VARICOSE VEINS AND VENOUS ULCERS
Varicose Veins has become increasingly common among all ages and work profile. Some common causes include 1. Standing in kitchen for long during cooking 2. Prolonged standing or walking during travel, work or at home. 3. Post pregnancy varicose veins
Generally the blood flow happens from skin to deep muscular veins and then further to the heart. When one stands continuously for a long period of time, the valves are not able to regulate the above flow. Actually a reversal of flow takes place and blood starts getting pushed towards the skin resulting in varicose veins.
When one reaches this stage, any activity which further increases the blood flow in legs such as jogging, cycling, swimming will potentially increase the size of varicose veins.
Varicose Veins are of 2 types
These veins are embedded deep in the skin. These are not visible outside as torturous veins.
These veins exert their effect by following
a. Pain in Legs - This is more on standing and at night
b. Hyper Pigmentation - Gradual darkening of skin is noted and eventually whole of skin becomes light brown to black in color.
c. Spider Veins - Small dilated veins on skin more prominent in fair skin parts.
d. Ulceration - Any wound which occurs on leg takes a long time to heal. Sometimes it may not heal at all.
These veins are just below the skin and consequently are more prominent as dilated veins.
They exert their effect by:
a. Cosmetic - Bad to look at and keeps on growing
b. Pain - Dull aching pain on standing.
In later stages, these veins can give features of type 1 veins above.
Laser ablation of varicose veins is now the gold standard of treatment world over. It must be emphasized that Surgery should never be attempted at any stage in varicose veins.
Side effects of surgery include
1. Bad scarring
2. Recurrence > 90%
3. Worsening of original condition >>>>>> As in picture to right
A thin laser fibre is passed directly under vision and sonography control and the defective vein is laserised from inside and closed. This effectively locks the pressure from inside.
Laser Ablation of varicose veins is of two types
|EVLT I||EVLT II|
|Time / Leg||10 mins||30 to 45 mins|
|Great Saphenous Vein Closure||Partial||Total|
|Short Saphenous Vein Closure||Not done in most cases||Total|
|Perforator Block under vision||No||Yes|
|Pain and Heaviness Relief||<10%||>90%|
|Hyper Pigmentation||No Change||Reverses|
|Ulcer Healing||Minimal||Very High Rate|
|Minor Scarring||Yes||No scars|
It must be emphasized without prejudice that EVLT treatment should be 100% laser (EVLT2). Sclerotherapy /
Minor Surgery can result in no effect to worsening of symptoms
including increase in pigmentation and ulceration.
In addition sclerosing solution can cause neuropathy which can result in nagging pain for months on end.
Orchid Laser Center performs only EVLTII which requires an enhanced level of expertise and has the best possible results