Glossary or how to get answers on all my questions about varicose veins


defintions of medical terms used in angiology

Check out the definitions of the most frequently used medical terms in vascular medicine: My-varicose gives you more explanations.

Varicose veins:
Varicose veins mean abnormal and permanent enlargement of the superficial veins of the lower limbs. These dilated veins no longer function normally, which means that they lose their ability to send venous blood, poor in oxygen, back up to the heart, leading to a reversal of blood flow. Restricted venous return is commonly due to malfunctioning valves in the veins. The venous valves normally prevent the blood from going backwards. This malfunction is caused by the loss of elasticity within the venous wall.
Saphenous veins:`
Two types of venous network coexist in the lower limbs: the deep venous system and the superficial venous system. There are two main superficial venous networks: the great saphenous vein, and the small saphenous vein. The great saphenous vein runs from the inner side of the ankle, at the front of the medial malleolus, to the groin area where the superficial vein joins the common femoral vein. The small saphenous vein runs from the back of the ankle, behind the lateral malleolus, to the back of the knee, where the superficial vein joins the popliteal vein. These four superficial veins, two in each leg, account for about 10 % of the venous return. When they no longer deliver, they can cause varicose veins, and are associated with symptoms like heavy legs, weightiness, restless legs and swollen legs. They no longer carry out their function of venous return, therefore they become useless. This is why it becomes reasonable to get rid of them, by removing or destroying them. In some cases, great saphenous veins are used as graft material for coronary artery bypass or peripheral artery bypass. It is then preferable to keep them if their condition isn’t too bad.
Endovenous laser ablation (EVLA):
EVLA is a minimally invasive and non-surgical treatment that delivers laser energy to destroy the faulty vein. A 2mm fiber-optic laser is introduced in the abnormal vein, using ultrasound guidance. The heat delivered through the optical fiber seals the vein and eventually, the dilated vein will disappear completely. The procedure is done under local anesthesia called tumescent anesthesia, which allows the patient to resume daily activity right after. There is no downtime. EVLA is an out-patient procedure, performed in a dedicated operating room: the procedure lasts an hour, and your presence in our facility won’t be required for more than two hours.
Radiofrequency ablation:
A thermal endovenous procedure performed with radiofrequency is a procedure similar to the laser ablation. The only difference lies in the type of fiber used to seal the vein with heat. Like laser ablation, the procedure is performed under tumescent anesthesia, in an operating room, with no downtime. It is an outpatient procedure.
Ultrasound-guided foam sclerotherapy:
This technique can be used for the treatment of medium-sized saphenous veins, including their branches, and varicose vein recurrences. A sclerosing agent made into a foam is injected in the varicose vein. Foam is more effective, and allows the physician to decrease the concentration of solution. The injection of the foam is performed under non-stop ultrasound monitoring for maximum security. The foam is rapidly destroyed by the blood cells and doesn’t spread far from the injection site. The vein will then collapse and disappear within weeks or months. This is an in-office procedure with no downtime. This treatment has been used worldwide for more than 15 years now.
Sclerosing agents: sclerosants:
In France, two solutions are commonly used: Lauromacrogol 400 (AETOXISCLEROL®) and chrome alun (SCLEREMO®). These agents must be avoided during pregnancy. AETOXISCLEROL® is the most frequently used sclerosing agent, but official marketing authorization for its use in a foam hasn’t been received yet (AMM).
Marketing Authorization delivered by French authorities.
Microsclerothapy is the treatment of spider veins, and telangiectasias by injection of a sclerosing agent in a liquid form. A magnifying lamp is used for a better vision of the vessels. A transillumination light can be used to spot deeper vessels through the skin. The veins treated by this method will disappear within a few weeks. This is an in-office procedure, requiring no downtime.
Ambulatory phlebectomy with Muller hook:
This procedure is aimed at removing surgically unsightly varicose veins, and is performed under local anesthesia. A small incision of about 1 mm is made over the faulty vein, and the varicose vein is removed through that incision with the help of a surgical hook called Muller hook. Scars will be minimal and will totally disappear within weeks. You will need to wear compression stockings for 8 days after the procedure. Mild discomfort might be experienced around the treated area for a few days. This procedure can be performed on an outpatient basis, and as a complement after a thermal procedure with laser or radiofrequency. There is no downtime required.
Compression stockings:
Compression hosiery exists in various styles: pantyhose, knee-high or thigh-high stockings. In France, it is usually called “contention”, but the scientific term is medical compression therapy. Medical compression therapy is achieved through hosiery, but also through bandages, which compression properties range from low-stretch to high-stretch. Occasionally, the two methods can be combined, for example in the case of venous ulcer. The compression level is divided in 4 classes, 1 being the lowest level of compression, considered ineffective, and 4 the highest. The average level of compression is 2, and suits most cases on a day-to-day basis: oedema, heavy legs, restless legs, and the prevention of chronic venous disease. Compression prevents venous stasis in the ankles and in the legs. This mechanical compression is highly effective, but only when it is worn. There is no residual effect when it is taken off. Compression stockings is not always easy to apply, or to tolerate all day long, but it is the only treatment that has demonstrated a real efficiency as a preventive measure. Compression stockings should be worn during the day for 8 days after a laser or radiofrequency procedure, or after a phlebectomy. If compression stockings are worn on a daily basis, they should be renewed every 3 months to ensure the maximum elasticity (loss of elasticity due to washing, and wear and tear of fibers). Compression level 3 is used in the treatment of deep vein thrombosis (blood clots). Compression level 4 is exceptionally prescribed because it is difficult to apply: its main indication would be lymphatic oedema. In certain cases, your physician might prescribe putting two different classes of compression stockings over each other, a class 3 and a class 1 for example, which equals a class 4: this might be an easier way to apply and tolerate a class 4.
Surgical treatment of varicose veins: Crossectomy and saphenous vein stripping:
Crossectomy and saphenous vein stripping is the traditional procedure to surgically remove varicose veins. This procedure has been used for decades. A cut is made under the knee (short stripping, most commonly performed nowadays), or in the ankle, and then in the groin so that the vein can be removed (stripped out) using the stripper inserted into the varicose vein through the incisions.
The surgical tool used to remove varicose veins.
The surgical procedure of pulling the varicose vein out.
Tumescent anesthesia:
It is a local anesthesia technique used to numb the leg before a laser or radiofrequency ablation, or even before a phlebectomy. A mix of saline and lidocaine solution is injected subcutaneously in the targeted area with the control of the ultrasound. The subcutaneous tissue becomes firm and hard and is protected from the heat delivered by the laser or radiofrequency catheter to the varicose vein beneath. Tumescence also numbs the leg to prevent the pain.
Thrombophlebitis or deep venous thrombosis:
A blood clot located in the deep venous network is called a deep venous thrombosis. Any deep vein can be concerned: abdominal, cerebral…but the most frequent location is the lower limbs. Deep-vein thrombosis is a serious condition as it can lead to pulmonary embolism. Medical treatment using anticoagulant medication and compression stockings class 2 or 3 should be prescribed immediately after the diagnosis.
Phlebitis or superficial venous thrombosis:
A blood clot located in the superficial venous network (saphenous veins) or in a varicose vein is called a superficial venous thrombosis. The main symptoms are visible on the skin over the vein that is red and swollen and will become painful. It is not a serious condition but nonetheless, it requires subcutaneous injections of anticoagulant for 4 to 6 weeks.
Skin ulcer:
Venous skin ulcer is a wound that occurs spontaneously, generally around the ankles, and is caused by venous insufficiency, especially if venous insufficiency is left untreated for a long period. Skin ulcers can have other causes: arterial, or a combination of both venous and arterial. Venous skin ulcer should be avoided at all cost because they indicate irreversible skin lesion, and they are slow and difficult to heal. Local treatments applied by a nurse and class 3 compression stockings will be required for months. Ablation of the responsible varicose veins will help to avoid the aggravation of the venous insufficiency causing venous ulcers.
Venous eczema:
Venous stasis along with varicose veins can be responsible for skin irritation. Consequently, an itching area with a scaly aspect (eczema) appears on the skin of the leg. Constant scratching can lead to a skin infection (cellulitis) or to the rupture of the varicose vein beneath. The treatment of this type of eczema requires the treatment of the varicose vein and the venous insufficiency that triggered it in the first place. The use of a cortisone cream provides quick relief but should never be applied without your physician’s approval since it could promote skin infection and skin thinning.

Lipoedema is an accumulation of fatty tissue under the skin, in a lobular shape. It occurs almost exclusively in women, is located mainly in the lower limbs, and affects either the entire limb, the thigh only, or the leg only. Fat cells tends to block the vessels of the lymphatic system promoting oedema. The skin of the legs can be tender and sensitive to pressure especially when performing “palper-rouler” technique of massage (subdermal tissue massage). The skin also bruises easily because of capillary fragility. Generally, lipoedema doesn’t involve the ankles and the top of the foot which helps to distinguish lipoedema from lymphedema.

Cellulite isn’t a disease per se, but a physiological variation of fat distribution most commonly seen in women. Cellulite doesn’t involve any inflammation nor infection, but simply fat accumulation around the thighs, hips and buttocks associated with an aspect of dimpled skin known as ‘orange peel syndrome’.

information provided on this website is not intended as and does not constitute medical claims or advice, and should therefore not replace the advice of trained medical professionals and healthcare service providers which are the only persons capable of making the right diagnosis and establish the appropriate treatment. This information must not be used for diagnosis, treatment, prevention, or cure of diseases or other medical conditions for oneself or others. People with health issues and medical conditions should seek the assistance of properly trained healthcare providers.

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The medical information on this site does not in any way replace the medical consultation which alone, makes it possible to establish a diagnosis and set up a protocol of care adapted to each individual case.
My-varicose-veins or "how to answer all my questions about varicose veins"