Varicose veins are extremely common. Heredity is the most common cause for large vein problems. Pregnancy, prolonged standing and heredity are the primary causes of spider veins. Varicose and spider veins can be a cosmetic nuisance because of their unsightly appearance but even small veins can cause painful legs. Larger veins can cause skin irritation or break down with ulcers forming around the ankles and lower legs as well as pain and swelling.
Treatment for varicose veins depends on the type of vein problem that exists. On your first visit with Dr. Balharry for this problem, a full medical, surgical and obstetric history will be taken. This is followed by a clinical examination of your legs and usually, a full ultrasound examination of the vein system in your legs. This will allow Dr. Balharry to understand what your problem is and to recommend the best course of treatment for your condition. Now, let’s looks at the options for treatment.
Examination of leg veins has changed over the last 20 or so years, allowing more precise treatment of the vein problem. One of the biggest changes has been the introduction of Ultrasound examination of the veins. Ultrasound allows us to see the anatomy of the veins in your legs and also to check the flow of blood in the veins (Doppler analysis). By doing this, we can tell exactly where the problem in your leg arises and permits much more accurate treatment. This also allows accurate determination of the best type of treatment for you, injections, surgery or laser. As I also surgically operate on veins, the other big advantage of Ultrasound examination is that it allows me to precisely know the anatomy of your veins which makes my surgical approach much more precise and also significantly improves the safety of the operation.
Depending on the complexity of the vein problem, ultrasound mapping can take anywhere from ten minutes to half an hour or more but it is now the standard of care in the treatment of venous disease. It is also worth knowing that when this procedure is performed in my office, it is not covered by Alberta Health Care Insurance. You will receive a receipt that may be used for your extended health care provider or for income tax.
For large veins with damaged valves, it is sometimes necessary to treat the veins with a surgical procedure called ‘stripping’. This is done in a Hospital operating room. The large vein in the thigh is removed by a relatively non-invasive procedure although there is a small wound in the skin at the groin and the knee. Sometimes, other large veins are also removed at the same time by what is called ‘hook phlebectomy’. This involves small punctures over the vein with a needle, and removal of this segment of the vein with small hooks that look a little like crochet hooks.
Recovery from this surgery takes about a week for a single leg. You are up and about and active but with some discomfort in the leg. It is also necessary to wear prescription compression stockings for 2-3 weeks after your surgery. Follow up injections may be required a month or two later.
ULTRASOUND GUIDED INJECTIONS
Some large veins can be treated in the office with this technique. The vein is visualized on the Ultrasound machine and an injection is made into the vein while it is viewed on the ultrasound screen. Then a fluid, usually turned into foam first, is injected into the vein. This will result in closing of the veins and its absorption by your body.
Dr. Balharry has sophisticated Ultrasound equipment for this purpose and has taken special training in vascular ultrasound.
SCLEROTHERAPY. Smaller veins and spider veins are treated by the injection of a fluid into the veins that results in the vein closing and being absorbed by your body. These injections are performed with a very tiny needle allowing the injections with a minimum of discomfort.
You may expect slight bruising and/or irritation of the skin at the injection sites but these problems are short term only. Other risks can include allergic reaction and most importantly, a blood clot forming in the deep veins. As a result we advise against any long distance travel by car or plane within a period of four weeks after any injection treatments.
We may recommend some form of compression after these treatments, such as stockings. Varicose and spider veins are, unfortunately, often a maintenance problem as the body does like to create new veins. The treatment of varicose veins, apart from surgery, is not covered by Alberta Health Care.
Please review the post treatment care information prior to receiving treatment.
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