There is a genetic component, but also external factors such as a sedentary lifestyle, being overweight that favor its appearance.
Tortuous and dilated veins that appear more frequently in the legs and feet. Photo: Shutterstock.
Specific, varicose veins represent a major health problem with social and economic repercussions, and that is that more than 40% of the population suffers from some form of venous problems, thrombosis, varicose veins, or vascular spiders.
varicose veins they are a condition almost inherent to the human being. Rarely, they occur in animals. The fact of living upright on our legs means that all our weight falls on them. This conditions an increase in pressure and a difficulty for the blood to return from the feet to the heart. In some people the return is not efficient and the veins are damaged causing the appearance of varicose veins” explains Dr. Luis Izquierdo Lamoca, head of the Angiology and Vascular Surgery Service at the HM Montepríncipe University Hospital, in an interview with Infosalus.
Thus, he explains that the veins carry the blood back to the heart, and inside they have valves that only open upwards and that allow the blood to rise from our legs and prevent the blood from going down again when we are standing. “A defect of unknown origin in the wall of the veins causes those valves to malfunction and not close, so blood pools in the lower veins and causes them to dilate. Those dilated and tortuous veins are varicose veins“, he adds.
Specify here that spider veins, broken capillaries, or telangiectasias are the different denominations by which the annoying and unsightly bluish or red vessels that appear on the thighs, knees, or calves are known, and what are the first degree of venous insufficiency. “They’re like varicose veinsbut limited to the veins of the skin,” he adds.
But why do they appear? The head of the Angiology and Vascular Surgery Service at the HM Montepríncipe University Hospital stresses that there is a clear genetic component, but also external factors such as a sedentary lifestyle, being overweight, work activities that involve a lot of time standing or sitting, especially in hot environments.
“The female sex, due to hormonal issues and pregnancies, also increases the risk of having varicose veins. They appear at any age, but the longer our legs are exposed to the above risk factors, the greater the risk of developing them. Thus, as the years go by and therefore age increases, so does the prevalence of varicose veins“, Remarks this expert.
Specifically, it details that chronic venous insufficiency, as the disease from which varicose veins they are a manifestation, they have different phases; the initial one being spider veins, a fundamentally aesthetic problem. He says that varicose veins Obvious and bulky are grade 2, and when they are accompanied by swelling of the leg or ankle, we already consider them grade 3.
“Later on, the skin begins to damage and darken on the ankles, which would be grade 4; and when a wound is produced on that damaged skin and it is slow to heal, it becomes an ulcer, which is the most advanced grade, 6. We reserve grade 5 for patients who have had an ulcer and it has been able to heal,” adds this vascular angiologist.
With this, he emphasizes that, in the initial phases, when they are spider veins, they generally represent an aesthetic problem, although they are the first sign of disease, so, without being alarmed, it is advisable to visit the specialist in Vascular Surgery who will say how our venous system is, will advise how to eliminate them if that is our wish and what measures we can take so that the disease does not progress. “When skin lesions begin to appear, the damage is already irreversible, therefore, varicose veins should be treated before that happens,” he adds.
He says that any time is good to treat them, although varicose veins and its symptoms worsen with heat, and sometimes the use of stockings is recommended in treatments, which are usually better tolerated in winter.
How to treat them?
Thus, Dr. Luis Izquierdo Lamoca indicates that the classic treatments that continue to be used in many centers are surgical removal of varicose veins and the main veins. “In traditional treatments, the shafts of the saphenous veins are destroyed by stripping or thermal ablation. The saphenous vein is the one that vascular surgeons generally use to perform bypass grafts for the heart or legs. Many surgeons prefer to keep them, since that the same or better long-term results are achieved”, he adds.
In his opinion, he highlights that today the most effective treatments for the treatment of varicose veins they are endovascular techniques, such as endolaser or radiofrequency; because both use thermal energy, produced by light or electricity respectively, to cauterize the walls of the vein from within and thus eliminate varicose veins.
He also mentions glue, inserting a cyanoacrylate adhesive into the vein and compressing it, causing its walls to stick. But even in the latter case, he warns that, to reach the vein to be treated, the laser or glue must be introduced with a catheter, through a puncture or incision. “This requires an anesthetic and also a sterile environment, that is, an operating room. Therefore, a preoperative period is required and, as in any surgery that invades our body, even minimally, there is a risk of bleeding and infection,” he warns.
With this, the head of the Angiology and Vascular Surgery Service of the HM Montepríncipe University Hospital highlights that the most recent treatment is EchoTherapy or echotherapy with Sonovein, which uses high-intensity focused ultrasound (HIFU).
Among its advantages would be that it is a technology that is already used in other fields such as the treatment of thyroid nodules, in breast cancer, or in neurology in the treatment of essential tremor in Parkinson’s. “The device that is totally extracorporeal, that is, it does not invade the patient’s body, has a component that is the display and treatment unit, and, on the one hand, an ultrasound machine that allows visualizing the vein in real time. On the other On the side, it indicates that it has a built-in HIFU high-intensity focused ultrasound emitter.
“Using the ultrasound machine, the target varicose vein or vein is located and, in a completely robotic way, a concentrated ultrasound beam is emitted at a point in a similar way to how a magnifying glass does light. In this case, the point is the vein to be treated, producing a rise in temperature, so that the affected vein contracts, is destroyed and closes”, he adds.
Being guided by ultrasound and being robotized, he appreciates the fact that it is also capable of following practically any venous path, even the most tortuous veins, regardless of size and mode. “Veins that are very difficult to access with other techniques, such as perforator veins, can also be treated, even in the presence of an open ulcer, without risk of infection. As it is so precise, it allows treating only the diseased areas while preserving the main veins” , Add.
Likewise, Dr. Izquierdo points out that, unlike previous treatments for varicose veins, this one does not require catheters, chemical injections or incisions, which means that patients do not need an operating room or a preoperative procedure, they do not have scars or risk of infection. , or bleeding, and can immediately return to their normal daily activities. “It can be done, for example, in patients who take anticoagulants because they do not have to suspend them, or patients of any age with previous pathologies that were dismissed for treatment of varicose veins due to their high operative risk,” he says.
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