Varicose Veins

Microsclerotherapy

Why it’s done?

Spider veins or telangiectasia are tiny blue, purple or red veins lying just below the surface of the skin.

Description

Using a tiny needle (0.3mm) the spider veins are directly injected with a liquid sclerosant (a chemical which damages the lining of the vein).

The injections work by damaging the lining of your veins. As your body needs time to heal the damage to your veins your legs will initially look worse before they look better. Most people notice a dramatic improvement approximately 4 weeks after their initial treatment. Maximal improvement often takes several months and more than one treatment is often required.

Risks:

Common side effects:
  • Bruising, itching, mild pain
  • Hyperpigmentation: A light brown discoloration of the skin develops over the injected veins in 20-30% of patients. It usually fades over several weeks, but may take several months to a year to totally resolve. In 1-2% of patients it persists after 1 year.
  • Telangiectatic matting: formation of new fine “spider” veins in the areas injected occurs in 10% of patients. It usually resolves in 3-12 months, rarely it can be permanent. It can be re-injected if it does not fade.
Rare side effects:

What can I expect after treatment?

You will wear graduated compression stockings for 3 weeks after your microsclerotherapy.

 You will be able to shower 24 hours after your treatment.

You will be able to resume your normal daily activities immediately after your microsclerotherapy. You will be able to resume sport the following day.

 You will be able to resume driving immediately.

Commonly more than one treatment is required.

 

Ultrasound guided foam sclerotherapy

Why it’s done?

 Varicose veins that are unsightly, painful or causing skin rashes, skin damage or ulceration.

Description

Under ultrasound guidance a needle is inserted into the varicose veins and a foam sclerosant (a chemical which damages the lining of the vein) is directly injected. Ultrasound confirms that all the varicose veins have been treated with the foam.

The injections work by damaging the lining of your veins. As your body needs time to heal the damage to your veins your legs will initially look worse before they look better. Most people notice a dramatic improvement approximately 4 weeks after their initial treatment. Maximal improvement often takes several months and more than one treatment is often required.

Risks:

Common side effects:
  • Bruising, itching, mild pain and inflammation
  • Trapped blood or “phlebitis”
  • Hyperpigmentation: A light brown discoloration of the skin develops over the injected veins in 20-30% of patients. It usually fades over several weeks, but may take several months to a year to totally resolve. In 1-2% of patients it persists after 1 year.
  • Telangiectatic matting: formation of new fine “spider” veins in the areas injected occurs in 10% of patients. It usually resolves in 3-12 months, rarely it can be permanent. It can be re-injected if it does not fade.
Rare side effects:

What can I expect after treatment?

You will wear graduated compression stockings for 3 weeks after your foam sclerotherapy.

You will be able to shower 24 hours after your treatment.

You will be able to resume your normal daily activities immediately after your foam sclerotherapy. You will be able to resume sport the following day.

You will be able to resume driving immediately.

Commonly more than one treatment is required.

 

Endovenous Laser ablation

Why it’s done?

If you have varicose veins that are unsightly, painful or causing skin rashes, skin damage or ulceration and an ultrasound scan has confirmed venous reflux in your great saphenous or short saphenous vein.

Description

Under local anaesthetic the vein that is the source of the venous reflux is accessed using a small needle under ultrasound guidance. The laser fibre is then inserted into the vein. Additional local anaesthetic is then injected surrounding the area of the vein to be treated. Ultrasound is used to ensure that the laser probe is in the correct position and the vein is treated by gradually pulling back the laser fibre ensuring that the entire length of the vein is adequately treated. A small dressing is placed on the entry site and a compression stocking is applied.

Risks:

Common side effects:
  • Mild pain, bruising, swelling and inflammation
Rare side effects:
  • Pulmonary Embolus/Deep vein thrombosis
  • Nerve injury (less than 3% and usually transient)
  • Skin Burns (very rare)

Recurrence of varicose veins (comparable to surgical vein stripping)

What can I expect after treatment?

You will wear graduated compression stockings for 3 weeks after the endovenous laser ablation.

You will be able to shower 24 hours after your treatment.

You will be able to resume your normal daily activities the day after your endovenous laser ablation. You will be able to resume sport and exercise after one week.

You will be able to resume driving the day after your endovenous laser ablation.

An ultrasound will be performed at 1 week and 4 weeks post endovenous laser ablation.

 

Radiofrequency ablation

Why it’s done?

If you have varicose veins that are unsightly, painful or causing skin rashes, skin damage or ulceration and an ultrasound scan has confirmed venous reflux in your great saphenous or short saphenous vein.

Description

Under local anaesthetic the vein that is the source of the venous reflux is accessed using a small needle under ultrasound guidance. The radiofrequency probe is then inserted into the vein. Additional local anaesthetic is then injected surrounding the area of the vein to be treated. Ultrasound is used to ensure that the radiofrequency probe is in the correct position and the vein is treated sequentially in 7cm segments ensuring that the entire length of the vein is adequately treated. A small dressing is placed on the entry site and a compression stocking is applied.

Risks:

Common side effects:
  • Mild pain, bruising, swelling and inflammation
Rare side effects:
  • Pulmonary Embolus/Deep vein thrombosis
  • Nerve injury (less than 3% and usually transient)
  • Skin Burns (very rare)
  • Recurrence of varicose veins (comparable to surgical vein stripping)

What can I expect after treatment?

You will wear graduated compression stockings for 3 weeks after the radiofrequency ablation.

You will be able to shower 24 hours after your treatment.

You will be able to resume your normal daily activities the day after your radiofrequency ablation. You will be able to resume sport and exercise after one week.

You will be able to resume driving the day after your radiofrequency ablation.

An ultrasound will be performed at 1 week and 4 weeks post radiofrequency ablation.

 

Venaseal glue

Why it’s done?

If you have varicose veins that are unsightly, painful or causing skin rashes, skin damage or ulceration and an ultrasound scan has confirmed venous reflux in your great saphenous or short saphenous vein.

Description

Under local anaesthetic the vein that is the source of the venous reflux is accessed using a small needle under ultrasound guidance. An introducer sheath is inserted into the vein and the catheter (small plastic tube) that delivers the glue in inserted into the introducer. The catheter is advanced into position and the dispenser gun is then used to deliver the glue (cyanoacrylate glue) into the vein while compression is gently applied to stick the walls of the vein together. The entire vein is treated in segments and the system is then removed.

Risks:

Common side effects:
  • Mild pain, bruising, swelling and inflammation
Rare side effects:
  • Pulmonary Embolus/Deep vein thrombosis
  • Infection
  • Allergic reaction
  • Recurrence of varicose veins

What can I expect after treatment?

You will not need to wear graduated compression stockings

You will be able to shower immediately after your treatment.

You will be able to resume your normal daily activities immediately after your venaseal. You will be able to resume sport the following day.

You will be able to resume driving immediately.

 

Varicose vein surgery

Why it’s done?

If you have varicose veins that are unsightly, painful or causing skin rashes, skin damage or ulceration and an ultrasound scan has confirmed venous reflux in your great saphenous or short saphenous vein.

Description

The surgery is performed under general anaesthetic. A small incision is made in the groin and the vein is dissected. The junction between the deep vein and the refluxing superficial vein (saphenous vein) is then disconnected and tied. The refluxing saphenous vein is then stripped out of the leg to the level of the knee using a vein stripper. The wound is then closed with dissolving stiches. Any remaining varicose veins in the calf or thigh are then removed by making a small nick in the skin and removing the vein with a vein hook. Your legs will be wrapped up in tight bandages, which will be removed the following day and you will be fitted with compression stockings.

Risks:

Common side effects:
  • Pain, bruising, swelling and inflammation
Rare side effects:
  • Pulmonary Embolus/Deep vein thrombosis
  • Bleeding
  • Nerve injury
  • Infection
  • Wound breakdown
  • Recurrence of varicose veins

What can I expect after treatment

You will need to wear graduated compression stockings for 3 weeks.

You can expect pain, swelling and bruising which limit your activity for at least 1 week.

It will be 2-4 weeks before you can resume exercise and strenuous activities.

You will be able to resume driving after several days.