Varicose veins refer to permanently elongated & visibly tortuous veins of the leg/s. There is a very high prevalence of this condition in the Indian population and a large number of cases come in a very advanced stage, due to various reasons: the fear of a morbid surgery, fuelled by the myth that it has no successful permanent cure, the later being often due to improper, inadequate and at times inappropriate treatment of this condition.
Complaints: Leg ache, night cramps, easy fatigability of leg, restless legs, heaviness of legs; all more pronounced towards the end of the day. Some have progressively increasing darkening of skin around the ankles and lower leg/s.
Complications: If treatable varicose veins are left untreated then this could lead to conditions like eczema with severe itching around ankle/s, thrombophlebitis with clots within the veins leading to sudden onset of pain, bleeding and non healing leg wounds.
Treatment Options: One who should be treated is guided by the 3Cs - Complaints, Complications and Cosmesis. The gold standard for treatment of varicose veins is Endovenous Laser Ablation. This is supplemented with injections of sclerosant chemicals
and/or surgical removal for the smaller veins through very tiny incisions. Laser surgery has the advantage of almost non existent wound infection rates, early return to normal activity and a very low recurrence rate as compared to conventional open surgery. Cosmetic results are also far superior with hardly any visible operative scars. Some cases are however not suitable for laser treatment & are better off treated with just compression stockings. This decision is best taken by an experienced vascular surgeon.
Benefits: The procedure can be done under local, regional or general anaesthesia, depending on the patient’s choice. It is done as a day care procedure with a maximum hospitalisation not exceeding an overnight stay.
Both legs can be treated in the same sitting. There is minimal aftercare and no requirement of bed rest post procedure. A brief course of pain killer needs to be taken for a week to overcome some soreness over the procedure site. Success rates in experienced hands are 97%-100%.
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