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.  

Walking compresses the deep veins in the leg muscles and this pumps the blood out of the legs. This is the most important mechanism to improve clearance of venous blood out of the legs. If you sit on an aeroplane for a long flight you might be aware of some ankle swelling because you haven’t been walking.

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.  

But 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. 

The price of the initial consultation at our Vein Clinic in Brisbane and Toowoomba includes a venous duplex ultrasound examination for which there is a medicare rebate. 

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AuthorNicholas Kemp

At The Leg Vein Doctor we work with other Brisbane based health professionals such as GPs, Midwives, Physiotherapists, Personal Trainers and Podiatrists in order to share our knowledge and assist their clients that suffer with varicose veins. 

The video we have collaborated on with neighbouring exercise physiologists BodyTrack shows simple exercises that can potentially assist with reducing pain or congestion in venous system of the legs and as received over 80,000 views to date. 

If you have questions regarding your leg veins you can book in for an initial consultation with Doctor Kemp which includes an ultrasound investigation. All treatment plans are valid for 12 months, you are under no obligation to book in straight away and although GP referrals are preferable they are not required. 

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AuthorNicholas Kemp

15% of people in the community develop chronic venous hypertension in their legs because of varicose veins. Unlike “Arterial” hypertension, “Venous” hypertension causes tissue damage due to an accumulation of waste metabolites and a build up of fluid leaking into the subcutaneous tissues under the skin.

After a number of years inflammation of the subcutaneous tissue leads to lipodermatosclerosis where there is damage to the lymphatic system and degeneration of the fat tissue. The skin becomes darkly pigmented, paper thin and vulnerable to injury.

Unfortunately 1-2% of people in the community will develop skin ulceration. This condition can also occur at an early age as we have treated people with skin ulceration in their mid-thirties. Treatment of varicose veins will abolish venous hypertension and prevent skin damage from occurring.

Venous Ulcer on a female patient with untreated Varicose Veins.

Venous Ulcer on a female patient with untreated Varicose Veins.

Lipodermatosclerosis due to untreated Varicose Veins.

Lipodermatosclerosis due to untreated Varicose Veins.

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AuthorNicholas Kemp

We are often asked the question, how safe is EndoVenous Laser Treatment for varicose veins in elderly patients? An international study by veindoctors has shown the treatment is feasible, safe, and well-tolerated by elderly patients.

Background

Varicose veins are a common vascular disease in elderly patients. Both endovascular laser ablation (EVLA) and radiofrequency ablation (RFA) are reported to have good technical, clinical, and patient-reported outcomes for the treatment of varicose veins. We did not find any reports on treating elderly patients with endovascular ablation procedures in the literature. The aim of this study was to determine whether endovenous thermal ablation techniques are safe and effective in treating elderly patients with varicose veins.

Method

A retrospective analysis of 57 EVLA cases and 46 RFA cases was conducted at a single center. Patients in the 65–88-year age group were assessed for postoperative pain, hematoma, thrombophlebitis, hyperpigmentation, wound infection, and skin burn.

Results

Minor complications identified in the studied patients were hematoma (2.9%), thrombophlebitis (5.8%), hyperpigmentation (8.7%), wound infection (4.9%), and skin burn (1%). In the RFA group, 38 patients (83%) had no need for oral analgesic tablets on postoperative Day 3. In the EVLA group, 25 patients (44%) had no need for oral analgesic tablets on postoperative Day 3. Two patients in the EVLA group needed a secondary intervention due to recurrent vein issues. There were no major complications in either group.

Conclusion

The outcomes for our older patients who underwent endovascular ablation therapy were comparable to other studies performed with the general population. Our results show that both EVLA and RFA are feasible, safe, and well-tolerated by elderly patients.

Lam P, Chao L. Endovascular Ablation Therapies for Varicose Veins in Elderly Patients. International Journal of Gerontology, 2014 ; 8 (4) 219–222.

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AuthorNicholas Kemp

This blog discusses why men are more likely to put of the treatment of their venous disease. The photo shows a 38 yr old male patient presenting with Ulcer inside ankle from untreated varicose veins.

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AuthorNicholas Kemp