Varicose Veins - EVLT Endovenous laser treatment

Varicose veins are caused by weakness in walls of veins, which can lead to distention. This distention then causes valves within the veins to malfunction, leading to leaking valves or reflux, where there is back-flow within the veins. This can lead to congestion of blood in the leg veins which can acidify and cause symptoms such as pain, throbbing, fatigue, cramps, burning sensations and restless legs.

A strong family history is a common finding in patients with varicose veins. Females are also more likely to be affected than males, due to factors such as fluctuations in hormones during puberty, pregnancy and menopause.  Pregnancy in itself causing an increase in volume, and pressure on the leg veins, so varicose veins during pregnancy are common. Other predisposing factors include obesity, immobility, standing occupations, previous deep-venous thrombosis and leg injuries.

If varicose veins become symptomatic or require treatment to prevent or cure varicose eczema or ulcers then a number of treatments are available. A medical consultation and ultrasound is performed to determine the most appropriate method of treatment.

Endovenous Laser Ablation (EVLA) involves a small laser fibre inserted painlessly into the vein under local anaesthetic. Laser energy is then delivered into the vein causing it to collapse and seal shut.

Ultrasound-guided sclerotherapy (UGS) involves the use of ultrasound to precisely locate abnormal veins and to inject them with foam to close them down. A combination of both EVLA and UGS is commonly used. Treatment takes approximately one hour per leg, after which medical grade compression stockings are worn for two weeks. Patients can walk immediately after treatment and are encouraged to walk to speed recovery. Patients have a follow-up treatment after three to five weeks, then another one a year after treatment to ensure any new veins that develop are treated.

Some medical insurance companies may cover the cost of consultations and treatment for varicose veins.

Your first step to healthier legs is to call for a vein consultation with Dr Deshpande. During this hour consultation she will take a detailed history about your veins and general health. She will then assess your veins using an ultrasound machine and discuss the best treatment options for you.

Varicose Veins - UGS Ultrasound-guided sclerotherapy

UGS is a modern technique that is reserved for treating advanced varicose veins that are hidden beneath the skin, feeding visible veins.

UGS is a versatile procedure that can treat saphenous veins, perforating veins, and other hidden varicose veins.

The ultrasound precisely displays abnormal veins, as well as adjacent structures such as deep veins and arteries. With ultrasound guidance, the phlebologist can inject these hidden abnormal veins while observing the process on the ultrasound monitor. Once injected, the treated vessel will be gradually absorbed by the body and will eventually disappear. A number of injections are required along the length of the vein to achieve complete closure. A significant advantage of this method is that it allows the phlebologist to monitor the effect of each injection, while ensuring the safety of all adjacent structures. The use of sclerosant as foam, rather than solution, has made this procedure much more effective.

The treatment may take up to half an hour. Following the procedure, patients are fitted with graduated compression stockings and asked to go for a 30-40 minute walk to promote blood flow in the deeper veins. Patients normally return to work the following day with no problem, and are encouraged to remain active, although it is best to avoid strenuous exercise such as weight lifting for a week or so.

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