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The Best in Vein Treatments
Written by Dr Sachit Shah   

New options for uncomfortable, unsightly varicose veins.

legs and feet with hands on them

Now that summer is here and shorts are in season, many of us look at our legs and wonder how to take care of our veins! Varicose veins affect 30 percent of men and women at some point in their lives. Varicose veins occur as a result of poor blood flow in the legs. Veins have valves that help to move blood back towards the heart. In varicose veins, these valves do not function properly, allowing the blood to pool in the legs and causing those veins to enlarge.

There are many reasons why we get varicose veins, including age, pregnancy, weight gain or even genetics. Many men and women will simply live with varicose veins if the pain is not bad, but the condition can cause complications such as inflammation and ulcers, and can create a lot of fatigue in the legs. In addition, they look awful.

legs with hands on them

Varicose veins will not heal themselves. Nowadays, however, there are many different treatment options available. Some veins respond better to one form of treatment than another; there is no single treatment that can universally resolve the problem.

Many people ask if treatment will interfere with blood flow. After all, aren’t these veins needed? The simple answer is that deeper veins do most of the work, while varicose veins are merely a hindrance when they become a problem both in appearance and function. The body can live very well without these veins. In fact, many people feel less fatigue and swelling of the legs – and look better, too!

Varicose veins are difficult to treat through the Medical Services Plan as they are generally cosmetic in nature and coverage is limited. A recent client had been waiting for three years to be treated for varicose veins that were painful and caused problems with bending her knees and sleeping. Her only options through MSP were stripping, surgery or minor sclerotherapy, which required her to go under general anesthetic and be off work for six to eight weeks. There is now a wide variety of treatments that do not require general anesthetic or long recovery periods.

SPIDER VEIN TREATMENTS

There are both laser treatments and sclerotherapy or foam injections that are used for spider vein treatments. The treatments are effective. However, spider veins will typically return if the underlying problem vein is not treated. The best approach is to use ultrasound to map out the legs and identify the underlying larger vein that is causing the problem. The larger vein can then be treated prior to treating the spider veins.

SCLEROTHERAPY

Sclerotherapy refers to the use of a chemical that is injected into the vein and causes the vein to inflame and close. Generally the best form of sclerotherapy is ultrasound guided sclerotherapy, which allows the doctor to pinpoint where the problem veins are and then inject them with foam. Without ultrasound mapping, it is impossible to pinpoint which veins are the troublesome ones. This type of treatment is best for smaller varicose veins, and more than one treatment may be required during this 30-minute procedure. Compression stockings must be worn following treatment. There is a 30 percent recurrence rate after two to three years.

LEG LASERS

Also known as EVLT, this technique uses a very thin catheter to deliver laser energy along the offending vein. The laser energy heats the vein walls, thereby destroying them. Local anesthetic is provided along the length of the vein. Compression stockings must be worn for at least a few weeks and can help relieve swelling and aching in your legs. This technique is good for long, straight veins, which allow the laser to pass through. There can be many days of discomfort following treatment.

Similar to EVLT is the use of radiofrequency electric current. This technique is known as Radiofrequency ablation. The advantage of using this technique is that there is less pain. It is good for early varicose veins but generally it is seen to be less successful than EVLT.

VEIN STRIPPING

Vein stripping, or ligation and stripping, is performed under a general anesthetic and involves a small incision made at the groin to expose the vein. The vein is tied and a hook-like instrument is used to remove the vein in sections through a small cut just below the knee. Although effective for treating large, lumpy veins that do not respond well to laser, this technique can be very painful with long recovery times.

Newer techniques using micro-phlebectomy do not involve general anesthesia or long recovery times. In fact, you are encouraged to walk immediately after the procedure.

PAINLESS REMOVAL

The procedure call the Clarivein requires only a single initial injection, and is completely painless – no need for pain relief. A rotating catheter is inserted into the vein, causing it to collapse. The advantage of this technique is that it is painless, quick and no more than one injection is usually involved.

VEIN GLUE

Still in its trial stages, this technique involves injecting a medical superglue into the vein, literally sealing the vein. The treatment is still in an assessment stage, but is purported to be a relatively quick, painless procedure that may not require compression stockings following treatment.

There are a number of treatments available today to effectively treat varicose veins. The most important point to remember is that no one technique is best for everyone. Consult a physician who can determine which treatment is best for you based on an ultrasound mapping of your legs.

Dr Sachit Shah -

Dr Sachit Shah is a Family Physician with a special interest in cosmetic medicine. He has a Diploma in Dermatology and has a large cosmetic clinic in Surrey, BC with more than 20 medical esthetic devices to help you age the way you want to. www.bclaserandskincare.com

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