The Vascular System

The circulatory system manages and controls the bloodflow around the body. The main parts of this system are the heart, arteries, capillaries and veins.

Blood is pumped from the heart full of oxygen. This is important for the cells in the brain and the body to do their work. The oxygen rich blood travels through the arteries to all the tissues.

The blood then travels back to the heart via the lungs through a system of veins. The lungs remove carbon dioxide and replace the blood with fresh oxygen. Veins are therefore an important part of our overall health in ensuring the blood circulates properly and effectively.

The Venous System

There are two vein systems, the deep and the superficial. The deep venous system is crucial to a healthy circulation. The superficial system works with the deep veins to help drain the blood that returns to the heart. The main superficial veins in the legs are the Saphenous veins.  

Vein Related Problems

The most common venous problems are:

1. Varicose veins 

2. Venous Thrombosis

3. Venous Insufficiency and venous ulcers

Varicose Veins

The leg veins have a challenging task in carrying the blood away from the feet, towards the heart and up against gravity. In an upright standing position, the blood will cumulate in the calves. As you start to walk, the pumping action of the foot (foot pump), calf muscle (calf pump) and the contraction of thigh muscles (thigh pump) will pump the blood up in the deep veins of the legs. Given that 'what goes up, must come down' the blood rushes back down in the veins. There are valves in the veins that open upward allowing the blood to get through, but they should close tightly after to stop the blood from going back all the way down- and this is where things may go wrong!

When the walls of the veins become weak, the vein stretches too much and the valves can no longer reach. So blood rushes back down towards the feet again and pools in the veins causing them to enlarge. These enalrged veins are caused 'varicose veins'. Varicose veins can be visible or could be hidden in the fat. The extent of the problem can only be determined through an ultrasound examination.

Venous blood is oxygen-low and carries toxins. As time goes on, more blood cumulates in the varicose veins, and eventually leaks outisde the vein and the toxins in the blood will 'poison' the skin around the ankles causing pigmentation, eczema and eventually ulceration.

Furthermore, the problem with the varicose veins, which are superficial veins, can eventually cause a problem with the deep veins. The established route for the blood to travel back efficiently to the heart this is via the deep veins. Because the varicose veins cause blood to flow back, the deep veins need to work harder to compensate for the varicose veins and as a result, in some patients the deep veins can become abnormal.

Symptoms and Signs

Several symptoms can occur, especially after prolonged standing or at the end of the day. These include aching, heaviness, throbbing, cramping and restlessness in the legs.

The first signs of venous disease can be the visible spider veins (the tiny thread-like veins) followed by the larger varicose veins. Sometimes swelling can happen, and in severe cases varicose veins can affect the skin, causing eczema, inflammation and possibly ulceration in the lower legs.

Causes of Varicose Veins

Venous disease is common and affects men and women of all ages, however there is not one definitive cause. Family history suggests that some people inherit veins that are more likely to deteriorate.

Women are more likely to suffer from abnormal leg veins. Puberty, pregnancy, menopause and taking oral contraceptives can have an affect on the venous system. During pregnancy hormone levels and the enlarged uterus can restrict blood flow from the legs.

Treatment

There are several treatment options avaiable for varicose veins. As varicose veins serve no useful function they can be closed down without any damage, and this will in fact improve the blood  circulation. Successful treatment will relieve many of the symptoms.

At Sydney Skin and Vein Clinic we offer the full range of treatment options avaiable including:

• Endovenous laser ablation (EVLA)
• Ultrasound Guided Sclerotherapy (UGS)
• Direct vision sclerotherapy
• Ambulatory phlebectomy
• Surgey- if required
• Management of leg ulcers
• Conservative management and compression therapy

It is important to understand that varicose veins can be a progressive condition and that new veins can develop with time. Ongoing maintenance treatment is likely for most patients.

Prevention

These may be helpful:

• maintain a healthy weight
• perform regular exercise
• avoid constipation
• avoid high heels
• avoid standing occupations
• wear compression stockings
• avoid hot baths and hot showers- these can enlarge the veins
• Get your veins checked by a professional every 2-5 years.