CAUSES AND SYMPTOMS OF VARICOSE VEINS
In the first stage of the disease, the affected veins are called varicosities. They resemble red or bluish filaments on the surface of the skin. When the affected veins have a larger diameter, these are called varicose veins.
Varicosis is caused by the weakening of the superficial vein walls and by the ineffectiveness of the valve system. A blood leakage occurs, especially when standing up. The leak comes from the depth of the limb to the surface. This happens in the superficial veins, which gradually dilate to become real pockets of blood.
This reflux of blood from the depth to the surface or from the top to the bottom in the superficial venous system and its stagnation in the venous “lakes” explains the following:
- Pain and heaviness, tingling and, more rarely, cramps.
- Swelling of the ankles.
- Cutaneous disorders: eczema and varicose ulcers, brown patches, blotches and induration (hardening of tissues).
- Development of thrombosis and even pulmonary embolism.
Treating these varicose veins and closing the “leaks” improves venous circulation of the limb.
Several factors can cause the development of varicose vein disease. Heredity is a factor, but also a trauma or accident. Some aggravating factors (obesity, standing stationary and prolonged, the number of pregnancies) can also cause the appearance of varicose veins. Heat (heated blankets, extended hot baths) can also cause venous dilation.
It is essential to consult a phlebologist to solve the problem of venous insufficiency.
Treatment options for varicose veins offered at our centres:
In order to choose the type of treatment that is right for you, Dr. Elise Bernier performs a complete examination of the affected veins. This examination is assisted by ultrasound and allows the assessment of incompetent veins, their depth, and location. This preliminary examination is important to determine the appropriate treatment.
Different treatment options are available at Dr. Bernier’s Centre de chirurgie et de médecine esthétique:
- Surface sclerosis
Lasers and phototherapy are also treatment alternatives offered at our centres.
Dr. Bernier usually starts with large varicose veins, which are very often the cause of varicosities.
They are used in sclerotherapy, which consists of injecting an irritant substance into the affected vein.
Classified according to their strength (light, medium, strong) or their action mode (chemical, detergent, osmotic), sclerosing agents can change strength depending on their form: liquid or foam.
Sclerosing foam is obtained by mixing gas (usually air) and sclerosing liquid. The foam form allows us to increase the sclerosing effect and to obtain better results more quickly while using less product.
Microsclerosis is the recommended treatment for telangiectasias (varicosities, small red or bluish vessels visible under the skin). Magnifying glasses and very fine needles are used to inject the sclerosing product.
Sclerotherapy or sclerosis is the safest technique because it is the least invasive for treating varicose veins. It does not require convalescence or post-treatment care and gives little or no discomfort.
Surface sclerotherapy is used when it is possible to treat visible veins by simple injection without ultrasound guidance. However, the doctor must have ensured that they are not fed by leaks (reflux) from deeper veins using a Doppler examination.
This treatment consists of injecting a sclerosing agent into the vein to be treated. This sclerosing agent can be in liquid form (for smaller veins) or foam (for larger varicose veins). The treatment takes about 10 to 20 minutes and doesn’t require any special care. Depending on the extent of the varicose problem, the treatment may need to be repeated and the same vein may require several injection points along its path.
The sclerosing agent causes irritation of the inner wall of the diseased vein. Its diameter will thicken and become blocked. It will then turn into a fibrous and hard cord called sclerosis. The vein will decrease in volume and disappear. The blood that circulated there then takes the path of the normal veins.
Used in large dysfunctional vessels, the sclerosing foam is effective in controlling the disease’s progression. Its advantage is that it is less invasive and less costly than other endovenous techniques.
Echosclerosis uses an echo-Doppler device to facilitate the identification of leakage points, venous insufficiencies and links between different vascular structures. This device allows us to confirm the intravascular presence of the sclerosing agent during injection and to monitor its progress.
To improve the safety and precision of the injection, especially if the vein is not easily accessible or visible, this treatment is done under ultrasound control (echosclerotherapy or ultrasound-guided sclerotherapy). For the treatment of saphenous veins or their recurrence, ultrasound guidance is mandatory and the recommended sclerosing agent is the foam (if there are no contraindications).
Post-treatment care is minimal and requires only avoiding high physical exercise for a few days. Therefore, no convalescence (work stoppage) is necessary. Treated veins may be sensitive to palpation, but this is usually well tolerated.
OTHER ENDOVENOUS TECHNIQUES
Endovenous techniques such as laser, radiofrequency, cryotherapy and glue injections require more elaborate preparation and are more invasive. They, therefore, have the potential to cause greater complications, convalescence, and pain. Usually reserved for very large veins, these techniques are also more expensive.
SURGICAL TREATMENTS FOR VARICOSE VEINS
Surgical treatments such as ligation, stripping, phlebectomy are nowadays considered as treatments of last resort, as they are much more invasive and therefore likely to create more serious complications. The decline in these treatments has also allowed us to observe a high rate of recurrences, which will then be more difficult to treat.
To learn more about varicose veins treatment in Montreal, Sherbrooke, or Val-d’Or, do not hesitate to contact us to book a consultation with Dr. Bernier.