Nearly one in every two adults 50 years or older develop varicose veins, which usually appear as swollen, twisted clumps of blue or purple blood vessels near the surface of the skin in the legs or pelvis. The condition is most common among women and older adults, but obesity, standing on the job, personal or family history of venous disease, and hormonal changes before and after pregnancy increase the risk for developing varicose veins.
Peter Lawrence, M.D., director of UCLA's Gonda (Goldschmied) Vascular Center, notes that it is important for patients to be evaluated and treated by an expert in venous disease. "There are many new approaches to varicose veins and venous insufficiency. To prevent recurrence, a comprehensive approach is needed," he notes.
"It's not just a cosmetic problem," says Cheryl Hoffman, M.D., medical director of UCLA's Imaging and Interventional Center in Manhattan Beach, who treats superficial varicose veins using minimally invasive techniques. "Varicose veins can be painful." The condition occurs when valves that facilitate blood flow between the heart and the legs begin to leak and cause blood to pool in the legs. Common symptoms include leg swelling, muscle cramps, soreness, tiredness and aching in the legs, itchiness around the vein, skin discoloration and ulcers.
"Once those superficial veins stop working, they really aren't needed," she says. "In most cases, we can easily close off problem veins using a catheter to direct laser or radiofrequency energy to heat the inside the blood vessels." Ultrasound is used to extensively map the vein physiology and blood flow and to guide the procedure. Unlike more invasive approaches, this technique, called endovenous thermal ablation, causes less pain, bleeding and bruising and enables patients to return to normal activities faster.