Venous Service
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. Varicose veins 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.
More information on Varicose Veins can be found here.
Deep Vein Thrombosis
Deep Vein Thrombosis (DVT) refers to the occurrence of a blood clot (thrombus) in deep veins, commonly within the lower leg and thigh. If a DVT breaks loose and travels through the body to the heart and lungs, there is a risk of serious complications including Pulmonary Embolism (blockage of a vein/artery in the lungs) which can be life-threatening. A Pulmonary Embolism can also be experienced without DVT.
Risk-factors for DVT include but are not limited to:
Sitting or standing for long periods of time such as when travelling on planes
Immobilisation after surgery or hospitalisation
Pregnancy
Obesity
Cancer
Smoking
Trauma to the vein, as well as complications following invasive vein procedures
Deep vein thrombosis commonly exhibits the following symptoms. You should seek urgent medical advice if these are experienced:
Swelling, pain and warmth near the vein
Constant cramping sensation in the calf
Redness of the skin
Swollen of thickened blood vessels
DVT can be diagnosed using an Ultrasound scan, blood test (D-Dimers) and/or Venogram. Treatment in most cases relies upon anticoagulants and in special cases Thrombolysis and/or Thrombectomy (mechanical or surgical) and Endovenous Stenting.
Chronic Venous Obstruction
In certain cases the blood clot can turn into scar tissue, thereby impairing blood flow in the veins. This blockage results in poor return of blood to the heart, and is referred to as a chronic venous obstruction. Large veins that are blocked can cause severe swelling and pain, with symptoms including swelling and/or heavy sensation in the legs and discoloration of the skin.
Traditional methods to treat chronic venous obstruction relied upon open surgery. Venous angioplasty is a modern, less invasive method to treat venous obstructions. It involves threading a balloon into the vein via a catheter, with the help of medical imaging to help guide the catheter to the obstruction. The balloon inflates to clear the blockage, and in some cases a stent is placed (a metal mesh tube) into the vein to regain adequate blood flow and keep the vein open.
Venous Leg Ulcers
A venous ulcer refers to the erosion/loss of the skin due to impaired blood flow (in the arteries or veins), infection, trauma or systemic diseases such as diabetes and autoimmune conditions (vasculitis). They are long lasting sores or loss of skin generally surrounded by inflammation/infection and can be very painful and very slow to heal, and may result in limb loss. Correction of blood flow is paramount for ulcer healing. This will include opening blocked arteries in ischemic arterial ulcers or correcting venous stasis (blood pooling) in venous ulcers.
You are at an increased risk of leg ulcers if previously suffering from DVT (deep vein thrombosis) or varicose veins, whilst other risk factors include phlebitis, smoking, obesity and previous operations on your leg such as knee or hip replacements.
Symptoms of venous leg ulcers include:
Rash or dry skin, itching
Brown discolouration
An unpleasant/foul smelling liquid coming from the injury
If you suffer from any of the following symptoms, the ulcer may have become infected and you should immediately contact a specialist:
Redness or swelling around the skin
Increasing pain
Fever
Pus
Our vascular surgeons have extensive experience in the treatment of leg ulcers. The symptoms are treated through compression therapy, whilst the underlying cause is addressed to prevent further ulcers from developing.