What is the deal with varicose and spider veins?
What are varicose veins? What causes them? Are they harmful or just annoying? Dr. Zachary Pallister, Baylor vascular surgeon, treats these and other vascular conditions. He explains that chronic venous insufficiency (which can lead to varicose and spider veins) happens when valves in the veins in the legs allow blood to pool down to the feet instead of pushing to the heart.
“These one-way valves in the veins are supposed to be like a trap door to prevent the blood from going backward,” Pallister explains. “But over time, these valves can become weakened or damaged and stop working correctly. As a result, blood collects in the veins and causes uncomfortable symptoms.”
Varicose veins are not considered a severe medical condition but can be uncomfortable and be a cosmetic concern to patients. Some patients worry about deep vein thrombosis when they have varicose veins, but Pallister says the two are usually not related.
Patients often complain that their legs feel tight or heavy and sometimes notice swelling, fatigue and burning pain. Varicose veins are enlarged, visible through the skin and look like blue or purple twisted knot-like cords. Spider veins are a milder type of varicose veins that look like a sunburst or spider web just under the surface of the skin.
Varicose veins are caused by genetics, prolonged standing and sometimes pregnancy. Treatment for varicose veins includes non-surgical and surgical options. “We do try non-surgical approaches first, like avoiding putting strain on the legs and wearing compression stockings,” says Pallister. “Unfortunately, there are not great FDA-approved medications to alleviate symptoms.”
If the non-surgical approaches are not effective, a patient may have surgery. These procedures typically take under 30 minutes, use only local anesthesia and allow patients to go home the same day and return to work the next day.
“The procedure we do typically is greater saphenous vein ablation,” says Pallister. “This involves poking a hole just below the knee and placing a special device called an RFA catheter to heat the vessel from the inside, which causes it to scar and close. The body then uses other vessels that still work.”
By Tiffany Harston, communications specialist in the Michael E. DeBakey Department of Surgery
