Varicose Veins Questions and Answers

Questions and answers regarding Varicose Veins.

Do we need our varicose and spider veins?

Varicose and spider veins are unhealthy superficial veins that do not function efficiently and fail to return blood back to the heart. Varicose veins impose an extra burden on the deep veins which can lead to their deterioration. To compensate for the lack of function in varicose veins, deep veins have to work harder, and in some cases they can become abnormal. Once varicose veins are removed, the blood circulation will improve. In general, varicose veins are not suitable for use in heart by-pass operations, because they are damaged.

Spider veins are unsightly, abnormal veins, and do not serve a useful purpose. They are often a cosmetic concern, and this is a very real problem mainly for women, who want to feel good about wearing shorts, or going to the beach and wearing swim wear without feeling embarrassed with unsightly varicose or spider veins. Often people with spider veins can have symptoms as well, which are frequently improved with treatment.

When do you need to treat your veins?

Early treatment of varicose veins may reverse the symptoms of venous congestion and minimise the risk of varicose vein related complications and further progression of the disease. Treatment becomes more urgent if there are co-existing complications such as bleeding, inflammation (phlebitis), clots (thrombosis), exzema or ulcers.

In general, it is much easier to treat varicose veins when they are smaller, as early treatment tends to be less complicated and less involved. It is recommended that varicose veins be treated before pregnancy, since complications, such as clotting and bleeding, can develop during pregnancy. Varicose veins that have worsened during pregnancy, may not fully recover after pregnancy, requiring more involved and complicated treatment than would have been required before pregnancy. Spider veins should be treated only after varicose veins have been successfully treated.

How do you investigate varicose veins?

Duplex ultrasound is the gold standard in investigating varicose vein disease. Phlebologists have considerable expertise in using vascular ultrasound which assists in achieving a more accurate diagnosis and management of venous disease. Before treating varicose veins, duplex ultrasound studies are organised to map the abnormal veins. Deep Vein Thrombosis (DVT) scans may also be required if there is a history of clotting. Patients with a personal or family history of blood clots will require blood tests to assess their relative risk. Once tests are completed, the phlebologist will be able to determine the most appropriate course of treatment.

Modern duplex ultrasound is a non-invasive, comfortable procedure, requiring no anaesthesia or sedation and it takes about 30 minutes to map the veins in one leg. Duplex ultrasound machines show up even small veins very well and can demonstrate clearly, whether the flow in the vessels is normal or if there is back flow or reflux. It’s now clear that even problems which seem to be due to local defects in vein function, can be due to reflux in larger vessels. In fact up to 25% of patients presenting just with spider veins, can be shown to have underlying varicose veins demonstrated by ultrasound. If these larger vessels are treated at the same time, it makes it easier to treat smaller veins and this makes the process more effective and long lasting.

Fraser Clinic has 2 modern duplex ultrasound machines which are used both in initial consultation and mapping, but also to assist with our ultrasound guided injection and laser treatments.