Can varicose veins occasionally be invisible?

Written by Zhang Xue Min
Vascular Surgery
Updated on September 09, 2024
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When varicose veins are mild in their early stages, if you wear compression stockings during winter, it's possible that the varicosities are not very noticeable occasionally when you take off the stockings. However, in more advanced stages, when there are clearly widespread and clustered varicose veins, they are difficult to conceal.

However, if deep vein thrombosis occurs, causing tissue edema, the swollen surrounding tissues may obscure the varicose veins, making them less visible. Therefore, we need to judge based on the specific circumstances. Generally, just because varicose veins are occasionally not visible does not mean that the condition has healed.

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Written by Zhang Xue Min
Vascular Surgery
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What happens if varicose veins worsen?

Varicose veins, when they worsen, can lead to changes in the skin, including thickening of the skin which feels woody to the touch. Additionally, the skin may exhibit pigmentation that can be severe enough to resemble the black color of a belt. More seriously, ulcers can develop, typically near the inner ankle, though they occasionally appear in other locations. These ulcers are referred to medically as “boot ulcers” and are commonly known among the general population as “continuous sore legs.” In extreme cases, these ulcers may persist for many years without healing and could potentially become malignant.

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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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Vascular Surgery
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Can varicose veins cause leg swelling?

Varicose veins are a broad concept that is clinically divided into seven grades, from 0 to 6. Grade 0 is normal, grade 1 involves some capillary dilation, grade 2 is marked by clear varicose veins, and from grade 3 onwards, edema can occur. Generally, the causes of varicose veins vary. Some people suffer from what is called simple superficial varicose veins, primarily due to problems with the valves in the superficial veins. These patients may experience mild edema, limited to the ankle area. Others suffer from secondary varicose veins, following dysfunction of the valves in the deep veins or communicating veins. In deep veins, there can be reflux or obstruction. In such cases, it is possible to cause compressible edema in the front of the lower leg, commonly known as shinbone area.

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Can varicose veins be detected by ultrasound B?

Ultrasound is currently the main examination method for varicose veins. It is non-invasive, safe, and affordable, making it one of the standard methods for assessing varicose veins. Besides viewing the superficial veins, it also allows visualization of the deformed deep veins within the muscles, enabling a basic assessment of the causes of varicose veins. Ultrasound now plays a crucial role in the treatment of varicose veins. Many new treatment methods, such as blood flow modulation techniques like wrist flexing, require high precision in ultrasound use. It is essential to locate the reflux points using ultrasound, and then specifically target these points for ligation.

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The difference between thromboangiitis obliterans and varicose veins

Firstly, these are two completely different diseases. Thromboangiitis obliterans is an inflammatory vascular disease involving the medium and small veins and arteries, causing migratory superficial phlebitis and leading to the obstruction of the veins, as well as some obstructions in the lower limb arteries. Thus, thromboangiitis obliterans includes some obliterative diseases of both arteries and veins, the cause of which is an autoimmune inflammation. Varicose veins are one of the most common vascular surgical diseases. They primarily manifest as tortuous, clustered, and dilated superficial veins of the lower limbs. This condition does not involve arterial changes, but varicose veins can progressively worsen and may lead to pigmentation and ulceration, which at that time necessitates differentiation from arterial ulcers. Generally, the ulceration in varicose veins is located in the "gaiter area," which is the area covered by a boot when wearing one, including the lower one-half to one-third of the lower leg. Most of the ulcers from varicose veins primarily appear above the inner ankle. The ischemia caused by thromboangiitis obliterans leads to a dry-type ischemia, where the limbs can gradually become dry, shriveled, atrophied, and blackened, with ulcers typically beginning from the extremities.