Varicose Veins

Varicose veins are prominent often lumpy veins found around the knees, calf and thighs.
They are worm-like in appearance, sometimes described as a bunch of grapes.

– Varicose and spider veins are an extremely common condition that affect more than 1 in 2 adults, more commonly women.
– Family history is also a significant risk factor while jobs that involve sitting or standing all day in a generally stationary position can also make them worse (think doctor, hairdresser, teacher & trades people).
– Other risk factors include obesity, which increases pressure in the abdomen, pregnancy, menopause and the use of birth control pills and postmenopausal hormonal replacement (HRT).
– Varicose veins also often develop during pregnancy, as increased fluid puts the veins under extra pressure, partly due to hormones allowing the valves to stretch more and partly due to the foetus causing obstruction to the flow of blood in the legs.

– Varicose veins are caused by faulty vein valves.
– The valves in the veins are supposed to be “one way” valves, only allowing flow of blood out of the legs.
However varicose veins occur when these fail and allow a two-way flow both in and out of the leg.
In turn, this causes high pressure in the veins, which stretch, weaken and become varicosed.

– Spider veins are generally smaller, blue, red or purple vessels. They most commonly appear on the legs, face or chest and are very fine vessels on the skin surface.
– Varicose veins are bulgy, sometimes bluish veins under the surface of the skin that usually develop on the legs.
– A varicose vein is a pre-existing normal vein that has been damaged due to high venous pressure related to valve failure, while spider are cosmetic generally and appear on the surface of the skin.

– Lifestyle measure to prevent vein issues include maintaining a healthy weight, exercising, and avoiding shapewear except for special occasions.
– Compression stockings however are not the same as shapewear and may help veins from worsening so speak to Dr Sung about compression wear for vein prevention.
– Pregnancy veins may resolve within 12 months after delivery without any treatment or intervention. However, if they do not please contact us.

Treatments include

– This is minimally invasive medical treatment whereby Dr Sung injects the visible spider veins on the skin with a solution, using ultra-fine needles and a special light to see deep into the veins.
– The veins start to harden and dissolve until they disappear.
– This is generally viewed as the optimal treatment for tiny, widespread spider or reticular veins that are extremely close to the surface of your skin and are very small (less than 3mm).

Sclerotherapy

– This is a walk-in walk-out procedure that involves injecting a solution (either liquid or foam) into the varicose veins.
– The injection is usually done using ultrasound guidance for pinpoint accuracy and to ensure the solution is injected into the correct spot.
– The solution creates an irritant reaction in the vein wall which blocks it off and causes it to become like a thread of scar tissue. This generally takes 30 to 90 minutes in total depending on the number of veins to be done, and whether one or two legs are involved.

Thermal Ablation

– This is used for the main superficial vein feeding the varicosed veins.
– AVC Canberra offers two thermal procedures including endovenous laser ablation (EVLA) and radiofrequency ablation.
– Both use heat to destroy the vein and the technique is similar for both. Dr Sung will choose the optimum treatment for your veins.
– In both instances, the fibre is placed in the vein under local anaesthetic via ultrasound.
The fibre is then passed from the calf up to the groin, the vein is numbed, and “ablated” using heat.

– This is a relatively new technique.
– No local anaesthesia is required, and some practitioners believe that it is not necessary to use compression after the process has been performed.
– If sclerotherapy injections are done at the same time stockings will be required.
 

Sclerotherapy, Thermal Ablation and Medical Super Glue are all minimally invasive and highly effective treatments for varicose or spider veins with either immediate return to normal activity, or just 1 or 2 days off.

There’s no hospital stays or painful vein stripping any more.

– These are very helpful, but not a treatment in themselves.
– The way they work is to help vein collapse while veins are sclerosing or becoming an invisible thread of scar tissue instead of the original larger vein.
– Ask us about high quality compression stockings.

– The most common way to investigate varicose veins is by using Duplex ultrasound.
– This is non- invasive, so there are no needles or injections. It is safe and painless.
– Gel is put on the skin and the blood flow in the veins is examined.
– That way, the cause of the varicose veins can be determined.
– A vein “map” is created and a treatment protocol can be decided upon.
– Depending on the severity, and the exact symptoms, more extensive investigations may be required. – – This would be discussed at length before going ahead.

Once treated will the veins return?

– If varicose veins are fully treated initially, then the chance of their coming back is approximately 2-3% per annum.
– If they do come back, then they are usually successfully treated by injections.
– As part of the long-term management of varicose veins, it is recommended that they be monitored using ultrasound performed yearly, and if there is evidence of recurrence, it should be investigated and treated appropriately, usually by injections.