Varicose Veins

The term varicose veins (varicosis) comes from the Middle High German word "Krummadern", which means crooked, winding veins. However, a varicose vein (varice) is not only a winding vein, but also a dilated vein that is impaired in its function.

Who gets varicose veins?

A major cause of this condition is hereditary connective tissue weakness with weakening of the vein wall and vein valves. This disrupts the return flow of blood to the heart in the superficial or deep veins. This condition is mainly exacerbated by obesity, prolonged standing in certain occupations, pregnancy and lack of exercise. Approximately one in two Europeans between the ages of 25 and 74 have varicose veins (varicosis).

What symptoms do varicose veins cause?

Varicose veins themselves do not cause any symptoms or pain. However, the associated venous circulation disorder can cause swelling in the legs, which may manifest itself in a feeling of tension, heavy legs or muscle cramps. Varicose veins are prone to inflammation (varicophlebitis), which can be very painful.

Superficial varicose veins can bleed heavily if injured. However, this bleeding can be stopped by local compression.

What causes leg swelling?

Varicose veins have valves that are unable to close or are even destroyed as a result of overstretching. This reverses the blood flow: it flows towards the foot instead of towards the heart. There, other veins have to collect and transport the additional blood, which also overloads their muscle-vein pump. The lower part of the leg swells.

In cases of severe venous reflux and a strong tendency to swell, chronic skin changes can occur over a period of years, leading to what is known as an 'open leg' (ulcer cruris).

What can be done about varicose veins?

A distinction is made between surgical and conservative treatment methods. The method used depends on various factors.

1. Compression therapy: External compression creates a counterforce for the muscles, which improves the pumping action of the muscle-vein pump. This is achieved with the help of compression stockings, which must be individually fitted and worn daily.
2. Sclerotherapy: Injecting a sclerosing agent into the varicose veins causes artificial inflammation of the veins, which leads to a connective tissue transformation of the varicose veins. They become completely impermeable. This method is low-risk and causes little discomfort to the patient. It is preferred for side branch and spider vein varicose veins (cosmetic reasons).
3. Surgical treatment: The varicose veins are pulled out using probes (known as stripping) and removed through small incisions in the skin (side branch varicose vein removal, miniphlebectomy). The often-made claim that surgery is useless because varicose veins will reappear anyway is not true. Although the tendency to develop new varicose veins remains after surgery (genetic predisposition), a newly occurring varicose vein rarely reaches the same extent as the previous one.
4. Radiofrequency therapy: A radiofrequency probe (VNUS) is inserted into the damaged vein via a puncture. The varicose vein is obliterated by the heat generated at the tip of the probe.
5. Laser therapy: Here, too, a probe is inserted into the damaged vein after a puncture and the vein is gradually closed.

Which treatment method is the right one?

The type of therapy used depends on the extent of the disease and the affected sections of the vessel. Accurate diagnosis is important here. Based on the findings, the specialist can advise you on whether compression therapy, sclerotherapy, conventional surgery or an endovenous procedure is suitable for you. In many cases, the various treatment methods must be combined.

However, please bear in mind that the tendency to develop varicose veins is congenital. We can therefore remove varicose veins, but we cannot protect you from their recurrence. Regular check-ups are therefore necessary even after successful treatment.