Healthy Times Magazine

What are varicose veins?

These are enlarged, tortuous, unsightly veins that usually appear on the legs. With the latest laser technology (EVLT) these varicose veins can be treated easily and effectively.

What are the symptoms?

Some patients have no symptoms whilst others may experience:

• Calf aches
• Obvious unsightly leg veins
• Calf heaviness ( usually at the end of the day)
• Swelling of the legs
• Nocturnal calf cramps
• Itching
• Eczema
• Discoloration of the skin
• Bleeding from the veins
• Ulcer formation

If you have any of the above symptoms, you may be suffering from symptomatic varicose veins

What causes varicose veins?

Some people are more prone to varicose veins because of their family history or their gender (women more than men) whereas certain conditions like obesity, prolonged standing, infection and trauma increase the pressure on the leg veins causing them to enlarge and bulge.

Veins normally return blood from the legs to the heart. These veins have one –way valves that are located throughout the length of the inside of these veins and usually these one-way valves prevent the blood from flowing backwards (reflux).

When these valves are “faulty or damaged”, the blood now flows in both directions thereby causing pooling. This pooling of blood in the leg veins over a period of time causes the vein to bulge and protrude from the skin surface.

How is the diagnosis of varicose veins made?

A duplex ultrasound should be performed to determine the exact pattern of abnormal blood flow (reflux) and the location of the abnormal or “faulty” valves.

Treatment for varicose veins is targeted at the superficial leg veins or the long saphenous vein (LSV). It is important that the deep leg veins are assessed before treatment to ensure they are normal.

The duplex ultrasound is performed in the clinic with conduction gel; there is no downtime, no pain or needles. The results of the scan are immediate and with this result, the best treatment plan can be tailored for each individual patient.

What is the treatment for varicose veins?

Varicose veins can be treated in 2 ways, either with conventional vein surgery or with EVLT. Conventional surgery involves removing the varicose veins through an incision in the groin. Though, effective, it has more pain, more complications, longer recovery period and more surgical scarring as compared with EVLT.

Endovenous Laser Therapy (EVLT)

This procedure is the latest treatment for varicose veins; it is the minimally invasive alternative to conventional vein surgery. It is safe, fast and effective.

A fine needle puncture is performed into the thigh vein (LSV) around the knee area, through this needle puncture, a laser fibre is inserted. This is performed accurately using ultrasound guidance.

The thigh vein is called the long saphenous vein and it is this vein that has the “faulty” valves that cause varicose veins. The laser fibre is heated and damages the inner lining of the “faulty” vein, this causes the vein to collapse and close, the collapsed vein disappears over time.

This procedure can be performed under sedation or regional/general anesthesia and is usually done as a day case. EVLT of a single leg usually takes less than an hour. There is no groin incisions, no surgical scarring, minimal pain and the recovery period is short.

This article was written by Dr Sanjay Nalachandran, General/Vascular Surgeon, Vein & General Surgery Clinic, Gleneagles Medical Centre, Singapore