What are varicose veins?

What are varicose veins? Is it worth it and how to treat them properly? Are they dangerous? Are they only found on the legs? Is it the right thing to do to start by treating veins on the legs? Do varicose veins lead to venous thrombosis? Why do varicose veins so often return after surgical treatment?

These are some of the more common questions that our patients ask us in the practice. Below is the answer, comments Dr Cezary Szary, phlebologist.

Varicose veins are dilated subcutaneous vessels with a tortuous course in which the blood flows in the opposite direction than it should. Sometimes the blood even stops there and can clot because of this. When standing or sitting, as well as during physical exertion, they become overfilled with blood and significantly dilated. Varicose veins usually arise as a result of local or systemic (overall) overload of the venous system.

It is important to remember that a varicose vein is only OBJECTIONand not DISEASE itself. This is often forgotten not only by patients, but also by doctors. A varicose vein is simply a type of collateral circulation, a mechanism that discharges increased venous pressure in the vascular system. Varicose veins can actually occur anywhere, and are most commonly found on the legs, in the pelvis (varicose veins of the uterus or vagina) or in intimate areas (varicose veins of the perineum or vulva in women). The occurrence of varicose veins, one of the more sepctacular symptoms of venous disease, always requires a Doppler ultrasound diagnostics.

Perhaps the most common myth is that varicose veins are a matter of genetics and only an aesthetic problem. Another untruth is the information often given by doctors to women that they should only be treated after all the children have been born. Another untruth is the information that they are not worth treating because they always come back. This is actually the case if we treat the symptom (varicose or spider veins!) and not the venous insufficiency that leads to their formation.

Here it is worth mentioning the topic of recurrent varicose veins. It is a somewhat historical and vague term already, the use of which has led to many misunderstandings. The reappearance of varicose veins on the legs, after a previously performed intervention, indicates an incorrect approach to the treatment of venous insufficiency as a disease or an inability to find the causative factor leading to increased pressure in the venous system.

As our practice shows, the correct diagnosis of the problem of venous insufficiency of the lower limbs, very often in the course of pelvic venous insufficiency, allows the patient to be cured permanently and effectively. The problem of recurrent venous disease is usually a multifactorial issue. Our role (phlebologists) is to look for all the causal factors and not be content to say that it is a "problem inherited from mum".

This approach to the subject of venous disease led to a situation where, over the years, we did not examine our patients well enough and the methods used were not very effective. They were, however, effectively duplicated by successive generations of doctors. The development of modern imaging and Doppler diagnostics opened our eyes. We have begun to better understand venous diseases and the principles of hydraulics that govern them, expertly referred to by doctors as the principles of haemodynamics," adds Dr Cezary Szary.

The most important tips for patients who want to take proper care of their veins are:

1. Early diagnosis of venous disease (initially, correctly performed Doppler ultrasound of the abdominal, small pelvis and lower limb veins);
2. In case of significant deviations on Doppler examination, appropriate planning of extended diagnostics (e.g. magnetic resonance venography);
3. Making a proper, maximally causal diagnosis;
4. Selecting an appropriate treatment regimen (preferably causal) in relation to the patient's clinical condition or life plans (e.g. pregnancies in the case of women), financial possibilities, way of working, etc.
5. Correcting the patient's habits, the type of exercises performed, selecting compression therapy (distant prophylaxis) or prescribing follow-up after the implemented treatment.

#flebologistwarszawa #flebologist #cezaryszary #justynawilczko #tomaszgrzela #zdrowezyly #phlebology #Health