Post on 24-Dec-2015
New Treatment Options for Varicose Veins
Minimally Invasive Techniques to Remove Varicose Veins
Dr. Shannon D. Thomas FRACS
Vascular, Endovascular and Renal Transplant Surgeon
Visiting Medical Officer
Southern Highlands Private Hospital
Varicose Veins affect 30% of the human population!!!
About 5% will develop venous ulceration
Many reasons for treatment
Common Reasons for Treatment
PainDiscomfort/swelling
ThrombosisBleeding
Venous ulcerationAppearance
Tailor solution to indication
Treatment Options
1.Lifestyle adjustments
1.Medical therapy
1.Compression Stockings
1.Sclerotherapy / MicroSclerotherapy
1.Open Venous Surgery
1.Endovenous Ablation
Lifestyle Adjustments
Avoid prolonged standing
Weight loss
Increase walking and exercise
Workplace seating/ environment
Medical Therapy
May improve symptoms of varicose veins and may also improve appearance of varicose veins
Horse Chestnut Seed ExtractBioflavonoidsGinko Extracts SaponinsParoven Forte VenotrexAnthogenol Veins Clear
Available from most health food stores
Endovenous Ablation
RCTs demonstrate less pain, faster recovery and less recurrence than
open surgery. On cost analysis, perioperative costs are higher, but total societal costs are lower
My Approach
1.Clinical History and examination
1.Duplex Venous Ultrasound: Venous incompetence
1.Duplex Arterial Ultrasound: If no pulses or risk factors
Lifestyle and Medical treatments appropriate for most patients
Venous Insufficiency with Incompetent Great and
Short Saphenous Vein (with or without ulceration)
1.Radiofrequency Ablation and avulsion of varicosities
2.Compression bandage 24 hours, stocking for 6 weeks
1.Back to work next day
Venous Insufficiency with a Large Saphenous Vein (>1cm diameter)
1.Open Saphenous stripping and avulsion of varicosities
1.Compression bandage 24hours, stocking for 6 weeks
1.Expect 1 week off work
Varicose Veins without Saphenous Incompetence
1.Foam Sclerotherapy - compression stocking for 2 days.
1.Back to work immediately
Reticular Veins / Telangiectasia
1.Liquid microsclerotherapy: compression stocking for two days
1.Back to work immediately
1.May require multiple treatments
Endovenous Radiofrequency ablation locally
Sclerotherapy – performed at St Judes Specialist Rooms (Bowral)