17614 Venous Disease Vein Ligation Stripping

Overview

Venous disease is a problem with the veins, the blood vessels that carry blood back to your heart. When vein walls or valves are weak, blood can pool in the legs. This can cause swollen, twisted veins called varicose veins. Vein ligation and stripping is a surgical treatment that ties off and removes badly damaged veins, usually in the legs, so blood can flow through healthier veins.

Yes. Varicose veins and other venous problems are common, especially as people get older.

It can affect adults of all ages. It is more common in people who stand for long periods, are overweight, are pregnant, or have a family history of varicose veins. Children can have vein problems too, but this is much less common.

Symptoms

Common symptoms

• Heavy, tired, or aching legs, especially after standing
• Visible twisted or bulging veins
• Swelling in the ankles or lower legs
• Itching, dryness, or skin colour changes near the ankle
• Night cramps or restless legs
• A feeling of warmth or tenderness over a vein

Symptoms in children

• Varicose veins are uncommon in children.
• If they happen, they may be linked to a vein problem present from birth or a family history.
• A child with leg swelling, pain, or visible veins should be checked by a doctor.

Symptoms in older adults

• Symptoms are more common with age as veins weaken.
• Skin changes, ankle swelling, and leg ulcers are more likely.
• Older adults may also have other health conditions that affect vein treatment choices.

Causes

Main causes

• Weak vein walls and damaged valves that let blood flow backwards and pool
• Increased pressure in leg veins from standing for long periods
• Family history and aging
• Previous blood clots in the leg veins

Risk factors

• Family history of varicose veins
• Being overweight or obese
• Pregnancy and hormonal changes
• A job that involves long periods of standing or sitting
• Lack of physical activity
• Previous deep vein thrombosis (DVT) or leg injury
• Older age

When to see a doctor

See a doctor urgently if:

• A leg ulcer or open sore that is new, painful, or showing signs of infection
• Increasing redness, warmth, fever, or pus from the leg
• Sudden worsening pain or swelling in one leg
• A varicose vein that becomes hard, very tender, or inflamed

Book a routine appointment if:

• Visible varicose veins that ache, feel heavy, or bother you
• Swelling in the legs that does not go away
• Skin changes, itching, or colour changes near the ankles
• You are worried about how your veins look or feel

Diagnosis

A healthcare provider will ask about your symptoms and examine your legs, usually while you are standing. They may use an ultrasound scan to see how blood flows through your veins and to find damaged valves.

Tests that may be done

• Duplex ultrasound — a painless scan that uses sound waves to show blood flow and vein structure
• Physical examination of the legs
• Review of your medical history and risk factors

What to expect at your appointment

The ultrasound is done on the outside of your skin. You may be asked to stand or sit while a small probe is moved over your leg. It does not use needles or radiation. The results help your provider plan the best treatment for you.

Treatment

Treatment aims to relieve symptoms, improve blood flow, and prevent skin problems. It may include self-care, compression stockings, minor procedures, or surgery. Your healthcare provider will recommend the best option based on your symptoms, age, health, and preferences.

Self-care at home

• Wear compression stockings if your provider recommends them
• Elevate your legs when resting
• Keep active with regular walking
• Avoid standing still for long periods
• Take breaks to move your legs if you sit for a long time
• Keep your skin clean and moisturised to prevent dryness and sores

Medical treatments

Doctors may suggest compression stockings to support veins and reduce swelling. Other treatments include sclerotherapy (injecting a solution to close small veins), endovenous ablation (using heat or laser to close a damaged vein), and phlebectomy (removing small veins through tiny cuts). Vein ligation and stripping is a surgical option that ties off and removes larger damaged veins. Your care team will explain the benefits and risks of each option.

When is surgery considered?

Surgery may be considered if symptoms are severe, if skin changes or ulcers are developing, or if other treatments have not worked. Vein ligation and stripping is usually done under general or local anaesthesia. The surgeon makes small cuts, ties off the damaged vein, and removes it. You may need to wear compression stockings afterwards and take it easy for a short time. Less invasive techniques are often preferred today, so ask your provider what is suitable for you.

Living with this condition

Many people manage venous disease well with simple daily habits. Wear compression stockings as advised, keep your legs moving, and raise your legs when you can. Check your skin for sores or colour changes, especially around the ankles.

Lifestyle tips

• Walk regularly to help calf muscles pump blood
• Avoid standing or sitting still for long periods
• Elevate your legs when resting
• Maintain a healthy weight
• Wear comfortable shoes
• Follow your provider's advice on compression stockings

Diet and exercise

A balanced diet and regular exercise support vein health. Walking, swimming, and cycling are good choices because they use calf muscles without putting too much strain on your legs. Cut down on salt if swelling is a problem, and eat plenty of fibre to avoid constipation, which can increase pressure in veins.

Mental health and emotional wellbeing

Leg symptoms and visible veins can affect how you feel about your body and may cause worry or frustration. This is normal. Talk to your healthcare provider if you feel anxious or low. If you are in crisis or feel unsafe, contact your local emergency number or a crisis support service right away.

Prevention

You cannot always prevent venous disease, especially if it runs in your family. But you can lower your risk and reduce symptoms by staying active, keeping a healthy weight, avoiding long periods of standing still, and elevating your legs when you rest.

Vaccines

Not applicable for venous disease.

Screening programmes

There is no routine screening programme for venous disease. See a healthcare provider if you notice aching, swelling, or visible veins.

Complications

If left untreated

• Skin changes, such as dryness, itching, and brown discolouration near the ankles
• Leg ulcers (open sores) that can be slow to heal
• Bleeding from a varicose vein
• Inflammation of a vein (thrombophlebitis)
• Deep vein thrombosis (DVT) in rare cases
• Chronic venous insufficiency, where long-term pooling of blood causes ongoing symptoms

Long-term outlook

Most people with venous disease can be helped. Treatment often improves symptoms and skin problems. Some people need more than one treatment, and veins can come back over time. With good self-care and follow-up, you can usually keep symptoms under control.

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