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The venous system is a network of muscular tubes. It collects blood which has been pumped through the capillaries into the smallest of veins (which are called venules). The venous system of veins delivers blood back to heart. The design of this network is such that a blockage, even multiple blockages, cannot obstruct the flow of blood back to the heart. If there is a blockage, blood will find another route to its destination. There are so many other routes that single obstructions are simply no problem. This fact allows for the possibility of surgical repair of the venous system.
All veins come equipped with one way valves. These valves occur every one or two inches and are aimed in the direction of the heart. The purpose of these valves is to conserve the work done to pump blood toward the heart. In other words, they are there to prevent back flow. Blood is driven through these veins by two forces.
During rest the major force which drives blood to the heart is the pressure exerted by the heart itself through the arterial system and capillaries. During activity this force is augmented by muscular motion which squeezes veins which are adjacent to, and within, active muscles. Thanks to the valves this muscular pressure squeezes blood through the veins in only one direction: toward the heart.
Sclerotherapy is a medical specialty in which the doctor treats cosmetic and functional vein disorders. Many types of doctors deal with vein disorders, however not all doctors who deal with veins really understand how to do the job properly so that the problem is solved and does not return. The purpose of this article is to provide you with the kind of understanding about vein disorders which will allow you to discriminate between doctors who know their stuff and those who do not. It can also serve to educate doctors on this common problem.
Most people come to a sclerotherapist for one of two reasons: appearance and discomfort. Probably the majority are concerned about the cosmetic appearance of "spider" veins just under the skin. True spider veins are fed from the arterial system and when compressed they refill from the center giving the impression of a spider spreading its legs. However, by convention, tiny veins on the surface which are blue/black in color and have only venous origin are also called spider veins. True spider veins are rare, however ordinary spider veins are quite common. The term "spider veins," in this article, refers to the latter.
The technique of sclerotherapy is the injection of a sclerosing solution into these veins. When done correctly these spider veins disappear after passing through a phase of inflamation and bruising. However, unless the underlying condition (incompetent larger veins — see below) which gave rise to these spider veins is dealt with first, more spider veins will quickly appear.
An "incompetent" vein is one which has ballooned out to a diameter exceeding the size of its valves. This pulls the valves apart so that they cannot snap shut on backward pressure. This results in blood flow away from the heart and thus increased pressure throughout that local part of the venous system. The smaller veins cannot always withstand this pressure and some of them balloon out to become larger and visible. Because their walls are stretched so thin, blood can be seen through the walls giving a blue/black appearance. This appearance is what many people find objectionable. Spider veins can occur without incompetence of larger veins, however this is not the usual situation.
| Marcus Malabad|
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