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Advanced General &
Minimal Access Surgeries

Varicose Vein Clinic

What are varicose veins?

Varicose veins are twisted, enlarged veins that you can see just under the surface of the skin. The veins most commonly affected are those in your legs and feet.

Varicose veins are caused by weakened valves and veins in your legs. When these valves do not work as they should, blood collects in your legs, and pressure builds up. The veins become weak, large, and twisted.

Causes of varicose veins?

  • Age. Elderly individuals
  • Pregnancy. Some pregnant women develop varicose veins.
  • Family history.
  • Obesity.
  • Standing or sitting for long periods of time.

What are the symptoms?

Some people do not have any symptoms.

Mild symptoms may include: Heaviness, burning, aching, tiredness, or pain in your legs. Symptoms may be worse after you stand or sit for long periods of time. Swelling in your feet and ankles. Itching over the vein especially on the lower leg and ankle.

More serious symptoms include: Leg swelling. Swelling and calf pain after you sit or stand for long periods of time. Open sores, or you may bleed after a minor injury.

When to see a doctor?

Self-care — such as exercise, elevating your legs or wearing compression stockings can help you ease the pain of varicose veins and may prevent them from getting worse. But if you’re concerned about how your veins look and feel and self-care measures haven’t stopped your condition from getting worse, see your doctor.

Complications

  • Ulcers.
  • Blood clots.

How are varicose veins diagnosed?

Your doctor will look at your legs and feet. You may also need an ultrasound test to see if the valves in your veins are functioning normally or if there’s any evidence of a blood clot.

Surgical management

Sclerotherapy

In this procedure, your doctor injects small- and medium-sized varicose veins with a solution that scars and closes those veins. In a few weeks, treated varicose veins should fade. Although the same vein may need to be injected more than once

Catheter-assisted procedures: Radiofrequency Ablation (RFA)

RFA is a newer, minimally invasive treatment of dilated and tortuous varicose veins usually done as a day procedure under local anesthesia or a mild sedative. In these treatments, your doctor inserts a thin tube (catheter) through a small incision into an enlarged vein and radiofrequency energy in the form of heat is directed to the tip of the catheter. As the catheter is pulled out, the heat destroys the vein by causing it to collapse and seal shut. Once the diseased vein is closed, blood is re-routed to the other healthy veins. This procedure is usually done for larger varicose veins.

Following the procedure, a simple dressing is placed over the insertion site and a compression stocking will need to be worn for 7-10 days. Most patients typically resume normal activities with a day.

Radiofrequency ablation (RFA) – benefits of RFA

  • Can be performed as an outpatient, walk in – walk out procedure
  • Quick procedure, it takes approximately 45-60 minutes
  • Faster return to normal life style
  • Success rate of 90-100%
  • Lower risk of complication than traditional surgery
  • Higher patient satisfaction

Vein stripping

This procedure involves removing a long vein through small incisions. Removing the vein won’t adversely affect circulation in your leg because veins deeper in the leg take care of the larger volumes of blood.

Ambulatory phlebectomy

Your doctor removes smaller varicose veins through a series of tiny skin punctures. Only the parts of your leg that are being pricked are numbed in this outpatient procedure. Scarring is generally minimal.

Venaseal Glue

Venaseal, as you may already know is one of the most recent procedures, evolved in the treatment of varicose veins. The procedure involves injection of medical glue into the damaged vein, which seals it off permanently. Once the damaged vein is closed, blood is immediately rerouted through other healthier veins in the leg. The side effects are minimum, and it is very patient friendly.

VenaSeal has been meticulously trialed in the United States and Europe over the last 5 years.  Results published show a low risk of complications and excellent medium-term results.  The VeClose Study out of Germany, showed a 98.9% closure rate at 6 months.  VenaSeal is considered as effective as Endovenous Laser Ablation but does not involve the use of heat and can therefore be performed with the application of a small amount of local anaesthetic as opposed to a Nerve Block or large volumes of Tumescent Anaesthetic.

Conservative treatment

  • Varicose veins are treated with lifestyle changes and medical procedures. Self-care — such as exercising, losing weight, not wearing tight clothes, elevating your legs, and avoiding long periods of standing or sitting can ease pain and prevent varicose veins from getting worse.
  • Wearing compression stockings is often the first approach to try before moving on to other treatments. Compression stockings are worn all day. They steadily squeeze your legs, helping veins and leg muscles move blood more efficiently.
  • Exercise. Get moving. Walking is a great way to encourage blood circulation in your legs. Your doctor can recommend an appropriate activity level for you.
  • Watch your weight, and your diet. Shedding excess pounds takes unnecessary pressure off your veins. What you eat can help, too. Follow a low-salt diet to prevent swelling caused from water retention.
  • Watch what you wear. Avoid high heels. Low-heeled shoes work calf muscles more, which is better for your veins. Don’t wear tight clothes around your waist, legs or groin. Tight panty-leg girdles, for instance, can cut off blood flow.
  • Elevate your legs. To improve the circulation in your legs, take several short breaks daily to elevate your legs above the level of your heart. For example, lie down with your legs resting on three or four pillows.
  • Avoid long periods of sitting or standing. Make a point of changing your position frequently to encourage blood flow. Try to move around at least every 30 minutes or so.
  • Don’t sit with your legs crossed. Some doctors believe this position can increase circulation problems

Self-assessment form for varicose veins (PDF download)

Meet our doctors

Get in touch with NMC surgeon to know more about the procedures and related solutions.

Dr. Nayan Vasa Jayshukhlal

Dr. Nayan Vasa Jayshukhlal

Hod & specialist general surgery

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Dr. Mahesh Krishna Ram

Dr. Mahesh Krishna Ram

Specialist general surgery

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Dr. Gyan Prasad Pokhrel

Dr. Gyan Prasad Pokhrel

Specialist general surgeon

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Dr. Mamta Arora

Dr. Mamta Arora

Specialist general surgery

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