Varicose veins are dilated and twisted veins that appear most frequently in the legs. They develop because the valves inside the veins, which help blood return to the heart, stop functioning properly (Fig. 1). Although they are often mainly an aesthetic concern, they can also cause symptoms such as heaviness, pain, swelling, or nighttime cramps.

tratamiento vairces de piernas

Fig.1. Function of the valves in the deep veins of the legs. Panels A and B show normal function with unidirectional, centripetal blood flow toward the heart. Panels C and D show valve failure, with incomplete valve closure allowing bidirectional flow and centrifugal reflux, which is transmitted from the deep veins toward the superficial veins, thereby giving rise to varicose veins.

Non-Surgical Treatments

The first step in managing varicose veins is to improve circulation:

• Compression stockings: These help blood flow back toward the heart and reduce symptoms such as swelling.
• Healthy habits: Daily walking, maintaining a healthy body weight, avoiding prolonged periods of standing or sitting, and elevating the legs when resting.

In mild cases of varicose veins, these measures may be sufficient to relieve symptoms.

Minimally Invasive Treatments

Currently, modern treatments allow varicose veins to be treated without the need for traditional surgery:

• Sclerotherapy: A substance is injected into the vein to close it, causing it to gradually disappear. This technique is ideal for the cosmetic treatment of small veins and spider veins (Fig. 2)

Escleroterapia

Fig.2: Reticular veins or spider veins (A) and their treatment with microfoam sclerotherapy (B).

• Laser or radiofrequency ablation: A thin fiber is introduced into the vein to close it using heat. This is an outpatient procedure with rapid recovery and excellent cosmetic results (Fig. 3)

Láser o radiofrecuencia

Fig.3. Diagram of the percutaneous radiofrequency catheter technique.

Surgery

In more advanced cases, where varicose veins are large or cause complications (ulcers, bleeding, inflammation), a surgical procedure may be required. The most common technique is saphenectomy, or removal of the saphenous vein; however, it is being used less frequently thanks to minimally invasive alternatives such as thermal ablation with radiofrequency or laser. Other minimally aggressive techniques, such as microfoam sclerotherapy, are highly effective when the type of varicose vein is appropriately selected.

Conclusion

Today, most people with varicose veins can be treated on an outpatient basis, without major surgery and with highly effective results. The choice of treatment depends on the size of the affected veins, the symptoms, and the patient’s overall condition. And although treatments eliminate existing varicose veins, the best prevention remains good circulatory care: staying active, not smoking, maintaining a healthy weight, and consulting a physician at the first signs of discomfort.