Varicose veins or spider veins? It is important to know their differences in order to apply the healing technique that suits each of them.
From Wizards we are talking to the doctor Enrique Puras Mallagray, Head of Angiology and Surgery Service Vascular Clinic of Olimpia Quironsalud and University Hospital of Quironsalud of Madrid, to shed light on this disease.
The expert explains to us that “among the risk factors that are associated with the appearance of varicose veins are age, gender, family history of varicose veins, obesity, pregnancy and previous phlebitis of the legs. There are also environmental or behavioral factors associated with this pathology, such as occupations that require prolonged standing.”
And he adds: “It is important to highlight that genetics plays a very important role in susceptibility to varicose veins, and if there is a family history of varicose veins, both men and women are at greater risk of developing them. Statistics say that if both parents have varicose veins, the likelihood of having an offspring with this problem exceeds 80%.”
In general, the doctor assures, Women are more likely to suffer from varicose veins than men..
“Varicose veins are more common during and after pregnancy due to hormonal changes, increased pressure in the pelvic veins and greater volume of circulating blood. Pregnancy is undoubtedly the main cause of pelvic varicose veins, a pathology that ranks second in the percentage of causes of chronic pelvic pain after endometriosis.”
“Women can also develop varicose veins associated with oral contraceptives or other hormonal medications, and this is more related to the appearance of telangiectasias or spider veins,” he says.
Enrique Puras Mallagray, Head of the Department of Angiology and Vascular Surgery at Olimpia Quironsalud and the Quironsalud University Hospital of Madrid
But, ¿dWhat are varicose veins and what types of varicose veins are there?
Varicose veins are superficial dilated veins that gradually become more tortuous. This eventually leads to chronic venous insufficiency, which is a spectrum of diseases ranging from simple telangiectasia or reticular veins to, in later stages, fibrosis of the skin, the appearance of terrible venous ulcers.
The main clinical signs of this venous insufficiency are dilation of the leg veins, swelling, pain in the legs and chronic changes in the skin of the legs.
Why are they formed?
The veins of the lower extremities are divided into superficial, deep and perforating veins. The superficial venous system is located above the muscular fascia. It consists of an interconnected network of veins, including the internal saphenous vein and external saphenous vein, as well as several accessory veins that can develop pathology contributing to venous insufficiency.
The deep venous system is located under the muscular fascia. The deep veins of the lower extremities are formed by axial veins, running along the main arteries, and intramuscular veins, which include venous sinusoids and plexuses. Perforating veins pass through the anatomical fascial layer and connect the superficial venous system to the deep venous system.
Valves inside the veins are necessary to ensure that blood flows in the right direction, especially when standing.
The return of venous blood to the heart is facilitated by muscle contractions that pump blood through the venous system with low resistance.
The vein valves open during systole and close during diastole to prevent retrograde blood flow.
In one contraction, the gastrocnemius muscle can empty 40 to 60% of the blood volume in the leg, which can reduce venous pressure by less than 70 mmHg. Art. in just a few steps.
Primary venous reflux can occur in any superficial or deep vein of the leg, but is more common in the former. Over time, dilation of the veins prevents the valves from properly coapting, causing blood reflux.
Reflux can further distort the venous structure and lead to progressive enlargement and varicose veins. The perforator vein system, connecting the superficial and deep veins, is also part of the valvular structure and can act as a hidden source of increased venous pressure.
What complications can arise if they are not treated on time?
Varicose veins, if not treated properly, can lead to serious complications. Some of the most common include:
Venous ulcers: Increased pressure in the affected veins can cause ulcers to form on the skin, usually near the ankles. These ulcers can be painful and difficult to treat.
Superficial vein thrombosis: In some people with varicose veins, blood clots may form in the superficial veins, known as superficial vein thrombosis. This may cause swelling, redness and pain in the affected area.
Deep vein thrombosis (DVT): Although varicose veins are less common, they can increase the risk of developing deep vein thrombosis, which leads to the formation of blood clots in the deep veins. This condition can be serious and potentially dangerous if blood clots travel to the lungs, causing a pulmonary embolism.
Hemorrhage, also known as varicorragia: Enlarged varicose veins can rupture, causing bleeding. Although this is not common, it can happen and may require immediate medical attention.
Skin changes: The accumulation of blood in the affected veins can affect the nutrition of the skin, leading to changes such as dark pigmentation or discoloration, inflammation and thickening of the skin.
Restless legs syndrome: Some people with varicose veins may experience discomfort, itching, or tingling in their legs, known as restless legs syndrome.
Infections: Open venous ulcers can increase the risk of infections of the skin and surrounding tissue.
Another issue to consider, especially in very elderly patients or those with other serious medical conditions, is that not all people with varicose veins develop complications, and many can manage symptoms through lifestyle changes and medical treatment.
If you have varicose veins or are at risk, it is important to consult with a vascular specialist to receive specific recommendations for your situation and receive appropriate treatment.
Previously, veins were removed surgically with all the ensuing complications, what are the new solutions and new methods?
In recent years, the treatment of varicose veins has developed very quickly. To summarize, we can say that modern techniques have allowed us to treat all patients effectively and with minimal aggression.
Depending on the severity of the condition, there are different techniques. In the mildest cases, sclerotherapy is used, which consists of introducing a sclerosing composition into an emulsion of CO2 microbubbles, which damages the inside of the vessel and ultimately leads to its closure through an inflammatory process.
For patients with more complex varicose veins, thermal removal with laser or radiofrequency is chosen. In these cases, a catheter is inserted under local anesthesia, which, guided by ultrasound into the varicose vein, delivers enough energy to damage the structural proteins of the vascular wall.
Due to the heat emitted by the laser or radiofrequency pulses, the vessel closes, as a result of which varicose veins disappear.
The most important thing is to be able to have all these systems and choose which one is most suitable for each patient, being able in many situations to combine any of them in one treatment session.
All these methods are completely outpatient and allow the patient to lead a completely normal life from the first day. The relapse rate after treatment with these technologies is almost zero.
Are there any exercises that can be done to prevent it from occurring or staying there?
Impaired pumping function of the gastrocnemius muscles plays a significant role in the pathophysiology of venous insufficiency.
Exercise that targets lower extremity muscle strength and ankle mobility, as well as physical therapy, can improve overall mobility, promote weight loss, strengthen the calf pump, and increase ankle range of motion, all of which promote venous return. .
Compression therapy is recommended at all clinical stages of varicose veins. The goal is to provide gradual outward compression. A variety of compression systems are available, such as graduated elastic compression stockings, multi-layer bandages, and other Velcro compression garments.
Treatment with a compression stocking should provide a significant reduction in pain, swelling, skin pigmentation, activity and well-being over long-term use. Using topical moisturizers, often with lanolin, can help reduce the cracking and brittleness associated with dryness.
What procedures will help get rid of spider veins?
Spider veins, also known as telangiectasias, are small dilated veins located near the surface of the skin, usually on the legs, but they can also appear in other areas.
Although they usually do not cause serious medical problems, most people choose to treat them for cosmetic reasons or to relieve minor discomfort.
The most common treatment options for spider veins are:
Sclerotherapy: This is one of the most common treatments for spider veins. It involves injecting a sclerosing solution into the affected vein, causing the vein to close and eventually disappear. This procedure is performed in a doctor’s office and does not require anesthesia.
Laser: Laser therapy uses intense light to heat and close the affected vein. This approach is effective for treating small reddish spider veins and may not be as effective for larger veins. Multiple sessions may be required to achieve optimal results.
It is important to note that the choice of treatment will depend on several factors, such as the size and location of the spider veins, as well as the patient’s preference. Additionally, results may vary and in most cases multiple treatments may be required to achieve the desired results.