- WHAT SHOULD I EXPECT AFTER ULTRASOUND GUIDED SCLEROTHERAPY OR SURFACE SCLEROTHERAPY?
Following injection treatment the veins may look worse initially as the inflammatory reaction is established.
You may notice bruising and even some lumpiness that is sore and tender to touch and occasionally patients can find this alarming if they are not aware that this is part of the normal healing process.
To accelerate healing some of the trapped blood in these lumps can be removed by needle aspiration. This will reduce the symptoms and allow for faster effective healing.
- HOW DURABLE IS ENDOVENOUS LASER TREATMENT?
The latest studies have shown ultrasound detected recurrence rates of 10 to 15% at 1 year and up to 30% at 3 years after surgery. Recurrence rates after laser treatment have recently been shown to be approximately 5% at 1 year and 7% at 3 years. This means that the endovenous laser ablation seems to be a very effective and durable technique.
- IS LASER TREATMENT OF SAPHENOUS TRUNKS AND VARICOSE VEINS PAINFUL?
Currently pain levels of 0 to 2 out of 10 are experienced by patients having endovenous laser ablation of their saphenous trunks. Ultrasound guided sclerotherapy is almost pain free apart from the one or two needle pricks that are required.
Due to the large number of injections made during surface sclerotherapy there is variability in how well this procedure is tolerated. 95% of people having surface sclerotherapy find it very tolerable.
For those that don’t I have available an inhalational agent called Penthrox that helps to reduce anxiety and pain and improve tolerability of the procedure. If this is used the patient must be accompanied by an adult who can drive the patient home.
- OF ALL THE KNOWN TREATMENT TECHNIQUES FOR VARICOSE VEINS WHAT WORKS THE BEST?
There are many techniques for treatment of varicose veins and most work well when the appropriate technique is selected for the appropriate venous problem.
Be wary of assertions that one particular technique is the only way to proceed. Often this is the only technique being offered by the proceduralist. It is better to have a balanced opinion from someone that performs all of the available techniques.
- WILL MY VARICOSE VEINS COME BACK?
There is no one that can guarantee the treatment of varicose veins will be permanent and curative. All varicose veins that occur are functionally useless and so there is no actual limit to the amount of treatment that can be performed to control this problem.
There are always other veins doing the appropriate work of draining the circulation from the legs. Varicose veins when they are removed are like removing a rotten branch from a tree and once that is done the healthy tree remains.
Recurrence rates associated with surgery to be a little higher than those with the more modern techniques of endovenous laser ablation and injection sclerotherapy.
- SHOULD I WAIT UNTIL AFTER MY PREGNANCIES BEFORE HAVING MY VEINS FIXED?
The usual advice given is to wait until all pregnancies are finished before treating varicose veins. This seems short sighted as patients with troublesome varicose veins who then go onto have a pregnancy find that they are in significant pain and discomfort during the latter stages of that pregnancy and these patients should begin a pregnancy with healthy legs.
There is no need to avoid treatment of your varicose veins before having children. There will be some recurrence of varicose veins during the period of the pregnancy and after the hormonal effects of the pregnancy resolve the varicose veins often resolve as well.
There will probably be a few that will not and these can usually be treated by modern techniques that are minimally invasive.
