 Do
you have Spider Veins or Varicose Veins?
Dr Stephen Tristram is an Associate Specialist in vascular
surgery, based at The Basingstoke and North Hampshire Foundation
Trust Hospital. His expertise is in the scanning and treatment
of varicose veins using ultra-sound guided compression
sclerotherapy in combination with laser. This technique allows
for the treatment of larger blue veins (reticular and varicose
veins) which in the past would only be amenable to surgical
treatment.
A Duplex scanner is used at the Chiltern Medical Clinic and
this allows him to identify problems in the larger vessels such
as “leaking” valves and perforator veins which are often the
source of thread veins and varicose veins. The scanner also
allows him to accurately visualise and safely inject larger
veins which would be sometimes impossible with the naked eye. It
is important to provide the right compression to these veins
after treatment and we provide the correct medical grade
compression stockings for this purpose.
What are Spider Veins?
Spider veins are small red, blue or purple veins that
commonly appear on the surface of the thighs, calves and ankles.
It's estimated that at least one third of the adult female
population is troubled with this common problem. People often
seek treatment for spider veins because of cosmetic concern.
However, it is also common for spider veins to cause symptoms,
such as aching, heaviness, itching and night cramps.
How can spider veins be treated?
An effective form of treatment for spider veins is
Sclerotherapy. This is a procedure where veins are injected with
a solution, using small needles, which causes them to collapse
and fade from view. The procedure typically improves not only
the cosmetic appearance but associated symptoms as well.
Laser treatment is used as an alternative to or to complement
sclerotherapy for small veins. They all work on the same basic
principle: a light beam is pulsed onto the veins in order to
seal them off, causing them to dissolve. Successful laser
treatment requires adequate heating of the veins. Your Doctor
will recommend the best treatment for you.
Spider veins may be isolated or associated with “feeder” veins.
They can also be associated with larger underlying varicose
veins.
Certain factors contribute to the development of spider
veins, including heredity, pregnancy, hormonal factors, weight
gain, occupations or activities that require prolonged sitting
or standing, and trauma.
Spider veins usually take on one of three forms:
- They may appear in a spider shape
with a group of veins radiating outward from a central
point.
- They may appear in a pattern that
resembles branches on a tree
- They may be in a linear pattern that
appear as thin separate lines.
What happens after spider vein treatment?
Recovery periods may differ from treatment to treatment. For
example, following sclerotherapy, support stockings and/or
bandages are worn on each treated leg. Dr Tristram will
determine how long you should wear the compression, generally
based on the type of veins and treatment you had. Most
physicians recommend that you walk a lot after treatment.
Depending on your treatment, other instructions may be given.
What are Varicose Veins?
Varicose veins are bulging veins that are larger than spider
veins, typically 3 mm or more in diameter. Moreover, varicose
veins are deeper than spider veins. Varicose veins may be of
primarily cosmetic concern, but can cause pain, leg heaviness,
fatigue, itching, night cramps, restless legs at night and leg
swelling. Moreover, severe varicose veins can compromise the
nutrition of the skin and lead to eczema, inflammation or even
ulceration of the lower leg. In addition, varicose veins
increase the risk for phlebitis.
Varicose veins are often caused by an underlying problem leg
vein. A painless non-invasive ultrasound test is usually done to
determine if an underlying source exists. Sclerotherapy may be
used to treat the visible, bulging varicose veins.
Ultrasound-guided sclerotherapy and vein stripping may be used
to treat underlying problem veins.
Normal veins have one-way valves that allow blood to flow
upward only to return to the heart and lungs. A varicose vein
has valves that are not functioning properly. The blood does not
efficiently flow upwards, but tends to pool in the vein because
of valve dysfunction. The valves themselves may be abnormal or
the vein walls may be dilated such that the valve leaflets are
too far apart. The varicose veins bulge because they are filled
with pooled blood.
Symptoms are often worse at the end of the day because more
pooling has occurred. Other things which increase pooling and
therefore symptoms also include prolonged standing and sitting,
exposure to heat (summertime, hot baths) and hormonal factors
such as pregnancy.
What happens after varicose vein treatment?
Recovery periods may differ from treatment to treatment. For
example, following sclerotherapy, support stockings and/or
bandages are worn on each treated leg. Dr Tristram will
determine how long you should wear the compression, generally
based on the type of veins and treatment you had. Most
physicians recommend that you walk a lot after treatment.
Depending on your treatment, other instructions may be given.
How many treatments are necessary to remove leg veins?
The severity and extent of each case will determine how many
treatments will be required. At the time of consultation Dr
Tristram will give you a more thorough evaluation of your
specific needs and determine the best method of treatment for
you. What is Duplex Ultrasound?
Duplex ultrasound is probably the best method of identifying
the cause of varicose veins. Sound waves are used to build up a
picture of the superficial veins, the deep veins as well as the
perforator veins. In a sense, the veins can be "seen" This is
very different to the handheld Doppler examination. In addition,
it can detect the direction of blood flow within the vein,
clearly identifying the sites of leaky valves. The direction of
flow is represented as a colour image on the ultrasound display.
The test itself is painless (no injections are involved), it
does not involve radiation or X rays and it is very accurate.
The skin overlying the veins to be scanned is covered with a
thin layer of acoustic gel, which is harmless, colourless and
odourless.
Many experts now agree that Duplex scanning is essential
prior to the treatment of varicose veins. Many people who are
treated without the information available from a Duplex scan
actually have the "wrong" operation or treatment.
You can have a Duplex Ultrasound test carried out at the
Chiltern Medical Clinic. What should you do next?
Contact the Chiltern Medical Clinic on 01491 873989 to make
an appointment with Dr Tristram. Our fees are very competitive.
During your initial consultation, Dr Tristram will assess your
condition and he will estimate the number of treatment sessions
you will need in order to give you an idea of cost. Scanning and
treatment can be carried out at the time of consultation. |
