Varicose veins in the legs: assessment and treatment at a specialist unit

Specialist assessment of varicose veins in the legs

Varicose veins in the legs are a common symptom of chronic venous insufficiency and can cause a feeling of heaviness, swelling or persistent discomfort in the lower limbs.

At the Varicose Vein Unit at the Publio Cordón Memorial Hospital, the assessment of varicose veins focuses on accurately identifying the cause of the venous problem and determining the most appropriate treatment for each individual case.

When dilated veins become more pronounced over time or symptoms become persistent, an assessment by a specialist can determine whether the problem is related to venous insufficiency and whether it can be treated using specific techniques designed to correct venous reflux.

Varicose veins are usually caused by a progressive failure of the venous valves, small structures that prevent blood from flowing backwards when we are standing or walking. When these valves stop working properly, blood tends to pool in the veins of the legs, causing them to dilate and leading to the appearance of varicose veins.

Although many people initially perceive varicose veins as a cosmetic problem, they are in fact the visible manifestation of a chronic circulatory disorder that can progress over time and lead to discomfort, swelling or skin complications if not properly addressed.

Symptoms and progression of venous insufficiency

Chronic venous insufficiency can manifest in very different ways depending on the extent of the disorder in the venous system and the progression of the condition.

In the early stages, many people experience symptoms such as a feeling of heaviness in the legs, tiredness at the end of the day or slight swelling in the ankles. These symptoms usually worsen after spending many hours standing or sitting and tend to improve when the legs are raised or when walking.

Over time, other, more obvious signs may appear, such as dilated veins visible under the skin, a sensation of warmth or itching in certain areas of the legs, night-time cramps or progressive changes to the skin.

In more advanced stages, complications may develop, such as superficial venous inflammation, skin changes associated with poor circulation or, in some cases, venous ulcers that are difficult to heal.

Understanding this progression helps to identify the right time to consider treatment and prevent the venous disease from continuing to progress.

Specialist assessment at the Varicose Veins Unit

The treatment of varicose veins requires a precise analysis of how each patient’s venous system functions. Not all varicose veins have the same cause, nor do they all require the same type of treatment.

At the Varicose Vein Unit at the Publio Cordón Memorial Hospital, the clinical assessment focuses on examining the venous system through specialised examinations and imaging tests that enable the precise location of the point at which venous reflux occurs to be identified.

This analysis enables the design of a personalised treatment plan, which may range from conservative measures to minimally invasive procedures aimed at closing or removing the affected veins.

An assessment by a specialist helps to confirm whether the symptoms are related to venous insufficiency and to decide which treatment is most appropriate in each case.

Diagnosis of venous insufficiency using Doppler ultrasound

The diagnosis of venous insufficiency is based on a combination of clinical examination and imaging tests that allow the functioning of the venous system to be studied in detail.

During the consultation, the specialist examines the patient’s legs whilst they are standing to assess the distribution of varicose veins, detect signs of inflammation or changes in the skin, and evaluate any possible associated complications.

The key test for confirming the diagnosis is venous Doppler ultrasound, an ultrasound scan that visualises the course of the veins and analyses blood flow in real time. Thanks to this technique, it is possible to detect venous reflux and precisely locate the point at which the valve failure occurs.

This information enables the origin of the circulatory problem to be determined and a decision to be made on the most appropriate treatment for each patient.

When to treat varicose veins

The treatment of varicose veins depends on the severity of venous insufficiency, the symptoms experienced by the patient and the impact the condition has on their daily life.

In the early stages, management may include conservative measures aimed at improving venous return, such as wearing compression stockings, regular exercise or specific postural advice.

When venous insufficiency is more advanced or symptoms are persistent, specific techniques designed to treat the affected veins may be considered.

The aim of treatment is not merely to improve the aesthetic appearance of the legs, but to correct the underlying circulatory problem and prevent the progression of venous disease.

Treatment of varicose veins: minimally invasive techniques

Nowadays, many varicose veins can be treated using minimally invasive procedures that allow direct treatment of the vein responsible for venous reflux.

Among the most commonly used techniques are:

• Endovenous ablation using laser or radiofrequency, which closes the vein from the inside using controlled thermal energy

• Microfoam sclerotherapy, which involves injecting a sclerosing agent that causes the vein to close.

In some patients, it may be necessary to combine several techniques to treat both the main vein and its secondary branches, tailoring the treatment to the individual’s venous map.

Recovery and follow-up after treatment

Following treatment, clinical follow-up allows the progress of the venous system to be assessed and confirms that reflux has been eliminated in the treated veins.

In most cases, minimally invasive procedures allow patients to resume their daily activities within a short time, although the specialist may recommend specific measures to aid recovery and prevent the development of new varicose veins.

Regular check-ups also enable the early detection of any new areas of venous insufficiency and allow these to be treated before they cause significant symptoms.

Deciding on treatment at the right time

Venous insufficiency is a progressive condition that can develop slowly over many years.

A specialist assessment enables us to identify the stage of the venous disease, confirm the cause of the reflux and determine whether treatment is advisable at that time.

At the Varicose Vein Unit at the Publio Cordón Memorial Hospital, accurate diagnosis and personalised treatment planning enable us to manage venous disease with an approach focused on safety, clinical efficacy and improving the patient’s quality of life.