varicose veins CT scan preparation

Overview

Varicose veins are swollen, twisted veins that you can see just under the skin, usually in the legs. They happen when the small valves inside the veins stop working properly, allowing blood to flow backwards and pool. A CT scan (computed tomography scan) is a special X-ray that takes detailed pictures of the inside of your body. For varicose veins, a CT venogram (a type of CT scan with contrast dye) helps doctors see the veins clearly and plan the best treatment.

Yes, varicose veins are very common. About 30% of adults will develop them at some point in their lives.

Varicose veins can affect anyone, but they are more common in women, people over 40, those who are overweight, and people who stand or sit for long periods. They also tend to run in families.

Symptoms

Common symptoms

• Bulging, blue or dark purple veins that look twisted and rope-like
• Aching, heavy, or tired feeling in the legs, especially after standing or sitting for a long time
• Swelling in the feet or ankles
• Itching or burning around the veins
• Muscle cramps in the legs, especially at night

Symptoms in children

• Varicose veins are uncommon in children. When they occur, they may be due to an underlying condition such as a vascular malformation or injury. Always consult a healthcare provider if a child has visible bulging veins.

Symptoms in older adults

• In older adults, varicose veins may be more noticeable and cause more discomfort. The skin around the veins may become thin, dry, or discoloured. Sores or ulcers can develop more easily, so it is important to get treatment early.

Causes

Main causes

• Weak or damaged valves in the veins that allow blood to flow backwards and pool
• Weakening of the vein walls, which can be caused by ageing, pregnancy, or genetics

Risk factors

• Being female
• Getting older (over 40)
• Being overweight or obese
• Pregnancy (especially multiple pregnancies)
• Standing or sitting for long hours every day
• Family history of varicose veins
• Previous blood clot in the leg
• Lack of regular exercise

When to see a doctor

See a doctor urgently if:

• If you have sudden swelling, redness, or severe pain in one leg
• If a varicose vein starts bleeding and you cannot stop it with gentle pressure
• If you develop a leg ulcer (open sore) that is not healing

Book a routine appointment if:

• If you have persistent aching, heaviness, or swelling in your legs that affects your daily activities
• If you are bothered by the appearance of varicose veins and want to discuss treatment options

Diagnosis

Your doctor can often diagnose varicose veins simply by looking at your legs while you are standing. They may also feel the veins and ask about your symptoms. If more detail is needed, especially before treatment, they may refer you for a CT venogram.

Tests that may be done

• Physical exam: Visual inspection and palpation (feeling) of the veins
• Doppler ultrasound: Uses sound waves to check blood flow and see if the valves are working. This is the most common test.
• CT venogram: A special CT scan with contrast dye that creates detailed 3D images of the veins. It is sometimes used if the doctor needs to see the deep veins or plan complex treatment.

What to expect at your appointment

If you are having a CT venogram for varicose veins, here is what to expect: You will be asked to change into a hospital gown and remove any metal objects (jewellery, glasses). You will lie on a narrow table that slides into the CT scanner. A small needle will be placed in your arm to inject contrast dye – you may feel a warm flush or a metallic taste, which is normal. You will need to hold still for a few minutes while the scanner takes images. The scan takes about 30 minutes. Before the scan, you may be asked to avoid eating or drinking for a few hours. Tell your doctor if you have any allergies (especially to iodine or seafood, as the dye contains iodine), if you take metformin for diabetes, or if you are pregnant or breastfeeding.

Treatment

Treatment for varicose veins aims to relieve symptoms, prevent complications, and improve appearance. It ranges from simple self-care to minimally invasive procedures. Your doctor will recommend the best option based on your symptoms, vein size, and overall health.

Self-care at home

• Wear compression stockings (support stockings) during the day – these help squeeze the legs and improve blood flow.
• Elevate your legs when resting, ideally above the level of your heart.
• Avoid standing or sitting for long periods – take short walks or flex your ankles frequently.
• Exercise regularly, such as walking, swimming, or cycling, to improve circulation.
• Maintain a healthy weight to reduce pressure on your veins.

Medical treatments

Medical treatments for varicose veins do not involve named drugs, but may include procedures done in a clinic or hospital. These include: sclerotherapy (injecting a solution into smaller veins to make them collapse and fade), endovenous laser therapy (using laser energy to seal the vein), radiofrequency ablation (using heat energy to close the vein), and phlebectomy (removing small veins through tiny cuts). Your doctor will explain which option is suitable for you.

When is surgery considered?

Surgery (for example, ligation and stripping) is less common nowadays because newer, less invasive treatments work well. Surgery may be considered if varicose veins are very large, causing severe symptoms, or if other treatments have not helped. Recovery takes a few weeks, and the procedure is done under anaesthesia.

Living with this condition

Living with varicose veins is usually manageable. Simple daily habits can make a big difference. Wear comfortable clothing and compression stockings if prescribed. Take breaks to move around if you have a desk job. When sitting, avoid crossing your legs. Keep your skin moisturised to prevent dryness and irritation over the veins.

Lifestyle tips

• Walk for at least 30 minutes most days – it helps pump blood out of your legs.
• Avoid high heels and tight clothes that restrict blood flow.
• If you travel long distances, stand up and walk around every hour or do ankle exercises.
• Stay hydrated – drinking enough water helps keep your blood volume normal.

Diet and exercise

A balanced diet rich in fibre can help prevent constipation, which can worsen varicose veins. Include plenty of fruits, vegetables, and whole grains. Reduce salt intake to help control swelling. Low-impact exercises like walking, swimming, and yoga are excellent for circulation. Avoid heavy weightlifting as it can increase pressure in the veins.

Mental health and emotional wellbeing

Varicose veins can affect how you feel about your appearance, which may cause embarrassment or self-consciousness, especially in social situations. It is normal to feel this way. Talking to a trusted friend, family member, or a counsellor can help. Remember that treatment options exist and many people have similar concerns. If you feel very anxious or depressed, speak to your healthcare provider – they can offer support and resources.

Prevention

It is not always possible to prevent varicose veins, especially if you have a family history. However, you can reduce your risk and slow their progression by staying active, maintaining a healthy weight, avoiding prolonged standing or sitting, and wearing compression stockings if recommended by your doctor.

Screening programmes

There is no routine screening test for varicose veins. Most people notice them themselves or their doctor spots them during a regular check-up. If you have symptoms, see a healthcare provider for an assessment.

Complications

If left untreated

• Skin changes like thickening, darkening, or dryness around the ankle
• Leg ulcers (open sores) that can be painful and slow to heal
• Bleeding from a varicose vein that may be difficult to stop
• Superficial thrombophlebitis (inflammation and clotting in the surface vein)
• Deep vein thrombosis (DVT) – a blood clot in a deeper vein, which is a serious condition that needs immediate medical attention

Long-term outlook

For most people, varicose veins are a cosmetic issue or cause only mild discomfort. With simple self-care and medical treatment when needed, symptoms usually improve and complications are rare. Even if you develop complications, modern treatments are very effective. Most people with varicose veins live full, active lives without serious problems. Talk to your healthcare provider about what is best for you.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.