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VENUS CENTRE VEIN CLINIC - Dr Chris Lekich

• Veins and Treatment - The Facts
• Making an Appointment
• Micro Sclerotherapy
• Ultrasound Guided Sclerotherapy
• Endovenous Laser Ablation
• Graduated Compression Stockings
• Who should treat your veins

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VEINS AND TREATMENT: THE FACTS

What happens in normal leg veins?

Healthy arteries and veins in the leg allow blood to travel through them in one direction only - just like the direction of a car in a one way street. Muscles in the legs act like pumps to help move the blood in the veins against gravity and back up the leg. The valves in leg veins prevent the blood from back-flowing back down into the foot. In normal veins, the valves and muscles maintain vein integrity with little retention of blood within the vein itself.

What happens when these veins become abnormal?

Often due to various reasons, the vein walls become weaker and tend to collect and retain more blood than normal, causing distension along the vein segment. As a result the valves in the vein do not function properly so a backflow of blood (often called reflux) occurs. The vein essentially bulges from the extra volume it now contains and appears as a visible lumpy line. These abnormal veins are described as "incompetent".

What types of abnormal veins are there?

1. Spider veins: these are the fine, red web-like veins visible on the surface of the leg - also known as telangiectasias. These veins serve no known biological purpose.
2. Reticular Veins: These larger veins lie a little deeper below the skin and are blue in colour.
3. Varicose Veins: These are the largest of the abnormal veins and can be seen bulging above the surface of the skin. Early treatment of these veins is usually easier and less complicated.

What Causes all of the different types of Abnormal Veins?

There is no known definitive reason why these veins become incompetent although there does appear to be links with a family predisposition. A strong family history of varicose veins is suggestive that some people are more likely to inherit veins that deteriorate. Approximately 30% of people are affected by varicose veins, with a 75:25 ratio of female to male with an average age of 50. Abnormal veins in women can also get worse from the use of birth control pills and fluctuations in hormone levels experienced in puberty, menopause and pregnancy. Some other factors that influence abnormal vein development include obesity, occupations that involve long periods of standing or sitting, immobility, ageing, previous venous thrombosis and some leg injuries.

What are the symptoms of Abnormal Veins?

Symptoms can include:

• Heaviness
• Aching
• Chronic pain
• Burning of legs
• Itchiness
• Night cramps
• Restless legs
• Leg swelling
• Skin discolouration
• Ulcers

How are Abnormal Veins Treated?

An ultrasound of your affected leg assists in determining which treatment option is appropriate. Microsclerotherapy, Ultrasound Guided Sclerotherapy and Endovenous Laser (Catheter Guided Sclerotherapy) are the treatment options used. For more information on:

Microsclerotherapy

Ultrasound Guided Sclerotherapy

Endovenous Laser (Catheter Guided Sclerotherapy)

My Mum had her Varicose Veins Stripped - Why has the treatment changed?

Because of the ability to treat large veins with sclerotherapy as a walk in walk out procedure, vein stripping is no longer the only treatment option. Traditionally vein stripping requires surgery, has lead to a high incidence of recurrence and recent studies indicate a poor long - term success rate. Sclerotherapy is effective, convenient and normal activities can be re-commenced immediately.

When do My Veins need Treatment?

If you are experiencing any of the symptoms above then treatment is appropriate. In general, it is easier and more effective to treat varicose veins early in the disease process. Early treatment minimizes the risk of varicose vein-related complications and can reverse the symptoms of vein congestion. Obviously urgent treatment is required if there are co-existing factors such as bleeding, phlebitis (inflammation), thrombosis (clots), ulcers or dermatitis.

I'm Planning to get Pregnant - Can my Veins still be Treated?

The Australasian College of Phlebology suggest that abnormal veins should be addressed before pregnancy to reduce complications such as clotting and bleeding that can occur during pregnancy. Slow development and worsening of varicose veins in pregnancy is a recognised complication of pregnancy due to hormonal changes on the vein walls and valve elasticity, increased blood volume and outflow obstruction due to the increasing size of the uterus. It is very common to develop varicose veins as early as in the first trimester.

I'm Pregnant - Can my Veins still be Treated?

Generally not. Vein treatment cannot be commenced during pregnancy but you can minimize the effects on your veins. To reduce the likelihood and overall severity of varicose veins during pregnancy, it is recommended that all pregnant women use special maternity support stockings (normal support stockings are too restrictive in the abdominal area). Aching legs can occur throughout pregnancy, but are particularly predominant in the last trimester. These stocking also maximize comfort by providing support along the entire leg. The VenusCentre can provide medical maternity stockings in various sizes and colours. Be optimistic - varicose veins that have developed during pregnancy often improve significantly within three months after delivery. As would be expected with successive pregnancies though, abnormal veins may get worse.

Can I help prevent the progression of Abnormal Vein Development?

Yes, you can. There are some effective measures that can be taken to assist in reducing the further deterioration of abnormal veins.

• Include daily exercises that work your calf muscle.
  This stimulates the movement of blood back to the heart and encourages good circulation. Exercises such as running, walking, jogging, cycling and step machines are all beneficial. Cross trainers and some other elliptical trainers do not activate the calf muscle or create that "pumping" effect in the lower leg.
• Elevate your legs whenever able.
  Although this is often difficult for busy people, take the opportunity whenever you can for example when watching TV, while reading or try resting your legs on a stool under your work desk.
• Wear medical grade compression stockings.
  While providing excellent support from the ankle upward, these stockings assist with blood flow back to the heart. At the VenusCentre, we offer several different styles.
• Avoid prolonged sitting and standing.
  Exercise assists with the movement of blood through your veins while movement of the calf muscle helps to empty leg veins. This minimizes retention and enlargement of the vein. Try frequent use of leg exercises when sitting at your desk or when standing for long periods.
• Keep a healthy weight.
  Excess weight can make varicose veins worse and can contribute to both lymphatic and venous problems.