflux, obstruction, or venous pump dysfunction), and identify the exact location and level of the disease. Currently, three main diagnostic methods are preferred:

1. Ultrasound
2. Contrast Venography
3. Magnetic Resonance Venography

Today, contrast venography has largely been replaced by non-invasive techniques like duplex ultrasound and magnetic resonance (MR) imaging for diagnosis. Other techniques are only used in cases of uncertainty. In summary, duplex ultrasound has become a frequently used method in clinics as it is easy, reliable, repeatable, non-invasive, and cost-effective. In duplex ultrasound, sound waves are used to obtain real-time anatomical images of deep and superficial venous structures while dynamically assessing blood flow within these vessels, enabling the identification of problems in the venous system and easy localization.