What are varicose veins? Varicose means the elongation and torturosities of veins. Generally when we refer to the term varicose vein, we are speaking of the prominent and dilated veins over the lower extremities (on the thigh or leg). Actually, the varicose veins are a common problem which accounts more than 90% of venous surgeries in daily practice of a vascular surgeon.
Initially , the patients of varicose veins will presented with dilated superficial leg veins over the thigh or legs which can be easily seen. The veins may be as small as millimeters or as large as centimeters in size. The symptoms may be mild in the beginning. And if no definite treatment had been done, the disease may progress gradually. Finally, the symptoms may be so severe that we have to consider to put the patient on some sort of surgical treatment in stead of conservative treatment. In adittion , if there are some sort of complication caused by the varicose vein, surgical treatment will be considered seriously.
The common indications for varicose veins are intractable symptoms which interfere the daily life in spite of conservative treatments. The symptoms include leg pain, leg heaviness, burning sensation on leg, swelling of extremities, focal or extensive dermatitis, healed or non-healed venous ulcers, any kind of superficial thrombophletitis, hemorrhage episodes<85>etc. of course, cosmetic concern may be one of the indication of the varicose vein surgery.
After complete and delicate physical examination, noninvasive vascular tests should be done to evaluate if the surgery can be done and how the surgery can be done. The most important is, we have to exclude the possibility of deep vein thrombosis. As all we know, if there is some sort of deep vein thrombosis, then any kind of saphenous vein stripping or ablation surgery cannot be performed. Because disaster swelling due to problem of venous return will be noted if the superficial venous system is ablated and the deep vein system is thrombosed. That is to say, we have to rule out the possibility of deep vein thrombosis prior to the planning of varicose surgery.
Venous duplex mapping is the most important non invasive study for varicose vein stripping. We have to first precisely make the diagnosis clearly by finding any abnormal reflux over the great saphenous vein or lessor saphenous vein. Also we have to decide if there is any incompetence of perforator veins. After the complete veous mapping of the varicose vein has been established, the definite surgical planning can be made. Surgeons thus can decide which superficial vein should be treated and what kind of modality of treatment should be choosed.
Evaluation of Varicose Veins
by Dr. Ko, Po-Jen
What are varicose veins? Varicose means the elongation and torturosities of veins. Generally when we refer to the term varicose vein, we are speaking of the prominent and dilated veins over the lower extremities (on the thigh or leg). Actually, the varicose veins are a common problem which accounts more than 90% of venous surgeries in daily practice of a vascular surgeon.
Initially , the patients of varicose veins will presented with dilated superficial leg veins over the thigh or legs which can be easily seen. The veins may be as small as millimeters or as large as centimeters in size. The symptoms may be mild in the beginning. And if no definite treatment had been done, the disease may progress gradually. Finally, the symptoms may be so severe that we have to consider to put the patient on some sort of surgical treatment in stead of conservative treatment. In adittion , if there are some sort of complication caused by the varicose vein, surgical treatment will be considered seriously.
The common indications for varicose veins are intractable symptoms which interfere the daily life in spite of conservative treatments. The symptoms include leg pain, leg heaviness, burning sensation on leg, swelling of extremities, focal or extensive dermatitis, healed or non-healed venous ulcers, any kind of superficial thrombophletitis, hemorrhage episodes<85>etc. of course, cosmetic concern may be one of the indication of the varicose vein surgery.
After complete and delicate physical examination, noninvasive vascular tests should be done to evaluate if the surgery can be done and how the surgery can be done. The most important is, we have to exclude the possibility of deep vein thrombosis. As all we know, if there is some sort of deep vein thrombosis, then any kind of saphenous vein stripping or ablation surgery cannot be performed. Because disaster swelling due to problem of venous return will be noted if the superficial venous system is ablated and the deep vein system is thrombosed. That is to say, we have to rule out the possibility of deep vein thrombosis prior to the planning of varicose surgery.
Venous duplex mapping is the most important non invasive study for varicose vein stripping. We have to first precisely make the diagnosis clearly by finding any abnormal reflux over the great saphenous vein or lessor saphenous vein. Also we have to decide if there is any incompetence of perforator veins. After the complete veous mapping of the varicose vein has been established, the definite surgical planning can be made. Surgeons thus can decide which superficial vein should be treated and what kind of modality of treatment should be choosed.