Saphenous veins are the underlying cause of severe varicose veins in about 90% of patients.  

Your leg has two saphenous veins. 

The great saphenous vein which runs inside the leg from the ankle to the groin.

The small saphenous vein which runs up the back of the calf and terminates behind the knee.

You can’t see saphenous veins because they lie deep under the skin.  Saphenous veins are NOT “deep veins” because they are not inside the muscles of the leg.

The blood in the saphenous veins normally flows up the leg draining into either the deep vein in the groin or into the deep vein behind the knee.

Inside the saphenous veins are a series of non-return valves which prevent blood from slipping back down the leg from the force of gravity.

If the saphenous vein walls become weak and lose their elasticity the vein starts to dilate. (see images below). When this happens the valves won’t close properly and blood starts leaking down the leg.

This reverse direction of flow causes back pressure on the surface veins lower down the leg and after a while the surface veins start to dilate and become “varicose veins”.  

Varicose veins don’t work properly because the blood flow is in the wrong direction - instead of the blood flowing back to the heart it is flowing back into the skin. Over time if the varicose veins become severe and are not treated then skin damage on the lower leg will occur and his can eventually lead to “venous ulcers”.

Incompetent  right Great Saphenous vein seen in cross section showing gross enlargement (7.5mm) in a 36 year old man with severe varicose veins in the lower leg.

Incompetent right Great Saphenous vein seen in cross section showing gross enlargement (7.5mm) in a 36 year old man with severe varicose veins in the lower leg.

The same man’s left leg showing a normal sized  Competent  Great Saphenous Vein in the mid thigh. Diameter is 4.4 mm which is in the normal range.  He has no varicose veins in his left leg.

The same man’s left leg showing a normal sized Competent Great Saphenous Vein in the mid thigh.
Diameter is 4.4 mm which is in the normal range.
He has no varicose veins in his left leg.

Posted
AuthorNicholas Kemp

With the temperatures rising and the winter days behind us, it's time to change your wardrobe from trousers and choose to wear shorts and sundresses. However for those affected by varicose veins the decision to bare their legs can be a little harder. Especially for women who maybe self conscious of the appearance of veins.

Varicose veins affect up to 50% of the population, with a small percentage suffering from more advanced venous disease. Varicose and spider veins appear on the legs, ankles and feet they can be caused by a variety of conditions. Most commonly they are hereditary but lifestyle being overweight or conversely exercise, standing or sitting for long periods of time can also contribute to them appearing earlier, as can hormonal changes such as pregnancy or menopause. If left untreated, varicose veins can lead to leg ulcers and other serious problems such as swollen legs, pain and an increased risk of blood clots.

Spring is a great time to seek treatment for varicose veins as there is plenty of recovery time before the summer months set in. Also it is more comfortable to wear compression stockings when the weather is a bit milder although our vein institute is still very busy in the summer.

Treatment usually consists of EndoVenous Laser Therapy and/or Ultrasound Guided Sclerotherapy, depending on the severity of the disease, which is determined through an ultrasound during the initial consultation. Patients that undergo varicose vein treatment can see results within weeks of the procedure and are getting back to their normal, active lifestyle straightaway.

Posted
AuthorNicholas Kemp
CategoriesVaricose Veins

In May 2019 the Australasian College of Phlebology conference was in Cairns and guest speakers were invited from all around the world.

Dr Lowell Kabnick from the USA and the Immediate Past President of the American Venous Forum informed us that not one person in the USA had their varicose veins treated by conventional surgical stripping in 2018.

Surgical stripping of varicose veins has been superceded by newer technologies such as endothermal venous ablation, endovenous cyanoacrylate closure (Glue) and ultrasound guided sclerotherapy which are now considered best practice.

before.jpg

60 yr old lady with skin damage from refluxing Great saphenous vein.

after.png

Treatment:

Endovenous Laser Ablation and U

ltrasound Guided Sclerotherapy.

Not hospitalized - Treated as an outpatient.

Appearance at Six months post treatment.

Posted
AuthorNicholas Kemp
CategoriesVaricose Veins

Normal circulation involves blood carrying oxygen being pumped from the heart into the tissues via arteries and then returning de-oxygenated blood carrying other waste products from the tissues back to the heart through the veins. Your arteries might be in good health but if your veins are not working properly and leaking back into the tissues due to varicose veins then in the long term tissue damage to your lower legs can occur leaving you at risk of varicose leg ulcers later in life.  

People with venous disease will often find relief from their swollen feet and ankles and alleviation of tired and aching legs by elevating their legs at the end of the day. There are many and varied medications and devices marketed as circulation boosters (e.g. the brand Revitive™).   Medical Graduated Compression Stockings have Evidence Based Medicine to support their use to improve leg vein circulation and improve leg vein health. Not all stockings are created equal so before you russell up the money to pay top price for a pair check the fit and compression rating, plus sizes are recommended for taller vein patients. 

However, these methods only provide temporary relief and do not prevent tissue damage from occurring in the long term. An Ultrasound investigation can establish if your aching or swollen legs are caused by poor venous circulation. 

Dr Nick Kemp writes a column in Style Magazine educating Brisbane readers on matters of venus health and questions frequently asked by patients at his vein clinic. 

 

Posted
AuthorNicholas Kemp

Spider veins are common, appearing as small blue or red veins seen close to the surface of the skin in the legs and ankles. While spider veins are commonly treated by many types of professions (e.g. beauticians, dermatologists, medispa nurses etc), there are 3 important reasons why you should consider going to a qualified sclerotherapist over any other practice to treat your spider veins.

1. Spider veins may actually be a symptom of underlying venous insufficiency.  

Spider veins, are often associated with underlying venous insufficiency (i.e. varicose veins).  In fact, approximately 25% of patients who present with spider veins have them as a direct result of an underlying  varicose vein insufficiency deeper within the skin. Therefore, the underlying issues of varicose veins must be treated to properly eliminate your spider veins, otherwise they will continue to come back regardless of how often or how many times you treat them. The ability to understand this thoroughly is the most important difference between seeing a doctor whom specialises in venous disease versus those who do not.

2. Sclerotherapists use a Duplex Ultrasound.

As a follow up to the above, in order to eliminate the possibility of any underlying venous insufficiency as the root cause of your spider veins starts with ability to provide a proper diagnosis.  During the initial consultation, the doctor will perform an ultrasound on your legs using a Duplex Ultrasound.  By doing so, they will be able to correctly and accurately map out a treatment plan custom tailored to your particular needs and address an issues that may often be overlooked by going elsewhere.  

3. Sclerotherapists only treat veins. Period.

The most common treatment for spider veins no matter where you go to have them treated is known as Sclerotherapy. Sclerotherapists are required to go through rigorous training so that they can provide safe and effective treatment of your veins. They only treat veins for a living, this is their specialty. More importantly, vein disease is real disease, so why treat it by anyone other than someone with the particular training and acumen required to provide the highest standards of venous care.

Posted
AuthorNicholas Kemp

Spider veins often cause concern because of their unsightly appearance if they become extensive. They can occur anywhere on the body but are most frequently seen on the legs. Telangiectasia is the medical term for spider veins. Incompetent feeder veins or reticular veins deeper under the skin causing “backwash” of blood back into the skin are the usual cause.

Gold standard treatment is sclerotherapy. Vascular laser is rarely indicated for the treatment of telangiectasia on the legs.

However for the treatment of varicose veins Endovascular laser is often the first step in treatment.

Sclerotherapy usually requires a number of sessions for optimal results.

Before

Before

After. At 3 months. Sclerotherapy 2 treatments.

After. At 3 months. Sclerotherapy 2 treatments.

Before

Before

After. 6 Months Sclerotherapy 4 sessions.

After. 6 Months Sclerotherapy 4 sessions.

Before

Before

After - 3 months. Sclerotherapy 2 treatments

After - 3 months. Sclerotherapy 2 treatments

Posted
AuthorNicholas Kemp