Bulging Veins in The Leg: A new solution to Leg Pain and Varicose VeinsBY DR. CHARLES LEE | CONSULTANT PLASTIC, COSMETIC & RECONSTRUCTIVE SURGEON | KPJ SABAH SPECIALIST HOSPITAL
For years, people who experienced painful swelling and bulging varicose veins in their legs had one of two options: learn to live with the pain or undergo vein stripping, a surgical intervention that requires the diseased vein to be literally stripped out. Pain and prolonged hospitalization was a disadvantage.
Now, a new laser procedure, first introduced in Sabah in 2010, has revolutionized the treatment of varicose veins in patients with Chronic Venous Disease. This exciting new high-tech, minimally-invasive option to better looking, less painful and healthy legs for life has improved the lifestyle of many patients.
What are varicose veins and spider veins?
Varicose veins occur secondary to abnormal vein walls or abnormal valves in the veins, which act as one-way valves preventing blood from pooling backwards, causing the veins to dilate (swell/enlarge) and become varicose. This is called venous reflux and often begins in the great or small saphenous veins situated in the leg. These veins are usually not visible and run along the front and back of the leg. When the valves in these veins get damaged, the branches enlarge and prominent varicose veins develop.
The relationship between varicose veins and spider leg veins (telangiectasias) is intimate. Increased pressure in the veins (venous hypertension) as a result of venous reflux is transmitted to the superficial epidermal vessels causing them to elongate and dilate and become visible to the human eye.
How do you diagnose venous reflux or malfunction of the valves in veins?
Venous reflux or insufficiency can be easily diagnosed with a simple non-invasive test called venous ultrasound or duplex examination. This will determine the severity of the abnormal veins and valves and plan of treatment.
What are the symptoms and causes of varicose veins and how can we prevent it?
Venous reflux disease results in symptoms such as painful, aching legs, heaviness, tiredness, night cramps, skin changes and ultimately skin ulceration. Left untreated, these symptoms can worsen over time.
Causes include increasing age, strong family history, obesity, multiple pregnancies or working in a profession that requires a lot of time on your feet, for example nurses, hotel workers and even housewives. Other causes can include sitting for prolonged hours for example clerks, managers and executives. Women are 4 times more likely to be affected. Conservative prevention will include leg elevation, compression stockings, weight loss and exercise.
What makes the new laser procedure different?
The new EndoVenous Laser Ablation (EVLA) uses heat from the laser light to seal off the diseased varicose vein under ultrasound guidance and local anaesthesia. The sealed vein is gradually reabsorbed by the body and the remaining healthy veins then take over the task of moving blood through the patient’s legs. Painless, no scar, quick recovery with no hospitalization required, this new laser therapy is a step into the future for patients with chronic venous disease.
What are the 5 most popular/common treatments for varicose veins and spider veins?
Each patient is unique and treatment should be tailored based on the underlying problem. For some, varicose veins and spider veins are a cosmetic issue. For many, the symptoms are significant and affect their lifestyle.
The most popular treatment for spider leg veins is microsclerotherapy. The superficial dilated veins are treated with an injection of a chemical solution and compression stockings are applied.
Other treatment options include laser and pulsed light sources for spider veins. The current most popular non-surgical treatment for varicose veins is the Endo-Venous Laser Ablation (EVLA) using heat from the laser light to seal off the varicose vein under ultrasound guidance and local anaesthesia. The procedure is painless and recovery is quick.
Foam sclerotherapy, the second most common form of treatment, to the tributaries (branches) is usually done at the same time and patient can return to work within a few days. Here, the chemical solution injected causes the vein walls to swell, stick together, and seal shut.
The collateral branches and tributaries can also be surgically removed by what is called ambulatory phlebectomy. All treatment modalities require post-treatment compression stockings to enhance early recovery and good results and strong patient compliance is required.
For the complete article about this subject can be read on this July to September issue of Parents Avenue Magazine. *Disclaimer: All information is for your general reference only. We do not accept any responsibility whatsoever in respect of such information.