Varicose Veins

Dr Venu Bhamidi | Gold Coast

What are Varicose Veins?

While arteries take oxygen rich blood to various parts of the body, veins are blood vessels that carry the blood back to the heart so it can be re-circulated. Because the veins in the legs have to pump blood back to the heart against gravity, they contain one-way valves, to prevent the blood from being pulled back down to the feet by gravity. There are two sets of veins in the legs; the main ones that lie in the middle of the leg (deep veins that transport ~90% of the venous blood) and ones that run close to the surface (superficial veins that transport ~10% of the blood). Blood is usually pumped from the superficial veins, through communicating veins (known as perforators) into the deep veins to be pumped back to the heart.
Varicose veins are dilated, enlarged veins that are present usually in the subcutaneous (‘fat’) layer and are often tortuous in nature. They are generally greater than 4mm in diameter, with severe cases being 15mm or greater in size. Generally speaking, they are found in around 20-30% of the population, with women often being more affected than men.
Spider Veins are very small-dilated veins that are present within the multiples layers of skin. These are the most common and are present in a large percentage of the population in some degree or the other. These do not necessarily need treatment; in so much as they present more of a cosmetic problem rather than any significant health issues. Treatment is usually in the form of foam sclerotherapy, which is usually done in an office setting.

FAQs

Varicose Veins treatment is unique for every patient, depending on the causes, the anatomy of the veins, symptoms and severity of the case. To successfully get rid of your varicose veins, we first need to understand if any underlying issues could be contributing to your condition. Trying natural methods such as regular exercise, maintaining a healthy weight, wearing compression socks and keeping to a healthy well-balanced diet will help alleviate symptoms. However, in many cases, medical intervention is still required. Following a thorough check-up, you may be advised to use compression stockings, undergo ultrasounds or partake in any number of other treatment methods. The best way to address the problem is to visit a varicose veins specialist in the field, such as Dr Venu Bhamidi, who can advise you on the most appropriate treatment methods available.
Unfortunately, varicose veins will not go away on their own. You can manage the appearance and discomfort of varicose veins by following a balanced diet and undertaking a regular exercise regime to assist with your blood circulation or by elevating your legs to alleviate aching. The varicose veins will still be present; however, you may find some relief in these methods.  That being said, the underlying issues that caused the varicose veins in the first place will need to be addressed. There are often multiple contributing factors that are best assessed by a vascular surgeon who will be able to diagnose, treat and provide you with the best varicose veins treatment options.  But whatever the underlying causes, treating the varicose veins correctly will bring symptoms relief and eliminate the chances of developing any complications in the future.
There are many new varicose veins treatments available that do not involve invasive surgery. Endovenous thermal ablation is highly effective in treating varicose veins and is often done as a day surgery procedure. A laser or radiofrequency fibre is used to seal off the problematic vein using heat. Sclerotherapy is another option where the vascular surgeon injects a small amount of solution to close the vein. Both of these methods will result in fading and the eventual disappearance of your varicose veins. The most recent advance in varicose veins treatment is Venaseal (a type of superglue) which is usually done under local anaesthetic as a ‘walk-in, walk-out procedure. Although a relatively new technique in the last 5 years, it is extremely effective with many patients opting for glue rather than heat to treat their veins. We recommend that you contact Vascular GC for a consultation to find the best solution for your particular case s. When attending our clinic, it is recommended to review the information required to ensure a hassle-free and effective consultation.
Complications or side effects of Varicose veins treatment are uncommon. Dr Venu Bhamidi will advise you of any potential side effects from the treatment you choose during your consultations before the treatment is performed. Newer varicose veins treatments offer safe and highly successful solutions with minimal side effects. The Vascular GC FAQs may assist with alleviating any concerns you might have, or you can simply contact us to discuss what treatments are available along with any potential side effects.
While varicose veins are not life-threatening, you can experience pain, discomfort and aching and ankle swelling. In most severe cases, patients can develop blood clots, skin pigmentation/discolouration, eczema, dermatitis, bleeding or ulcers/wounds. A visit to a vascular surgeon will help determine the underlying problem and provide you with the best treatment options.

Varicose vein treatment is a safe and straightforward process, especially with the modern minimally-invasive varicose vein treatments available. Experience the benefits of improved circulation, reduced risk of ulceration in your legs and fewer aches and pains resulting from untreated varicose veins.

What causes Varicose Veins?

Varicose veins most often occur when the valves within the veins stop functioning normally. This allows the blood, which should be pumped back to the heart, to pool in the superficial veins in the leg due to the effects of gravity. The subsequent abnormal reverse flow is known as venous reflux. If reflux is left to occur over a significant period of time, it will cause increased blood pressure in the veins, resulting in them becoming distended, swollen and varicose – a process that usually takes many years. There are a number of risk factors for developing the condition. These include:

  • Increasing age
  • Family history/s
  • Obesity
  • Pregnancy
  • Injury to the leg veins
  • Hormonal factors (e.g. puberty)
  • Occupation requiring prolonged standing
  • Gender (usually more common in women)

How are Varicose Veins diagnosed?

The most common problems encountered by those who have varicose veins include:

  • Aching legs (ranging from mild to severe)
  • Swelling of the leg/s
  • Itchiness and dry skin (eczema)
  • Clots and inflammation in the veins (thrombophlebitis)
  • Skin discolouration (lipodematosclerosis)
  • Skin ulcers

How are Varicose Veins diagnosed?

The most common problems encountered by those who have varicose veins include:

  • Aching legs (ranging from mild to severe)
  • Swelling of the leg/s
  • Itchiness and dry skin (eczema)
  • Clots and inflammation in the veins (thrombophlebitis)
  • Skin discolouration (lipodematosclerosis)
  • Skin ulcers

How are varicose veins treated?

In the majority of cases, diagnosing varicose veins is usually relatively straightforward. They are often easily visible and the distribution and direction of the varicose veins will usually suggest which vein in the leg is most affected.

What a physical examination cannot always confidently diagnose is where the highest point of reflux (abnormal functioning valve) occurs. Most of the time, it is located in the groin but occasionally it can be in the thigh or in the pelvis.

As well as the distribution of veins, the leg is examined for signs of other tissue damage that can be cause by the condition, such as skin discolouration, ulceration and eczema.

All varicose veins require an ultrasound to check the deep and superficial veins, get an exact diagnosis of the highest reflux point and provides a ‘map’ showing the surgeon exactly where the problems are in the veins.

The scan also shows whether the veins contain clot or are blocked due to inflammation, both of which help determine the best treatment option.

How are varicose veins treated?

Varicose veins can be treated in a number of ways – conservatively, surgery, endovenous laser or RFA therapy or ultrasound guided sclerotherapy. For minor veins that are symptomatic, a trial of conservative treatment with compressions stockings and lifestyle modification is sometimes helpful. While compression stockings don’t treat the veins, they help with managing the symptoms. As a specialist vascular and endovascular surgeon, Mr. Venu Bhamidi is a Vascular & Vein specialists who can offer the full complement of varicose vein removal techniques – from sclerotherapy through to surgery.

Surgery

Surgery most often involves a small incision in the groin to disconnect the troublesome vein from the main veins and removing the varicose vein.

Endovenous Therapy

Endovenous therapy, such as laser therapy (EVLT) or radiofrequency ablation (RFA), can be done in an office setting under local anaesthesia or under a general anaesthetic in hospital. The procedure involves ablating the vein using heat and often only takes 30-60 minutes depending on the complexity of the procedure.

Sclerotherapy

Sclerotherapy involves using a foam solution into the vein in order to irritate the inside lining of the vein and cause it to seal. The procedure is done under local anaesthetic and often under ultrasound guidance. It is not uncommon to require multiple treatments in order for the procedure to be most effective.

Prevention

While nothing can be done about several of the risk factors (age, gender, genetics), several strategies have been suggested to slow the progression of varicose veins.

These include:

  • Being a healthy weight
  • Wearing compression stockings regularly
  • When not walking, elevate your legs to reduce some of the swelling and discomfort
  • Be as active as possible – keeping the calf muscles active helps pump the blood back to the heart

Prevention

While nothing can be done about several of the risk factors (age, gender, genetics), several strategies have been suggested to slow the progression of varicose veins.

These include:

  • Being a healthy weight
  • Wearing compression stockings regularly
  • When not walking, elevate your legs to reduce some of the swelling and discomfort
  • Be as active as possible – keeping the calf muscles active helps pump the blood back to the heart
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