2024-04-23 04:50:08
According to data from the National Health Insurance Corporation, about 210,000 patients received treatment for varicose veins in 2020. More than half of them were found to be women. If venous insufficiency, which is the cause of varicose veins, is left untreated, it can cause problems such as edema, pigmentation, and skin ulcers, so caution is required.
Varicose veins are a disease in which the lower extremity veins, which are blood vessels that transport blood from the lower extremities to the heart, dilate tortuously by more than 3 mm, causing problems in returning blood from the periphery to the heart. Main symptoms include heaviness in the lower extremities, fatigue, swelling, itching, cramping, throbbing, burning, and pain that occurs when standing for a long time.
The cause of varicose veins is ‘venous insufficiency’, where blood normally delivered to the periphery has problems returning to the heart due to problems with the veins. Risk factors for venous insufficiency include female sex, obesity, family history, advanced age, pregnancy, and occupation or lifestyle habits that involve standing for long periods of time.
Professor Lee Sang-ah of the Department of Vascular Surgery at Soonchunhyang University Bucheon Hospital said, “In particular, in Korea, there were about 145,000 female patients who received treatment for varicose veins in 2020, accounting for more than half of the total, and people in their 50s are the most frequently treated for varicose veins. Age range,” he explained.
If varicose veins are suspected, diagnosis can be made through examination and interview. Since symptoms are usually more noticeable when standing, it is advisable to perform the examination while standing.
An ultrasound examination is performed to check for venous reflux, which is one of the causes of venous insufficiency. Ultrasound examination is essential to determine the exact location of the blood vessel where reflux occurs, confirm the patient’s previous treatment experience, and confirm the presence or absence of deep vein thrombosis.
This test checks for reflux by inducing reflux by squeezing your legs while standing up, or by doing the ‘Valsalva maneuver’, which involves taking a deep breath, covering your mouth and nose, and exhaling by pressing your stomach. Venous reflux is considered significant when reflux in superficial veins, which are shallow veins located under the skin, lasts for more than 0.5 seconds or when reflux in deep veins lasts for more than 1 second.
Professor Lee Sang-ah said, “If you have symptoms such as pain, ulcers, or pigmentation in your legs, it is important to differentially diagnose whether it is due to rheumatic disease, arterial disease, or neurological problems.”
If reflux of superficial veins is confirmed on ultrasound, symptoms such as lower extremity discomfort are severe, and there are findings such as varicose veins, pigmentation, or ulcers, surgical treatment is recommended.
Radiofrequency ablation is the most widely used surgical treatment method to remove saphenous veins with reflux. In addition, there are procedures to occlude the saphenous vein by injecting adhesive into the blood vessel, or saphenous vein extraction to remove the saphenous vein.
Treatment includes treatment to resolve venous insufficiency by removing saphenous veins with reflux, removal of tortuous varicose veins through small incisions, or treatment to harden blood vessels with sclerotherapy.
Professor Lee Sang-ah said, “Surgery is not necessarily necessary to treat varicose veins. “If the symptoms are not severe or there is no significant inconvenience in daily life, it can be managed non-surgically.”
Non-surgical treatments for varicose veins include lifestyle modification, drug treatment, and compression therapy. Avoiding standing or sitting for long periods of time and wearing compression stockings to improve venous circulation can help improve symptoms.
The effect of stocking length on improving symptoms is not significant. Therefore, it is recommended to wear stockings below the knee that are easy to wear and less prone to skin sensitivity. Taking medications to improve circulation can also help improve symptoms and relieve swelling.
Professor Lee Sang-ah said, “Compression treatment may not be necessary after some procedures such as adhesive occlusion surgery, but wearing compression stockings for a certain period of time is recommended after most surgeries. Whether or not it is worn and for how long depends on the type of surgery. “It is recommended that compression stockings be worn continuously while walking and living, except while sleeping, and they should be replaced approximately every six months,” she advised.
Song Chi-hoon, Donga.com reporter [email protected]
2024-04-23 04:50:08