During pregnancy, Weiss says the increased blood volume the mother is circulating for herself and her fetus can make veins bulge. Sitting with a full uterus on the top of the thighs also does not help blood return to the heart (varicose veins that pop up during pregnancy usually deflate in three months, although new pregnancies can bring them on again, sometimes to stay).
Aging, obesity, and prolonged standing can also cause leg veins to balloon.
Diagnosis and Treatment
If you had a mother or grandmother treated for varicose veins and thought the treatment sounded worse than the disease, take heart. Times are changing. "We now use duplex ultrasound to look at the circulatory system of the leg," Weiss says. This means taking a sharp, two-dimensional picture instead of a doctor listening to blood flow in the leg with a Doppler device and trying to decide which veins are affected and where.
Duplex ultrasound is also a boon, says Sandy S. Tsao, MD, an instructor of dermatology at Harvard Medical School and assistant in dermatology at Massachusetts General Hospital in Boston. She says this is because knowing the condition of the exact vein affected can help the doctor determine which treatment to use.
In the old days, a flexible metal rod was inserted into the vein at the groin level, passed through the vein and taken out the other end, where a metal cap was screwed on. The rod was then pulled back through the leg, stripping the vein out through the groin incision. With the vein gone, the deeper circulatory systems took over and the wormy mass was not longer visible.
Stripping is hardly ever done anymore. "We have really widened the frontiers!" Tsao exclaims. Now, a thin catheter may be inserted into the affected vein and the whole inside of the vein, called the lumen, heated by radio waves, which shrinks the tough collagen in the vessel wall and causes it to collapse and re-absorb. Anesthesia mixed with fluid is injected first to make the procedure painless and, at the same time, press the blood out of the vein. Scarring is almost imperceptible, although there may be some bruising and the vein may take eight weeks to re-absorb.