Varicose veins: Diagnosis and therapy from a single source
Introduction
The human vascular system consists of arteries and veins. The term "artery" is often used for arteries because the arteries become more visible than the veins due to the pulse. They transport the oxygen-rich blood from the heart into the body and supply the tissues with oxygen.
The used blood is returned to the heart more quietly and slowly by the veins. Veins have to work very hard because they are fighting against gravity. In adults, blood is returned to the heart against gravity over a distance of about 1.5 meters. The venous-muscle pump contributes to the blood supply to the heart. When we move, the skeletal muscles compress the venous vessels, causing the venous blood to move towards the heart. The closed inner walls of the veins ensure that the venous blood flows back unhindered.
The venous valves in the veins serve as check valves. There are connective tissue pockets every 8 to 10 centimeters on the inner wall of the veins. They ensure that the venous blood no longer flows back (following gravity). If the venous valves are weak or defective, varicose veins (varicosity) develop.
There are four different venous systems that are closely adapted to the body's function:
leading veins (deep position)
trunk veins (on the muscles)
side branches (in the subcutaneous fat)
reticular (located directly under the skin)
varicose veins
Veins, regardless of their diameter, are sensitive and have thinner connective tissue than arteries. These have to withstand the pumping power of the heart. The connective tissue of a vein has less strength in the area of the venous valves than in between them.
At the points between the venous valves, the connective tissue expands and gives way. On the way back to the heart, the amount of venous blood remains unchanged, filling the dilations and expanding them. The diameter of the vein increases, which means that the venous valves no longer close properly.
The weakness of the vein walls is often genetic and mainly affects women. It accounts for 95% of varicose veins. In medical terms, this corresponds to primary idiopathic varicosis.
Secondary varicosis is caused by deep vein thrombosis. The blood flows past the closure of the vein through the superficial venous system. This accounts for a total of 5% of cases.
The result is vein inflammation and skin discoloration, which can develop over the years. In addition to the visible symptoms, patients often feel "heavy legs" and a tingling sensation. If left untreated, small spider veins can become painful varicose veins.
Normal
varicose veins
Diagnostics
We radiologists use ultrasound to diagnose vein insufficiencies. The sound waves hit different tissues and reflect the reflection as an image. Doppler sonography also records the blood flow.
Color-coded Doppler sonography shows blood flow using red and blue colors. This enables us to distinguish veins from arteries, interpret the shape of veins, and measure blood flow.
We also look at the inner walls of the vessels. This provides a clear picture for assessing the individual risk of varicose veins or the severity of the disease.
The examination usually takes no more than 15 minutes and is carried out while standing. The examination is painless and no harmful radiation is used.
Therapy
As a private practice for vein medicine in Vienna, we specialize in minimally invasive catheter treatments for varicose veins and spider veins. These do not result in scars or cuts and enable gentle and almost painless treatment.
First, the affected vein is visualized using ultrasound. Then a laser probe catheter is inserted into the great saphenous vein through a small skin incision.
As the probe is withdrawn, we activate the laser, which damages the vein wall and causes it to stick together. This closes the vein and the blood flow is taken over by surrounding healthy veins
We locate the veins precisely using a special light source and apply a sclerosing agent using a special needle. This irritates and sticks together the inner wall of the vein (intima). The treated vessels stick together from the inside, close and are broken down by the body within a few weeks. This results in an attractive cosmetic result.