What are Varicose Veins?
Varicose veins are enlarged, swollen and twisting veins that appear throughout the leg. They are on the largest end of a spectrum that includes the much smaller spider veins. More than 20% of Canadian adults are affected by varicose veins.
If a patient has no symptoms or discomfort and is not bothered by the sight of the varicose veins, treatment might not be necessary. However, if there are symptoms, treatment may be required to reduce pain or discomfort, address complications, such as leg ulcers, skin discolouration, or swelling. Many patients may also want treatment for cosmetic reasons - at North Toronto Vascular, we offer a full range of treatment options to all of our patients.
Compression stockings squeeze the patient's legs and improve circulation.
They are tight around the ankles and loosen further up the leg. This way, compression stockings support blood flow upwards, against gravity and back towards the heart.
Compression stockings can help with discomfort, pain, and swelling. We encourage the use of compression stockings to all of our patients with varicose veins and symptoms of discomfort.
If varicose veins are large, they may need to be removed surgically. This is usually done under general anesthetic. Two incisions are made, one near the patient's groin at the top of the target vein, and the other is made further down the leg. The top of the vein is tied up and sealed. A thin, flexible wire is threaded through the bottom of the vein and then pulled out, taking the vein with it.
This procedure does not usually require a hospital stay. Ligation and stripping can result in bruising, bleeding, and pain. In rare occasions, there may be deep vein thrombosis or nerve injury.
After surgery, most patients will need 1-3 weeks to recover before going back to work and other normal duties. During recovery time, compression stockings are worn.
A chemical is injected into small and medium-sized varicose veins, which scars and closes them. A few weeks later, they should fade. A vein may need to be injected more than once.
Most treatments are successful, but up to 10% do not respond to sclerotherapy - in some cases due to the fact the veins on the surface are being fed from deeper veins that are not seen.
Staining in the area of injection is common but is usually temporary (lasting 2 to 8 weeks), however some people may have permanent staining (2-5%).
Endovenous laser treatment
This procedure is performed in our office clinic. A catheter is inserted into the patient's vein. A small laser is threaded through the catheter and positioned at the top of the target vein; it delivers short energy bursts that heat up the vein, sealing it shut.
With the aid of an ultrasound scan, we thread the laser all the way up the vein, gradually burning and sealing all of it. 98% of treatments are successful. This procedure is done under local anesthetic. At North Toronto Vascular, we can also use a topical anaesthetic gel to numb the area of needle pokes.
Recovery is rapid with only minor discomfort. Post-procedure pain is much less compared to surgery, but you may experience pulling or aching in the treated area that can last a few days. Bruising is common, but resolves quickly within 1 to 2 weeks.
EVLT treats the main superficial veins. Over the following 6-8 weeks, many of the branches off of these main veins will shrink and disappear. After 8 weeks, any remaining branches can be treated definitively with sclerotherapy. The follow-up treatment is expected and is part of EVLT treatment package.