Veins are the blood vessels that transfer blood to the heart. The circulatory system pumps blood through the heart to the lungs and gets oxygen. Then a heart sends oxygenated blood to other body parts by arteries. The blood is pumped to the heart from the capillaries through venules (most minor veins) that coalesce in the more prominent veins. The veins return the deoxygenated blood from the parts of the body back to the heart. The veins are 1mm-1.5cm in diameter. Our body’s venous system is divided into deep and superficial systems. The superficial veins are located on top of the foot and help transfer blood through the tissues to the skin’s surface. These veins drain into deep veins that return blood to the superior and inferior vena cava and the heart’s right atrium. In addition, the superficial veins consist of truncal veins and collecting veins. The truncal veins are composed of great and small Saphenous veins.

Great Saphenous Vein

This large superficial vein is referred to as the long saphenous vein. The longest vein within the body originates from the marginal vein at the foot. Then it moves from the ankle to the inner side of the knee and groin and drains to a femoral vein at the saphenofemoral junction. The saphenous vein has been derived from the word Safina, which means hidden, so this vein is hidden inside the layer of connective tissue. This vein returns blood to the heart under gravity. Furthermore, these veins have collected small veins through the ankle and foot. The smaller veins are the small saphenous and medial marginal veins (in the ankle).

Small Saphenous Vein

The superficial vein is referred to as a short saphenous or lesser saphenous vein. This vein runs within the back of the calf through the ankle to the knee and drains within the deep venous system at the saphenopopliteal junction. It carries deoxygenated blood through the lower legs and returns it to the heart. Generally, large bulging veins in the leg are saphenous veins. These veins are extended through the lateral margin of a foot to the lateral malleolus. These conditions have been associated with a small saphenous vein, such as:

  • Varicose veins
  • Spider veins
  • Venous insufficiency or venous reflux disease
  • Thrombophlebitis

Varicose Veins

Varicose veins are enlarged, twisted veins that have a rough, knotted look and are close to the skin’s surface. Generally, these veins are red or bluish purple and appear raised and swollen in the ankle and feet. During this condition, veins have not worked properly. The deep veins (anterior tibial, posterior tibial, popliteal, femoral, fibular) have been discredited from superficial veins through different valves. These valves make the blood flow through a superficial system to the deep system, thereby preventing backflow. Incompetency in these valves has resulted in damaged or dilated veins, known as varicose veins. These veins are caused by obesity, pregnancy, family history, and menopause. In addition, Sclerotherapy, micro sclerotherapy, and laser surgeries block these veins.

Spider Veins

Spider veins are superficial thin red or purple veins that appear as spider shapes on the ankles, legs, thighs, and feet. These veins are similar to varicose, do not work correctly, and cause swelling and increased blood flow. Ankles and feet are susceptible to developing spider veins. The slow blood circulation and enhanced force within the veins are resulted in feet swelling and forming spider veins. Spider veins are caused by vein valve dysfunction or when it is weakened to the point where it cannot flow blood and raptures. The other factors that cause spider veins are heredity, trauma, obesity, and sunlight exposure. The symptoms of spider veins are throbbing, discolored skin, cramping, itching, bleeding, and ulcer.

Venous Insufficiency

A small superficial saphenous vein causes Venous insufficiency. Varicose veins are present together with lymphoedema and lipoedema because of enhanced force in the venous system. The enhanced pressure causes vein incompetency. During this condition, valves in the veins of the lower body do not work efficiently to flow the blood because of venous valve malfunction. It slows the blood flow and increases the pressure, causing swelling in the feet.

Thrombophlebitis

It is a circulatory condition in which blood clots are formed due to venous inflammation. It restricts the blood flow and causes tenderness, pain, swelling, and skin redness. Thrombophlebitis affects the superficial veins. It is caused by trauma, obesity, autoimmune disease, pregnancy, immobilization, and hormonal therapies. Furthermore, anti-inflammatory and blood thinning medications are used to reduce the potential complications of thrombophlebitis.

Treatment

There are different ways to reduce veins on the ankle and feet, which may include:

  • Exercising or physical activity to prevent the vein discomfort
  • Wearing compression socks to improve blood circulation and prevent pressure on the Foot veins
  •  Massaging in the ankles and feet
  • Reducing weight
  • Don’t stand and sit for a longer time
  • Putting the feet up
  • Taking high fiber diet
  • Reducing salt intake
  • Not wearing uncomfortable shoes for a longer period
  • Sclerotherapy

Sclerotherapy: It reduces the discomfort and pain in the ankles and feet and eliminates potential complications, like vein bleeding or ulcers. These are surface treatments using laser or micro electric devices, phlebectomy, and endovenous ablation. Sclerotherapy works best on smaller veins, such as varicose and spider veins. It may usually take six months for the removal of larger veins.

Venous ablation: A small laser is inserted into the vein in this procedure. The specialist makes a very little cut in the vein and takes it into the catheter. The catheter sends heat from laser light or radio waves into the vein. The heat results in the vein closing and fading away. Moreover, this therapy is minimally invasive and less complicated. This therapy leaves no scars because relatively small skin holes are required for catheter insertion rather than lengthy incisions.

Surgery: Surgical techniques are used to treat stripping and ligation. During these procedures, small cuts are made to the skin over the defective vein. Then through the lower cut, the vein is tied off and pulled out. It generally takes 2 to 3 hours and has done in the outpatient setting. The recovery time takes 1 to 2 weeks.

Ambulatory phlebectomy is used to remove large veins from small lesions. Surgery is performed using spinal, local, and general anesthesia; most patients can discharge within the same day. The doctor has outlined the vein that has to be removed and injected anesthesia into the skin. He makes a small cut and hooks a vein using a large needle. Then he removes the vein. Furthermore, the patients have required to wear compression stockings for one week.

References

https://www.nuvelaveins.com/leg-vein-anatomy-los-angeles/

https://www.kenhub.com/en/library/anatomy/great-saphenous-vein

https://www.physio-pedia.com/Small_Saphenous_Vein#

          https://njvvc.com/spider-veins-on-ankles-and-how-to-treat-them

          https://www.webmd.com/skin-problems-and-treatments/cosmetic-procedures-spider-veins