Dr. Ashish Dhadas

Varicose Veins, Spider Veins and Laser Treatments

Introduction

Varicose Veins and Spider Veins is a common problem affecting the general population throughout the world. In India, it is estimated that around 25-30% females and10-15% of males suffer from this disease. However, majority of the patients who suffer from Varicose Veins are unaware of the disease and the complications it can lead to. Moreover, many family physicians and consultants too fail to impress the need for early intervention in these patients. Valuable time (months/years) is lost in alternative therapy of various oils, oral medications, ill designed stockings. Resultantly, many patients present late with complications such as blackening of legs (pigmentation), non-healing wound (venous ulcer) or blood clotting (superficial vein thrombosis). A problem which could have been nipped in the bud reaches irreversible stages.

What exactly are Varicose Veins?

Varicose veins, by definition, are enlarged, tortuous, ugly looking veins in legs with weak valves.In initial stages, they can cause symptoms such as dull aching pain in calf, swelling at ankle joint. In advanced stages, they result in blackening of skin near ankle and non-healing wound (venous ulcer). In few cases, they can also lead to sudden, spontaneous bleeding. Thrombosis(blood clotting) in these veins can be life threatening.

Weak valves in the leg veins is the main reason for formation of varicose veins. Hereditary tendency is seen in nearly 80% cases. People involved in prolonged standing such as teachers, shop keepers, traffic policemen are more like to suffer from them. In many females, varicose veins start after

pregnancy and progress over a period of time if not diagnosed and treated on time.

Diagnosis and Treatment

The first step in diagnosis of varicose veins is a Venous Colour Doppler (ultrasonography of the leg veins). It gives a detailed information about the extent of disease. Traditional method of surgical treatment is now being fast replaced by Laser treatment of varicose veins. Laser treatment is more effective, painless, scarless and helps patients to resume work in 48 – 72 hours. 1470 nm diode laser is  used worldwide for Endovenous Laser Treatment (EVLT) of Varicose Veins.

Prevention

Regular exercise, focusing on fitness routines that strengthen your legs and improve blood circulation helps. Running, power walking or dancing are great choices.

Reach and maintain a healthy weight to relieve pressure on your legs, knees and feet.

Wear sunscreen to protect your skin from the sun damage that can spread spider veins.

Opt for lower-heeled shoes to help tone your calf muscles and keep blood moving through your veins.

Choose low-salt, high-fiber foods and snacks like whole grains and fresh fruits and vegetables. The added fiber will help reduce constipation that can cause varicose veins, and eating less salt can help keep varicose vein swelling at bay.

Elevate your legs while resting and flex your calf muscles while standing as much as possible. Elevating your legs them helps keep the blood from pooling in the veins. And flexing your calves keeps blood pumping upward and out of your legs.

Role of stockings

Varicose Veins stockings are used by some patients as treatment modality. However, these stockings only help in prolonging the disease progression to some extent; they do not offer cure. It is important to note that varicose veins stockings need to give graduated compression'(18 mm – 32 mm Hg pressure). This is not the case with majority of ‘over the counter’ stockings available and hence do not prove useful.

Spider Veins – The first stage of Venous Disease

Spider veins, also called as telengiectasias, are well-defined small veins measuring from 0.1mm to 3 mm in diameter and appear on the surface layer of the skin. They are the 1ststagein the ‘Spider Veins – Varicose Veins’ disease complex. They may appear as scattered irregular veins but commonly occur in clusters of varying density. They are commonly seen in females (especially post pregnancy) and in elderly people. Almost 95% patients are females.

Spider veins are of cosmetic concern to many patients because of their appearance and location, which may be at any site on the thigh, leg, ankle, and foot. But they may also cause symptoms such as :

– Pain

– Burning

– Fatigue that increase with prolonged standing or sitting

– Itching

– Subcutaneous spontaneous haemorrhage

It is not uncommon for patients to change their lifestyles because of the appearance or the symptoms of spider veins of the legs. Women, especially, often change their way of dressing and their activities.

CLACS – Cryo Laser and Cryo Sclerotherapy

‘Cryo Laser and Cryo Sclerotherapy’also called as ‘CLACS’ is a revolutionary treatment for Spider Veins and small Varicose Veins. It was pioneered by Prof. Dr.Kasuo Miyake of Sao Paulo, Brazil in 1999. Over the years, CLACS has been used to treat thousands of patients with extremely good and long lasting results. It is done in nearly 30 countries around the world and was introduced in India for the first time at Surekha Varicose Veins Clinic, Dombivli in April 2019.

CLACS uses the most advanced technology from around the world- Augmented reality with Vein Viewer (Christie, USA), 1064 Nd:YAG laser (Alma, Israel) and Cryo 6 (Zimmer, Germany). It is done in a specially designed Phlebosuite on OPD basis under local anaesthesia. It is a painless treatment with patients going back to routine activities in just few hours!

To summarise, early diagnosis and treatment of varicose veins is a classic case of the adage – ‘A stitch in time saves nine’.

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