Understanding Veins

Veins and arteries are everywhere. Arteries are thicker, high pressure tubes that help propel blood and oxygen from the heart to the muscles, organs, and cells of the body. Once that task is accomplished, the blood collects into a network of thinner walled veins for a slow trip back to the heart, and another circuit around the body. When blood collects too long in these thin walled veins, they begin to distend, pooling more blood. When we see large, discoloured clumps of oversized veins, we call them ‘varicose veins’.

Competent Valve

An incompetent (or Leaky) Vein Valve

Venous Valves

The blood that is pumped down to your feet needs a way to get back up to your heart - against gravity. The deeper veins in your legs, the ones winding their way through muscle, can do this by using the 'Skeletal muscle Pump'. As the muscles surrounding those veins contract, they squeeze the blood back upwards to the heart, like tooth paste in a tube. These veins have no valves, because they don't need them.
Veins just under the skin are not surrounded by contracting muscles, so the Skeletal muscle Pump can't work. These veins have one-way valves that allows blood to move upward toward the heart, but stops the blood from falling back down to your feet.

Venous Icompetence

When valves become leaky, the blood that falls through the leaky valves' stands on top' of the next most competent valve beneath it. As more and more blood leaks, the vein gets wider and wider, and eventually the valve flaps can't meet in the middle, causing that valve to fail. That starts the process of failure for the next valve in line. The extra blood that pools in these veins isn't flowing back to the heart, it just distends the veins causing large visible veins, aching discomfort and swelling.

Larger veins

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Normal veins come in all sizes, and so do varicose veins. When most people talk about 'varicose veins', they mean the larger ones that bulge from under the skin. These can be as large as a finger.

These are the type of veins that, in the past, could only treated by surgery ('vein stripping'). Today, the pain and extended recovery associated with surgery can be avoided by Endovenous Laser Therapy (EVLT) which has been shown to be as good or better than surgery, with fewer complications.

Smaller veins

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Varicose changes can also happen to veins that are extremely small, however. These veins are usually within the skin itself, and are under the width of a pencil line. We call these 'Spider veins'. Treatments for larger varicose veins are usually different from treatments for spider veins.

Deciding on treatment

Treatment varies according to vein size, and the severity of the problem.

Smaller veins, ones just within the skin (spider veins) are best suited to sclerotherapy. As the veins get larger, they are harder to treat with sclerotherpy. In the past, larger veins were treated with surgery. While surgery is still an option for larger veins, EVLT offers results that are the same or better than surgery, with fewer complications, and no need for painful, multi-week recovery.
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