Treatments for Varicose Vein Care
                     Treatments for Varicose Vein Care
Endo Venous Laser Treatment (EVLT)
This is the latest technique replacing surgery for large saphenous veins and their major branches.
EVLT is a doctor's office procedure. The abnormal vein is treated under local anaesthetic and a fine laser fibre is inserted
under ultrasound guidance. The vein is then surrounded by a tumescent (local) anaesthetic, and laser energy is then
delivered into the vein with the fibre then slowly withdrawn to treat the full length of the vein. This replaces the
surgical ligation and stripping of the vein as EVLT is a closed system the recurrence rate is significantly reduced. The
ligation of veins in surgery sheds cells around the subcutaneous tissue from which new veins are formed causing a high
recurrence rate after surgery.
The remaining veins are treated by Ultrasound-guided sclerotherapy (UGS) or ambulatory phlebectomy. Published data
on the success rate of EVLT is very encouraging. More than 1000 patients have shown over a 90% success rate over a
three-to-five-year period. After the procedure bandages or compression stockings are applied. The patient can return to
work following the procedure.
Sclerotherapy and Micro sclerotherapy
These procedures are suitable for patients who do not have hidden or visible varicose veins. Pre-treatment
photographs are taken and later given to patients to keep as a record. Usually, multiple treatments are necessary
to get optimum results. A treatment session lasts about 45 minutes. Very fine needles are used and with his
extensive experience in this field, Dr Dhillon takes considerable care to minimize the pain and discomfort. Direct
vision sclerotherapy is directed to control reticular veins or venules, i.e. the feeder veins for small starbursts or
spider veins. Micro sclerotherapy is directed to control spider veins. After the treatment compression stockings are
applied.
Ultrasound-Guided Injection
The procedure is performed with the patient lying on the treatment couch. The ultrasound technician localizes the
abnormal vein with the Ultrasound Transducer and measures the distance the vein is located beneath the skin
surface. The doctor then guides the fine needle to the centre of the abnormal vein and injects a precise amount of
sclerosant solution which has the effect of sealing the vein off at that point. This will prevent abnormal flow down
the vein. The procedure involves minimal discomfort. Usually, two to four injections are required. Following the
procedure, you are required to wear a graduated venous compression stocking for two weeks continuously day
and night. As with other forms of sclerotherapy, you must walk for 45 minutes immediately after the procedure.
An appointment will usually be made 2-3 weeks following the Duplex Ultrasound-Guided Injection to check the
success of the procedure and to treat the remaining surface varicose branches by standard sclerotherapy
techniques. It is important to recognize that although Duplex Ultrasound-Guided Injection Sclerotherapy (UGS) is a
significant breakthrough in the management of varicose veins, not all varicose veins are suitable for the procedure.
Ultrasound Guided Sclerotherapy (UGS)
Sclerotherapy is the non-surgical elimination of varicose veins by injection. It is used to treat many types of
varicose veins. In the past, many varicose veins were considered too large to be treated by this method and surgery
was often recommended. Surgery, however, has the risk of anaesthesia, disfiguring scars, expensive hospitalisation,
painful recuperation and involved time off work. Recently there have been advances in the diagnosis of varicose
veins and management by compression stocking. First, with Duplex Ultrasound Imaging precise mapping of the
abnormal varicose veins can be performed. This ensures that the physician is able to treat all abnormal veins (both
obvious on the skin surface and hidden beneath the skin) which ensures better long-term results. Second, using
Duplex Ultrasound to image abnormal veins and guide the injection to the exact point of abnormality results in a
quicker response to the treatment with fewer injections to be required. The procedure is done without any
additional risks since Duplex Ultrasound has no adverse reactions and is radiation free.
Large varicose veins above 4.0mm are now treated very effectively with Endo Venous Laser Technique (EVLT) with
excellent long term success. UGS is also used in conjunction with EVLT to treat the veins below the treated
segment with EVLT. UGS is a very useful technique for tortuous varicose veins usually observed in those patients
with previous surgeries. These patients are usually apprehensive and avoid seeing doctors for veins as they are
fearful of another operation. The UGS can safely and effectively keep their varicose veins under control.
Surgery being replaced
Surgery is now being replaced by modern non-surgical techniques. However, surgery is still one of the options and it
depends on the patient's choice. Surgery becomes a less attractive proposition due to the side effects of general
anaesthetics, hospitalisation, time off work, cuts, scars and a high recurrence rate in comparison to non-surgical
techniques. Please be aware that none of the above procedures will completely cure varicose vein disease.
Everything one needs to know about varicose veins and its treatment A varicose vein is a chronic disease that requires
ongoing maintenance and surveillance. Treatment at the earlier stages will help avert expensive and morbid
complications including stains, dermatitis, thrombophlebitis, leg ulcers and a host of other unpleasant symptoms that
patients endure
prior to treatment.