Thread veins or spider veins are surface veins similar to varicose veins but smaller. They’re also situated close to the skin’s surface and can be red or blue in colour. They can appear as tree branches or spider webs, composed of short non-linear strokes. They can appear on legs or even the face and can occupy areas ranging from small to large. These thread veins can be caused by weakened or damaged venous valves. Veins have valves that operate like unidirectional pathways, preventing the blood from flowing backwards (retrograde flow or reflux).
If these valves are destroyed, damaged or weakened then blood reflux becomes a possibility, in which case blood can accumulate in these areas of the veins (venous insufficiency). When this blood reflux becomes significant it can lead to varicose veins. There are multiple factors that can lead to spider veins, among which blood reflux, hormonal changes, exposure to the sun, injury, age or pregnancy. In some countries 55% of women and 45% of men are by this condition.
Thrombophlebitis is defined by intramuscular blood clotting (thrombosis) accompanied by inflammatory reactions of the venous wall (phlebitis). Clinically, they appear as:
- Superficial Thrombophlebitis, in which the inflammatory reactions of the superficial veins (redness of the skin) are predominant and don’t often generate embolism; they’re common in varicose veins, some forms of arthritis (Bürger disease), in endophlebitis caused by pharmaceuticals;
- Deep Thrombophlebitis must be correctly diagnosed because it can lead to pulmonary embolisms; they occur most often after surgeries, pregnancy, infections, neoplasia. 60% of cases appear in patients who’ve had a prolonged bed rest, wasting afflictions, or infectious diseases. Deep Thrombophlebitis is clinically associated with pain in the lower legs, spontaneous or provoked, local edema, localized heat, fever and sometimes tachycardia.
Venous ulcers, also known as stasis ulcers of the legs appear when blood no longer flows normally in the lower limbs. This condition is also called venous insufficiency. Typically, venous ulcers appear on either side of the lower calves, above the ankles. Veins have valves which direct the blood flow to the heart. In patients with venous insufficiency these valves are destroyed and blood is no longer directed towards the heart and remains in the legs.
Circulation then becomes poor as the blood passes from the veins to neighboring tissues, where it pools. The tissue around the veins is damaged and venous ulcers appear.In rare cases venous ulcers contribute to the obstruction of the veins.
For veins located on legs, the best treatment available is microsclerotherapy. Microsclerotherapy solves an esthetical problem without producing post-treatment symptoms. This is accomplished by injecting the veins with minuscule needles, the final effect being the closing of the affected vein which later is reabsorbed in the body.
Varicose veins (Varicose Disease) is the most common condition of the veins and is characterized by segmental dilation of the large veins conduits or tangled aspect in the smaller veins. The origins of varicose veins is unknown but they are primitive and their presence indicates a congenital insufficiency of the venous valves, which are no longer able to prevent reflux.
Pregnancy and standing up for prolonged periods of time increase the likelihood of developing varicose veins as well as worsen existing ones. Secondary varicose veins are those developing as collateral pathways, typically after stenosis or occlusion of the deep veins, a common sequel of extensive deep venous thrombosis. Clinically varicose veins can be associated with cramps, aching and heavy legs often after exercise or walking, tingling or edema.
Deep vein thrombosis is the formation of a blood clot in a deep vein, predominantly in the lower limbs, pelvis or upper limbs. Thrombi can appear either in veins close to the skin’s surface (the condition is called either thrombophlebitis or simply phlebitis) or in the deep veins. The thrombi in the superficial veins rarely cause any serious health issues, whereas the ones located in deeper veins require immediate medical attention. The latter can grow in size and can travel along the bloodstream reaching the lungs and causing a life-threatening pulmonary embolism.
Deep vein thrombosis can have other long-term complications. In approximately 25% of cases, deep vein thrombosis damages the vein’s wall and leads to long-term post-thrombotic syndrome. This can cause pain, edema, pigmentation disorders (depigmentation) and lesions in the limbs. Most thrombi appear in the calves and thighs and less frequently in the upper parts of the body.
Deep vein thrombosis and pulmonary embolism are both included in a single clinical entity called Venous Thromboembolism. Inferior legs thrombosis is the most common deep vein thrombosis with a prevalence of 1 out of 1000 people. It represents the most frequent source of pulmonary embolism with a mortality of 25.000 per year.
Another severe complication of deep vein thrombosis is chronic venous insufficiency. Formation of thrombi in veins determine endothelial lesions and initiates inflammatory processes which lead to thrombophlebitis and the fibrosis of venous walls. Chronic venous insufficiency leads to the formation of chronic ulcers which don’t heal, varicose veins and lipodermatosclerosis.