What are Varicose Veins?
Varicose veins are the larger, usually bulging blue green veins visible on many people’s legs. Not all visible leg veins are varicose, or “incompetent”, and ultrasound examination can help to define the nature of such veins. Varicose veins are of concern due to cosmetic appearance, but may also cause leg aching, swelling, and more severe skin changes in the lower legs.
Assessment of Varicose Veins
Varicose Vein assessment consists of a review of medical history and the symptoms associated with the veins. Dr McMaster will also check for signs on the lower legs of progressive tissue compromise secondary to the varicose Veins. Accurate venous ultrasound scanning helps to diagnose the source of the varicose vein problems and identify the most appropriate treatment approach.
Management of Varicose Veins
After a thorough clinical assessment Dr McMaster can advise on his recommendations for treatment of your veins. This may range from a recommendation to have no active treatment other than the use of compression stockings and lifestyle modification, to ultrasound guided sclerotherapy, endovenous laser, or cyanoacrylate glue treatment. Very occasionally, surgery may remain the preferred approach.
Ultrasound Guided Sclerotherapy (UGS) also known as Echosclerotherapy, is the treatment of veins with injection of sclerosant with the assistance of ultrasound imaging. This will occur in people who have visible varicose veins, and occasionally in those with “incompetent” but not visible superficial veins, where there are other symptoms such as pain, or signs such as patches of surface veins.
Also known as Endovenous Laser Ablation (EVA), this is a very effective method for treatment of incompetent Superficial Trunk Veins, which are commonly the main problem underlying visible varicose veins. Dr McMaster uses EVLT to treat these veins in his rooms under local anaesthetic and ultrasound guidance.
Cyanoacrylate adhesive, also known as super glue, or vein glue, this has been used for many years to treat venous malformations elsewhere in the body. In the past few years this has been used as another minimally invasive method to treat stubborn segments of varicose veins in the legs which are not amenable to laser and not effectively treated with Ultrasound guided sclerotherapy.
Frequently Asked Questions
Firstly, recurrence can occur following vein treatment of any type. However, recurrent veins can be treated. The best approach for treatment of recurrent veins will be apparent following ultrasound examination and mapping of the veins.
It is true that one of the veins commonly treated in varicose vein treatment is one that surgeons often use for coronary artery bypass grafting. However if this vein has become dilated and varicose, it will not be suitable for the cardiac surgery, and other alternatives are available.
There is plenty of capacity in the deep veins of the legs to take extra flow. The deep veins already take the vast majority of blood flow from the legs back towards the heart.