Varicose Veins

Varicose veins are swollen, twisted blood vessels most commonly found in the legs, often presenting as bulges of a dark purple or blue colour. They are a result of blood pooling (stasis) in the veins due to a weakness of the vein’s wall and/or valve damage in the leg (venous insufficiency). Varicose veins can be a cosmetic issue, however when they become painful or associated with swelling, cramps or skin discolouration /eczema, you should seek medical advice.

Symptoms can include:

• Pain especially after sitting or standing for prolonged periods of time

• Heavy feeling in your legs

• Restless legs

• Burning sensation around the veins

• Itching

• Skin discoloration/brown staining around a varicose vein

• Rarely bleeding, spontaneous bruising, or thrombophlebitis (hard and tender varicose veins)

In rare cases varicose veins can lead to complications such as ulcers, blood clots or bleeding from a burst vein close to the skin, which may severely affect quality of life. SMC provides a variety of the latest minimally invasive procedures to treat varicose veins, the choice and combination of which will depend on each individual case.

Symptoms can worsen throughout the day and are partially relieved by elevating the legs or wearing compression stockings.

Sometimes varicose veins can clot and become painful, hot, hard and discoloured. This is an indication of thrombophlebitis, a condition not as serious as DVT which gets better on its own within a few days or weeks. Clots associated with phlebitis are not dangerous; as they are limited to surface veins they don’t normally travel to the heart or lungs and cause life-threatening conditions. Deep Vein Thrombosis (DVT) refers to clots that form in the deep veins, which can then travel to the heart or lungs and could become life threatening.

Spider Veins

Spider veins (also called telangiectasias) differ from varicose veins, however venous insufficiency is the underlying cause for both problems. Spider veins are smaller, thinner veins closer to the skin that may be raised or flat. They can present as a blue, purple or red colour and are easily visible on the legs and face. Spider veins form when structural abnormalities in the blood vessels prevent blood from being pushed back to the heart, leading to stasis (blood pooling) and venous reflux (backflow of blood).

Spider veins are often a cosmetic issue, however they can cause pain and discomfort depending on the severity and the presence of larger varicose veins. Compression therapy is usually recommended before any procedure is undertaken. Spider veins can be treated with liquid or foam sclerotherapy, and compression stockings should be worn for several days.

Sclerotherapy for cosmetic spider veins may not be covered by your insurance company, so it is advisable to check before any treatment is carried out.

Progression of Venous Insufficiency

I   Telengectasias (spider veins) reticular veins

II   Varicose veins

III   Edema

IV   Skin changes:  pigmentation, hemociderin staining, lipodermatosclerosis

V   Healed venous ulceration

VI   Active venous ulceration

Treatment Options

A range of options exist for the treatment of venous insufficiency and varicose veins:

• Compression stockings

• Phlebectomies

• Endovenous Laser (EVLT) and Radiofrequency Ablation Closure

Endovenous Laser Therapy (EVLT)

Endovenous laser treatment is a minimally invasive ultrasound-guided technique used for treating severe varicose veins. EVLT is used to seal off defective superficial saphenous veins, eliminating the source of surface varicose veins. This method uses heat generated by radiation (laser) to create scar tissue and close the vein. The laser fibre is inserted into the vein via a catheter, which is activated and then pulled back slowly. EVLT is a day-case procedure, meaning the patient can walk in and walk out the same day without any lengthy and costly hospital charges.

Phlebectomy

Phlebectomy is a minimally invasive technique used to treat varicose veins that lie just below the surface of the leg. Small incisions are made in the skin through which the vein is removed with the use of a clamp. Phlebectomies are completed as a day surgery procedure, under the use of local anaesthetic and usually does not require stitches.

VenaSeal Closure System

The VenaSeal closure system is a recently developed technique to treat varicose veins. The procedure uses an injectable medical adhesive which treats the underlying source of varicose veins, reversal of venous blood flow or reflux in the great and small saphenous vein. The method is non-thermal, non-tumescent and non-sclerosant, offering a quick recovery time and minimised pain and discomfort during the procedure. 

Varicose Vein Treatments

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