Advancements in technology have led to the development of endovenous treatments, offering a minimally invasive solution to this common problem. Endovenous treatment of varicose veins involves using specialised techniques to treat the affected veins from the inside rather than through traditional open surgical methods.
They provide a safe, effective, and durable alternative to traditional open surgery. In addition, endovenous treatments offer several advantages over traditional vein stripping surgery, including shorter recovery times, reduced risk of complications, and minimal scarring. Most patients can resume their normal activities within a day or two, with only mild discomfort and bruising at the injection sites.
For these reasons endovenous techniques have largely supplanted open surgery for varicose veins.
Endovenous laser ablation (EVLA) involves accessing the incompetent
(refluxing) vein with a needle under local anaesthetic infiltration. Following this, a thin wire is passed through the needle into the vein, over which the thin laser fibre is inserted into the damaged vein.
Once the fibre is in the correct position, the laser is switched on which delivers targeted heat energy to irreversibly damage the vein wall. This results in the permanent thrombosis (closure and seal) of the vein treated. The blood flow then redirects to the deep veins.
Similar to the EVLA technique, Radio frequency ablation (RFA) involves
accessing the incompetent (refluxing) vein with a needle under local
anaesthetic infiltration. Following this, a thin wire is passed through the needle into the vein, over which the thin laser fibre is inserted into the damaged vein.
Once the fibre is in the correct position, the RF machine is switched on which delivers targeted heat energy to irreversibly damage the vein wall. This results in the permanent thrombosis (closure and seal) of the vein treated. The blood flow then redirects to the deep veins.
Venaseal involves the use of a medical adhesive, cyanoacrylate, to seal off the diseased vein. The technique involves accessing the incompetent (refluxing) vein with a needle under local anaesthetic infiltration. Following this, a thin wire is passed through the needle into the vein, over which the thin venaseal catheter is inserted into the damaged vein.
Unlike thermal-based methods that rely on heat to seal the vein shut, Venaseal works by occluding the vein with the adhesive, creating an immediate bond that prevents blood from flowing through the diseased segment. The blood flow then redirects to the deep veins.
Spider and reticular veins are smaller, superficial veins that are typically not associated with any significant medical complications but can be a cosmetic concern for some individuals. The options for treatment include:
During a microsclerotherapy procedure, a very fine needle is used to inject a small amount of sclerosing chemical solution into the spider veins. The sclerosant irritates the inner lining of the blood vessels, causing them to stick together and collapse. Over time, the body reabsorbs the treated veins, leading to a significant reduction in their appearance.
Microsclerotherapy is particularly well-suited for treating spider veins on the legs, although it can also be used to address veins on other parts of the body. The procedure is typically performed in-office and does not require anaesthesia, making it a convenient option for many patients.
Some patients may experience temporary redness, bruising, or swelling at the injection sites, but these side effects typically resolve on their own within a few days.
Most patients require multiple microsclerotherapy sessions to achieve the desired results, as spider veins may reappear over time or new ones may develop. However, with each treatment session, patients can expect to see gradual improvement in the appearance of their skin, resulting in smoother and clearer legs.
The Cryo Laser and Cryo-Sclerotherapy (CLaCS) technique is a modern approach to treating spider veins. The CLaCS method combines the use of laser sclerotherapy to effectively target and eliminate unsightly spider veins, offering patients a non-invasive and efficient solution.
CLaCS begins with a thorough evaluation by a trained healthcare provider to assess the extent and severity of the spider veins. During the procedure, a special laser device is used to precisely target the affected blood vessels with focused light energy. The laser energy heats and collapses the walls of the spider veins, causing them to fade from view over time. In order to minimise the pain from the laser heat, a cooling device is used to rapidly bring down the skin temperature, which has an anaesthetic (numbing) effect.
In addition to laser treatment, sclerotherapy (chemical ‘irritant’ solution) injection is used to cause inflammation of the vein walls, leading to their eventual closure and disappearance.
One of the key advantages of the CLaCS technique is its versatility and ability to address a wide range of spider vein types and sizes. Whether the spider veins are fine and delicate or larger and more pronounced, CLaCS can be tailored to meet the unique needs of each patient, providing targeted treatment with minimal discomfort and downtime.
Furthermore, CLaCS offers improved cosmetic outcomes, with many patients experiencing significant improvement in the appearance of their spider veins after just a few treatment sessions. Unlike traditional sclerotherapy techniques, which may require multiple injections and sessions to achieve desired results, CLaCS often delivers noticeable improvements with fewer treatments.
Treatment of DVT in most instances involves anticoagulant medications (blood thinners) to prevent clot propagation (movement) and Pulmonary Embolism (blood clots travelling to the lungs). Newer oral anticoagulants (NOACs) and traditional warfarin therapy are commonly used, along with low molecular weight heparin (LMWH) injections. Long term treatment may involve compression stockings for prevention of recurrence.
Surgical treatments are considered when conservative therapies like anticoagulant medications (blood thinners) and compression stockings have not effectively treated the condition, or in extensive cases where there is a significant risk of complications like pulmonary embolism.
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