Varicose Veins

Medically reviewed by Dr. Rohan Parab, M.D,  FRCPC (Diagnostic Radiology), FRCPC (Interventional Radiology)

What are Varicose Veins?

Varicose veins are bulging, twisted veins visible beneath the skin. Varicose veins are a manifestation of an underlying venous condition known as chronic venous insufficiency (CVI) and are most often seen in the lower extremities (legs and ankles).

What Causes Varicose Veins?

Varicose veins are caused by venous hypertension, which is the result of prolonged venous insufficiency. Venous insufficiency occurs when vein walls or one-way valves weaken or fail.

Blood that typically flows through the valves from the body’s periphery to the heart now flows in both directions. This backwards flow of blood is known as venous reflux and can lead to pooling and accumulation of blood in the extremities.

Usually, the blood will pool in the lower extremities as it has a harder time fighting gravity on its way back to the heart. Pooling blood increases venous pressure, hypertension and further weakens veins – compounding in a downward spiral.

If left untreated, venous pressure and CVI can lead to additional symptoms such as swelling in the lower extremities and more varicose veins.

What Factors Lead to Valve Failure and Venous Reflux?

Four factors mainly impact valve damage and reflux:

1. Heredity: family history is strongly associated with chronic venous insufficiency (CVI).
2. Gender: estrogen and progesterone can weaken vein walls, leading to reflux and enlarged veins.
3. Pregnancy: blood volume and hormone production increase during pregnancy, contributing to vein enlargement.
4. Age: vein walls lose elasticity over time, increasing the likelihood of valve failure or reflux.

Additional factors correlated with CVI that can speed up vein disease:

1. Prolonged standing: occupations or hobbies that require standing for an extended period can cause increased volume and pressure of the blood in the lower extremities due to gravity.
2. Obesity: central obesity is strongly associated with intra-abdominal pressure from fat which may worsen vein problems.
3. Hormone levels: treatment like birth control pills or postmenopausal hormone replacement may contribute to vein enlargement.
4. Physical trauma: any damage to the lower extremities can also impact blood vessels and add to the problem.

Venous insufficiency is typically the result of hypertension. Occasionally, obstructions (blood clots) in the deep veins of the legs, known as deep vein thrombosis (DVT), can also lead to chronic venous insufficiency (CVI).

Research conducted by the Cleveland Clinic (2019) shows that as many as 30 percent of people with DVT will develop CVI within 10 years after their diagnosis.

Varicose Vein Assessment at MIC

The first step in assessing varicose veins is talking to your physician and obtaining a requisition to book an appointment with our team.

When you arrive at MIC for your assessment, our team will start with an ultrasound scan. We will examine the area of interest and your veins.

If we identify venous insufficiency, the next step is a consultation with one of our interventional radiologists.

During this consult, we will identify if any of our minimally invasive treatments are a viable option, and if so, which one is the best fit.

Varicose Vein Treatment at MIC

MIC offers three different types of treatments for venous insufficiency: ultrasound-guided sclerotherapy, radiofrequency ablation, and Venaseal^TM. All three methods are minimally invasive and typically scheduled within three to six months after an assessment.

 Learn more about our varicose vein treatment options:

1. Ultrasound-guided Sclerotherapy
2. Radiofrequency Ablation
3. Venaseal^TM

Varicose Vein Symptoms

Sometimes, patients might not experience any symptoms of varicose veins, or they may be very minor. Minor symptoms are usually cosmetic; veins appear twisted and bulging like cords on your legs.

However, depending on the patient, some might experience more serious or painful symptoms. More serious symptoms include:

• Sensations such as throbbing, burning, or achy feeling in the legs
• Swelling of the lower extremities
• Skin discolouration or a rash around the varicose veins
• Dry, thinned, itchy skin
• Pain or discomfort at the end of the day, after sitting or standing for long periods
• Skin tissue problems such as ulcers or sores on the legs

Patients with varicose veins may find some relief by elevating their feet after a long day. Patients must talk to their healthcare provider to obtain a proper diagnosis. Sometimes varicose vein symptoms may resemble other conditions and, on rare occasions, can lead to complications.

How to Prevent Varicose Veins

If you are looking to reduce your risk of developing varicose veins, you should focus on self-care and improving circulation in your legs. Self-care is particularly important during times of your life when you might experience hormonal fluctuations such as pregnancy.

The following steps can help reduce your risk to some extent:

• Use compression stockings to improve circulation
• Avoid long periods of standing or sitting
• Maintain a balanced diet – high in fibre and low in salt
• Exercise regularly (walks, biking, stairs etc.)
• Elevate your legs at the end of the day
• Quit smoking

Spider Veins

Spider veins are small clusters of red, blue, or purple superficial veins found just beneath the skin. The veins are often clustered in a weblike network and get their name from the discolouration pattern. Generally speaking, spider veins are harmless and only cause a cosmetic nuisance.

Spider Veins vs. Varicose Veins

While both conditions can cause discomfort and irritation, varicose veins are a medical condition resulting from chronic venous insufficiency (CVI). Spider veins are a cosmetic condition linked to many factors, including genetics and hormonal fluctuations. Varicose veins look like twisted ropes bulging above the skin, while spider veins look like delicate purple/blue clusters beneath the skin