Valves and their importance – Treatment of varicose veins

Veins play an essential role in the body. Veins carry blood from legs to the heart. Valves in veins are a flap-like structure that regulates and maintains the direction of the blood flow throughout the body. The valves’ main job is to keep the blood moving in the correct path that is towards the heart and stop the blood from flowing in the opposite direction. 

Damaged veins valves 

Damaged veins valves can occur due to a variety of reasons, and it may be due to – 

  • Ageing
  • Obesity 
  • Hereditary factors 
  • Pregnancy 
  • Any injury 
  • Medical condition (varicose veins, etc.)
  • Sitting or standing for a prolonged period.

Damaged valves can cause increased venous pressure in the leg, causing the leg to swell and feel heavy. This condition is known as venous insufficiency. It causes the blood to pool up in the leg veins and therefore, predisposes the patient to have clots in the veins (Deep vein thrombosis). This can prove to be life threatening if the clots travel all the way up to the lungs.

Damaged valves in the veins cause increased pressure over the venous walls and therefore, these veins swell up and become tortuous. These are called varicose veins. 

How do I know that my valves are damaged?

People keep asking me how to know whether my venous valves are damaged, so that I can take medical help to prevent it from getting worse and causing severe venous disease symptoms. 

As a vascular surgeon, I’m mentioning a few signs and symptoms so that you can identify if your valves are getting damaged.

Signs & symptoms:

  • Heaviness in the legs 
  • Swelling in the lower leg or ankle, especially after standing for a long time
  • Aching or tiredness in legs
  • Non healing ulcer 
  • Itching in legs
  • Pain in legs 
  • Discolouration of leg especially near the ankle

One of the most common symptoms of damaged veins valves is heaviness and tiredness in legs. It can be felt especially after walking or standing for a longer period. 

As the venous disease keeps on worsening, clinical features also keep on evolving. Fluid may collect in your lower legs or ankles, and it can cause swelling in the legs. Your skin may appear discolored, and skin above the ankles and legs becomes thin. 

If these symptoms are ignored and left untreated, it can lead to an open wound or ulcers that are non- healing and can form a venous stasis ulcer.

If you notice any of these symptoms, you might very well suspect venous insufficiency. You should consult a doctor immediately.  

What is the treatment?

Currently, modern methods to treat varicose veins are so easy and so successful that even after a surgical / interventional treatment, you can walk the same day and go to work the next day

Non-Surgical Treatment 

  • Compression stockings give relief from these signs and symptoms.
  • These stockings also aid ulcer healing.
  • If superficial veins are affected, then they may be treated through injection or vein ablation (laser / glue).
  • In severe cases, angioplasty and stenting may be recommended if deep veins are affected.

Venaseal 

In the vena seal process, a medical adhesive which is a type of thin glue will be injected inside your veins through small hole in the skin. This vena seal vein glue helps to seal or close the vein. 

During the procedure, a continuous compression is applied on the leg. Venaseal method closes the damaged vein and encourages blood flow to other areas. 

Radiofrequency Ablation (RFA)

In this RFA procedure, radio waves are used to close the damaged veins. 

During this procedure, the heat produced by radiofrequency is transmitted to the vein wall by using a thin and flexible tube called a catheter, this stops the blood from flowing in a damaged vein.  

 Sclerotherapy 

In this procedure, a liquid chemical solution is used to seal the varicose veins. 

Endovenous Laser Treatment (EVLT)

In EVLT, laser heat is used to close and treat varicose veins. 

The procedures mentioned above take only a small amount of time. Patients may feel minimal discomfort during the above-mentioned procedures. After the treatment, the majority of patients can go back home and resume their day to day routine.  These procedures can be done under Local anaesthesia and may not require even a single suture. 

Angioplasty

It is an interventional procedure that helps to open the blocked blood vessels that carry blood from the legs to the heart (deep veins).

This procedure requires a tiny hole on the skin. Doctors will insert a fine tube called catheter or sheath inside the affected artery. 

The narrowed or blocked blood vessels are stretched and opened by using a stent / balloon. The stent is a small mesh tube made of metal that keeps the artery open. This treatment is also used to treat narrowed veins which are deep inside close to the bone of the lower legs and are the main blood vessels responsible for carrying the blood back to the heart.  

Superficial Venous Surgery

Superficial Venous Surgery refers to the procedure that usually involves stripping or tying off the affected veins. Very few conditions in today’s world are there in which, we need to do a surgery and not EVLT/RFA/Venaseal as mentioned above. 

How to manage varicose veins medically?

  • Exercise daily
  • Maintain a healthy weight
  • Try to avoid standing or sitting for more extended periods 
  • If you have diagnosed varicose veins or spider veins, don’t neglect the state and consult a vascular surgeon before it gets late. 
  • Take good care of your leg – keep it clean and moisturize it at least twice a day. 
  • Wear stockings regularly as advised by your Vascular Surgeon

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