Venous disease

Varicose veins is a very common medical condition. The venous system is divided in a deep (accompanying the arteries deep within the leg) and a superficial (just below the skin) component. Varicose veins occur as a result of incompetent valves, mostly within the superficial system that allow backflow of blood and therefore abnormally high venous pressure to develop. The venous system is designed as a low pressure system and therefore unable to cope with the increase in pressure. This leads to varicosities forming secondary to the high pressure with further weakening of the venous valves. It is not possible to repair these delicate valves. In some patients, it leads to cosmetic problems. In most, however, it is a source of discomfort, pain, swelling and thrombophlebitis (clotting and inflammation of the vein). It may also lead to skin changes, ulcers, bleeding and disability.

What are the related symptoms of venous disease?

Venous disease symptoms include:

• Enlarged, swollen, knotted clusters of purple veins
• Swelling in the legs
• Pain or tenderness
• Bluish skin colour in the limb or toes
• Fever and chills (if thrombophlebitis occurs)
• Ulcers on the inner aspect of the ankles
• Aching or sensation of heaviness in the legs

Treatment options for venous disease:

The aim of treatment in venous disease would be to divert blood flow from the diseased superficial system to the healthy deep venous system. This can be accomplished either by removing the diseased segment of the vein (tying and stripping of the vein), performing sclerotherapy (injecting the vein with a substance that will induce scarring and obliteration of the lumen) or by applying heat to the vein from the inside to obliterate the lumen (the Venefit / Venus procedure).

• Tying and Stripping
  This is a surgical procedure that is usually done in theatre under full anaesthetic. Dr Cooper will make an incision in the groin and tie the major superficial vein of the leg, which may also be 'stripped' (pulled from the leg). Several small incisions are also made in the lower leg to remove some of the smaller veins that have also become dilated. A tight-fitting dressing is then placed in theatre to minimize bruising.
• Sclerotherapy
  Sclerotherapy is used to treat smaller varicose veins called 'spider veins' (telangiectasis) or reticular veins (slightly larger blue veins). Larger varicose veins are always best treated by the Venefit / Venus procedure or tying and stripping. In some instances it might be necessary to treat larger varicose veins first before sclerotherapy of smaller veins can be done successfully. Sclerotherapy is an office-based procedure where Dr Cooper will use very small needles to inject a special solution directly into the affected veins. This then causes the walls of the veins to stick together, and blood flow is diverted to other, healthy veins.
• The Venefit / Venus Procedure
  This is a revolutionary minimally invasive procedure where Dr Cooper will insert a thin, flexible tube (‘ClosureFast’ catheter) into a diseased vein to seal it shut using heat (this process is called radiofrequency ablation). Blood that would normally return toward the heart through these veins will then travel through other, healthy veins instead. Compared with surgical options like ligation, vein stripping and endovenous ablation results in less pain and quicker recovery time. The procedure can be done in theatre or in the doctor’s rooms as an outpatient, under local anaesthetic and sedation. The obliterated vein is also left in place and not stripped, which results in virtually no post-operative bruising.