Varicose veins are enlarged, rope like veins that occur in the legs. Often dark blue in colour, they appear near or raised above the surface of the skin.
Varicose veins don’t occur suddenly. In fact, they usually take years to develop. Although they’re often inherited, anyone can get them. And they’re common for people who have had certain types of leg injuries or deep-vein blood clots.
Another factor in developing varicose veins is doing work that requires standing or sitting for long periods of time. This deprives the veins in the legs of the regular blood flow that occurs when the leg muscles flex during walking and other activities.
As you go about your day, blood flows from your heart to the rest of your body through arteries. It then returns to the heart through veins. It first collects in small superficial veins, then flows into larger veins that have one-way valves to keep the blood from flowing backward.
In healthy veins these valves make sure the blood is directed upward and inward toward the heart and the lungs. But when one or more of these valves don’t work properly, some of the blood leaks and flows back down the leg. This causes the vein to overfill with blood, making the branches of those small superficial veins bulge under the skin.
The deep veins can withstand this pressure, partly because of their construction and partly because they’re surrounded by muscles. But over time this extra pressure can cause superficial veins to become distended. And without treatment, chances are they will become varicose veins.
As these superficial veins weaken further, more and more blood accumulates under pressure and causes swelling. Eventually, the valves no longer close at all, and blood begins to pool in the superficial veins of the lower leg. These engorged, rope like veins—varicose veins—are abnormal, yet they are common and mostly affect women.
As well as the visible protrusion of varicose veins, other symptoms may include leg swelling, pain, fatigue, itching as well as cramping in the leg/s and a burning sensation. In severe cases rashes, skin discolouration, superficial blood clots, bleeding and ulcers may develop.
Varicose veins are often hereditary, but are also common for women during pregnancy and they can also be caused by injury to the leg, spending a lot of time standing up, being overweight or not very mobile, or simply as part of the ageing process. Up to a third of the population is affected by varicose veins, with women slightly more prone to develop them and at a younger age.
Although varicose veins are visible on the skin, ultrasound is usually used to diagnose the extent of the vein structure affected.
Once there are changes affecting the skin it is recommended that varicose veins are treated, as any poor flow of blood in the veins may lead to future complications such as ulcers, inflammation (phlebitis) and formation of blood clots.
Varicose veins that are not causing you any problems and are not affecting the integrity of skin on the leg do not need to be treated. However, even if you do not have severe symptoms of venous insufficiency you may have unsightly visible veins that you want removed.
This is very common.
Dr Hagley uses a range of techniques to treat varicose veins and he will tailor a treatment based on the location and degree of insufficiency as well as your treatment goals. Treatments available are…
Three surgical techniques are currently used for varicose veins:
These open techniques have been around for a long time, and they are safe and effective.
Dr Hagley however prefers to use minimally invasive techniques in most cases. They also have excellent results and allow faster recovery and return to work.
These techniques are generally used on the larger saphenous veins and use keyhole techniques with laser, radiofrequency or glue together with ultrasound technology to collapse the affected vein/s.
The catheter system delivers a small amount of a specially formulated medical adhesive to the diseased vein. The adhesive seals the vein and blood is rerouted through nearby healthy veins
The catheter is powered by radiofrequency or laser energy, delivers controlled heat to the vein wall, causing occlusion by clotting.
This is a procedure where a ‘sclerosing agent’ is injected via a micro needle into the affected vein which makes the vein close up. Sclerotherapy techniques such as Ultrasound Guided Sclerotherapy (UGS),
Microsclerotherapy and Catheter Guided Sclerotherapy (CGS) deliver the sclerosing agent in different ways.
When veins are treated they are no longer able to carry blood, however the treated veins are not working in the first place, and they generally make up less than 1% of the vein structure in each leg. After treatment, blood makes its way back to the heart through the remaining vein structures. Overall blood circulation is improved when ‘incompetent’ veins are removed or sealed.
You will be taken to the theatre recovery area after the operation, where you will wake up. When you are fully awake (usually 20-30 minutes) you will return to the ward or day surgery area. The nursing staff will check your blood pressure and other observations.
Most people describe the leg as stinging when they wake up. It is unusual for the leg to be painful. Following this sort of surgery you are very unlikely to feel sick, and you should be able to eat and drink again within a few hours.
Some of the smaller incisions may bleed a little over the first 24-48 hours. For this reason, it is best to keep the leg covered with bandages overnight.
If you are staying overnight, the nursing staff will remove the dressings and replace them with your stocking in the morning.
If you go home after the operation; on the second morning remove the bandage being careful to keep the smaller “Steristrip” dressings in place. You will then put on the compression stocking. You may require assistance. They should be worn continuously for the first 24 hours.
After this time, the stockings will provide support to the bruising, making the leg more comfortable. Wear the stockings during the day for a further 14 days, and up to 6 weeks for best results.
You can shower with the ‘Steristrips’ in place and these will fall away after about a week. Any larger incisions will be closed with dissolving stitches under the skin.
The incisions, although initially very visible, will subside to become virtually invisible within 9-12 months. There is usually bruising in the leg, particular down the inside of the thigh. This bruising usually lasts for 3-4 weeks.
You will be encouraged to mobilise as soon as possible after surgery to encourage the deep circulation.
Driving: You will be able to drive within 48 hours of the operation provided the leg is not too uncomfortable. If you are travelling for more than 2 hours, stop and walk for 10-15mins every hour.
Flying: No air travel for 7 days after the procedure. No long haul flights for 1 month
Bathing: You can shower within 48 hours of operation. Sometimes bathing or showering immediately after surgery may lead to bleeding from the smaller incisions. No hot tubs or hot baths for 1 week
Work: You should be able to work within 2 days to 1 week of surgery depending on your job. You may return to work when you feel able.
Lifting: Avoid heavy lifting and strenuous exercise for 2 weeks.
Medicines: You will usually be sent home with some pain relief. You will be advised on their use before you leave the hospital.
Bleeding: If any of the small incisions start bleeding, sit down and apply firm broad pressure to the area for 10mins, if ongoing apply another 10mins, if still ongoing notify Dr Hagley and call an ambulance.
If you have any further questions, please do not hesitate to ask either Dr Hagley, one of his team, or the nurses looking after you on the ward. If any problem arises after surgery contact the Mater Private Clinic 3831 4499, your GP, or attend the Mater Private Accident & Emergency Department.
