Beneath the Surface: Managing Varicose Veins

The recommended method for investigating leg varicose veins is a venous duplex ultrasound in the standing position, performed by a specialist trained in ultrasonography (Whiteley, 2022). At Guaynabo Vascular Specialists, your doctor will collaborate with your general practitioner or other healthcare providers to gather a comprehensive health history, discussing symptoms, family history, lifestyle, and activity level. In addition to a physical exam, diagnostic tests may include:

• Duplex ultrasound: Combines doppler and conventional ultrasound to create a two-dimensional, moving image of blood vessels in the legs.
• Magnetic Resonance Venography (MRV): An advanced MRI technique that uses magnetic fields and radio waves to visualize blood flow, identifying deep-seated obstructions and abnormalities within the veins.
• Computed Tomography Venography (CTV): A specialized CT scan that uses X-rays combined with contrast dye to create detailed images of blood vessels, mapping blood flow patterns and highlighting any blockages in the legs.
• Conventional Venography: An imaging technique using X-rays and contrast dye to visualize vein structures, allowing for the detection of pooling, blockages, and abnormalities within the venous system.

Early treatment is most effective, making prompt diagnosis essential. Although VV is a chronic condition that cannot be fully cured, there are numerous treatment options to help manage it. According to Whiteley (2022), patients with varicose veins who pursue treatment experience greater improvement compared to conservative approaches like venotropic drugs. This underscores the value of active interventions, which can significantly alleviate symptoms and potentially prevent complications associated with varicose veins.

• Lifestyle changes: Avoid long periods of sitting or standing. Move every 10 minutes within each 30-minute period during waking hours. Elevate your legs above your heart while resting, and maintain regular exercise. Diets rich in fruits and vegetables such as grapes, blackberries, avocados, ginger, and rosemary are also beneficial (Gawas et al., 2021).
• Weight loss: Incorporate moderate exercise as recommended by your doctor, and create a weight-loss plan if needed.
• Compression: Compression stockings are a mainstay in managing varicose veins and are effective in alleviating symptoms related to venous ulcers (Gao et al., 2022). These stockings apply graduated pressure to the legs, promoting blood flow and reducing discomfort and swelling. The benefits of compression therapy also extend to reduced postoperative pain and faster recovery when used after procedures like endovenous thermal ablation. Patients are typically advised to choose thigh-length stockings for better management of conditions affecting the main axial superficial veins.
• Nonsurgical treatments: Sclerotherapy is a simple, in-office procedure involving the injection of a solution directly into the veins, reducing pain in the feet, ankles, and legs, and improving skin appearance. Endovenous thermal ablation, using laser or radio waves, is another nonsurgical option with minimal bleeding or bruising.
• Surgical treatments: In cases where surgery is recommended, options may include ligation and stripping, microincision/ambulatory phlebectomy, or vein bypass surgery. Contact our clinic to discuss treatment options with a vascular surgeon at Guaynabo Vascular Specialists. Addressing varicose veins early can prevent serious complications.

Anyone can be at risk for varicose veins, though studies show they are more common in women, particularly those over age 40, and tend to have a higher prevalence in developed countries (Evans et al., 1999; Carpentier, 2000; Aslam, 2022). Key risk factors include:

• Age: Aging is associated with a higher risk of varicose veins due to weakened leg muscles and decreased flexibility of venous valves (Naoum et al., 2007; Beebe-Dimmer et al., 2005; Homs-Romero et al., 2021).
• Family History: Family history is a strong contributing factor in developing varicose veins, with studies showing significant familial involvement (Hirai et al., 1990; Carpentier, 2000; Cornu-Thenard et al., 1994).
• Occupation: Jobs requiring prolonged standing can increase pressure on leg veins, contributing to varicose veins (Bahk et al., 2012; Bihari et al., 2012).
• Pregnancy: Hormonal changes and increased blood volume during pregnancy raise the risk of varicose veins (Beebe-Dimmer et al., 2005; Golledge & Quigley, 2003).
• Obesity: Higher body mass index (BMI), particularly in females, is associated with an increased risk of varicose veins (Criqui et al., 2003; Beebe-Dimmer et al., 2005).
• Physical Activity: A lack of regular exercise can exacerbate varicose vein symptoms, while regular activity may reduce some risks (Sharif Nia et al., 2015; Klonizakis et al., 2009).
• Genetic Factors: Genetics play a role, with certain hereditary factors linked to a higher susceptibility to varicose veins (Evans et al., 1999; Mellor et al., 2007).

Important: Varicose veins affect approximately 10% of the population, and if left untreated, they can lead to serious conditions such as deep vein thrombosis (DVT) and pulmonary embolism (Gao et al., 2022). Bleeding from a varicose vein is a medical emergency—seek immediate medical attention.

People with varicose veins can lead healthy lives while managing their condition with a range of treatment options, from lifestyle changes to nonsurgical outpatient procedures. For personalized care, visit our clinic in Guaynabo for a consultation with our own vascular specialists.

A vascular specialist can help you explore options to manage your condition, limit further damage, and support overall health. Visit us to discuss treatment options and, if necessary, schedule an intervention with Guaynabo Vascular Specialists.