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Plastic Surgery Heidelberg

Vein Treatment

Vein treatment for varices and spider veins

What are varicose veins?

The term “varicose” comes from the Latin word “varix”, meaning “node”.

In the most of cases, varicose veins occur due to a partially hereditary venous insufficiency. In 95 % of these patients, doctors cannot identify any cause of the condition. In these cases we speak of primary varices. The disease affects almost exclusively the superficial venous system. The portion of the blood that flows through the superficial venous system back to the heart is very low. Therefore these veins can be surgically removed.

If there is, however, a deep vein thrombosis, then we speak of secondary varices. This thrombosis causes inadequate drainage in the deep venous system. The superficial veins of the legs are then used as bypass vessels. However, they cannot regulate the flow of blood adequately. Little by little, the pressure from the deep vein system causes the characteristic varicose changes in the superficial venous system.

From a medical perspective, congestions, pathological changes in the skin and similar complaints are a clear indication that treatment should be initiated. All changes that affect venous function require treatment. These include varices of the saphenous veins and of the lateral veins, as well as so-called reticular veins.

We distinguish four types of varicose veins:

  1. Spider veins
  2. Reticular varices
  3. Saphenous vein varices
  4. Varices of the lateral veins

1. Spider veins

Spider veins are a subclass of varicose veins. They are small visible veins within the skin, usually arranged in a net- or fan-like shape and occuring mainly on the outer side of the thighs. Spider veins do not cause complaints and are not a disease in the medical sense. They are rather an aesthetic problem. Nevertheless, they may already be a first sign of a disease of the deep venous system that necessitates treatment.

2. Reticular varices

Reticular varices are likewise net-shaped varicose veins. They form a coarser mesh and are on average larger than spider veins. They occur mainly on the outer sides of the upper and lower legs, and in the hollows of the knees. They, too, are of cosmetic significance only. Therapies suitable for the treatment of spider veins and reticular veins include laser therapy and sclerotherapy (obliteration).

3. Varices of the saphenous veins

In the human leg there are two saphenous veins which can degenerate into varicose veins, the vena saphena magna and the vena saphena parva. The vena saphena magna most commonly appears as varicose. It runs along the inside of the leg from the ankle along the lower leg and the thigh to the groin, where it merges into the deep venous system.

The smaller vena saphena parva runs from the outside of the ankle along the mid-calf to the hollow of the knee, where it merges into the deep venous system. In contrast to the vena saphena magna, this vein, when diseased, is often only partially visible as varicose. For diagnosis, however, in both cases technical examination methods should be used.

Left untreated, saphenous vein varicosis can lead to serious and even life-threatening complications. In advanced stages, it severely impairs the blood flow in the deep venous system. Yet it does not necessarily cause perceptible complaints. The first signs of saphenous varices are small dark-blue vein nests on the inside of the ankle. If the disease is allowed to progress untreated, skin discolouration, eczema and / or hardening of the tissue will follow. Ultimately, the resulting venous congestion will lead to severe skin damage and may result in an “open leg” (venous ulcer). Under certain circumstances, varicosis of the saphenous veins may even lead to pulmonary embolism.

4. Varices of the lateral veins

These are superficially situated small varices that merge into the large saphenous veins. They can form a network of varicose veins anywhere on the leg and occur in combination with varicosis of the saphenous veins. Treatment is usually performed for cosmetic reasons. Today it is possible to successfully treat not only smaller lateral varices but even thumb-sized lateral vein varices by obliteration. Veins in other areas of the body may also be affected by varicosis.


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