How should young people deal with varicose veins in the lower legs?

Written by Zhang Xue Min
Vascular Surgery
Updated on September 16, 2024
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Firstly, for young people with varicose veins in the lower leg, it is recommended to go to the hospital for an ultrasound examination to check the condition of the deep veins. Additionally, consult a professional vascular surgeon to assess the severity. If the deep veins are unobstructed and the superficial varicose veins in the lower leg are not too severe, the doctor will suggest the patient wear medical compression stockings and continue with normal life activities. If the condition is more serious or there are certain issues with the deep veins, the doctor might recommend surgery. For such patients, it is important in daily life to avoid standing or sitting for long periods, and to avoid letting the legs dangle for too long. If standing, one can also step in place appropriately, which helps alleviate varicose veins. Also, when resting, take any opportunity to elevate the legs and avoid soaking feet in hot water.

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Written by Zhang Xue Min
Vascular Surgery
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Can venous varicosity be measured by CT?

Venous varicosities can undergo CT imaging, but generally, it's best to avoid injecting medication into the varicose veins. If the varicosities are in the lower limbs, a routine ultrasound examination is usually sufficient. To perform venous imaging with CT, medication is typically administered through the upper limbs. It moves through the general circulation, enters the arteries, reaches the peripheral tissues, and then flows back through the veins to allow imaging of the lower limb veins. This process is time-consuming, laborious, and costly; therefore, CT is generally not used to detect lower limb venous varicosities. However, CT can be used to examine venous abnormalities in other areas, such as problems with abdominal veins.

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Written by Zhang Xue Min
Vascular Surgery
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Does Grade II varicose veins require surgery?

In our clinical staging, Grade 2 varicose veins are the most common type of varicose veins. Often, these do not have complications and are relatively early-stage. The decision to undergo surgery depends on the patient's personal treatment preference. Some individuals might be motivated by cosmetic reasons, such as wanting to wear skirts or shorts in the summer to show off their legs. In such cases, their desire for treatment might be stronger. For some older individuals, they might not care as much, so the choice of undergoing surgery or opting for conservative treatment for Grade 2 varicose veins really depends on the patient's own wishes.

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Written by Zhang Xue Min
Vascular Surgery
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What is the cause of pain in varicose veins?

Varicose veins can sometimes cause localized pain, and there are several reasons for this pain. One reason is the formation of blood clots in the varicose veins, which can cause very obvious pain. Additionally, the affected area feels harder, not soft. When we say soft, it's like the softness of one’s lips; if it feels like the tip of the nose or the forehead, then it's considered very hard. In such cases, it indicates that the vein is not empty but contains a solid blood clot, which can cause pain. Another situation is if there is poor venous return in the proximal segment, causing the veins to fill significantly in a short time. This can also pull on the nerves outside the vein wall, leading to a sensation of pain.

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Written by Zhang Xue Min
Vascular Surgery
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Is vein varicose treatment better with injections or surgery?

Venous sclerotherapy involves injecting a sclerosing agent and is a relatively good and minimally invasive treatment method. Its advantages include being minimally invasive and even suitable for outpatient surgery, with low costs. However, there are drawbacks; one is that the medication might enter the deep veins, causing deep vein thrombosis. If the dosage is too large, it could reach the lungs, causing pulmonary embolism. Additionally, the medication might seep into surrounding tissues, causing inflammatory reactions. Some patients may experience temporary hyperpigmentation. Surgical treatment is a more traditional method, but it depends on the specific situation. Generally, it causes more trauma than sclerotherapy and usually requires some level of anesthesia. Surgery entails a certain amount of blood loss, and like other methods, it cannot prevent recurrence.

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Written by Zhang Xue Min
Vascular Surgery
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What are the effects of secondary surgery for varicose veins?

If varicose veins recur, we need to carefully investigate the cause of the recurrence and rule out problems in the deep venous system. If there is an obstruction in the deep veins, recurrence can occur quickly even after secondary surgery on the superficial veins. If the deep veins are only involved in venous reflux, surgery can still be performed, but it is hoped that medical compression stockings will be worn for a period of time after surgery. Otherwise, there is still a possibility of recurrence after the secondary surgery.