Varicose veins are large, swollen veins that can bulge above the skin’s surface. They are most commonly found on legs and feet. Varicose veins are thought to be caused by faulty valves in veins which stop the blood from flowing efficiently. Varicose veins can sometimes cause swelling, aching and discomfort, however a number of invasive or non-invasive treatments are available.

These treatments are usually performed by a Phlebologist, who are medically qualified doctors that have specialised in the treatment of venous diseases.

For Medicare to cover the costs of treatments, the varicose veins must be larger than 2.5mm in diameter. Medicare will not pay for treatment of smaller “cosmetic” veins.

How to prevent Varicose Veins?

Although there is no way to completely prevent varicose veins from occurring, there are some simple ways to reduce the likelihood of them developing. In general, a number of lifestyle changes can be made to help prevent varicose veins in the future such as: – Regularly exercising – Avoid sitting for long periods of time – Avoid high heels – Maintain a healthy weight / diet

What is the modern technology used in treating Varicose Veins? If your varicose veins are causing you pain or you are concerned with the appearance of them a number of treatments are available. At Specialist Vein Care we use a range of treatments incorporating more traditional methods as well as treatments using the latest technology.

Conservative

In many less severe cases varicose veins can be treated with self help mechanisms such as elevation of limbs, avoidance of sitting or standing for long periods of time, exercise and weight loss. Compression stockings/socks may be used to treat and relieve the symptoms of vein disease and this may be all that is required.

When required we also use several more advanced and modern treatments:

Any prospective treatment is individually tailored to a particular patients situation/needs.

Endovenous Laser Ablation (EVLA)

Endovenous Laser Ablation therapy or laser vein treatment involves a small skin puncture being made with a laser probe. The laser fiber gets passed up the vein under ultrasound guidance. The vein is next surrounded by a column of anaesthetic. The laser fiber is activated and slowly withdrawn, destroying the vein.

EVLA is very effective for treating larger veins and does not require admission to hospital or anaesthesia. This means no time needs to be taken off work and you can continue with your everyday activities.

EVLA is reasonably new treatment that has been in use since around 2001, often showing better results than traditional varicose vein surgery.

Ambulatory Phlebectomy (AP)

Ambulatory Phlebectomy, is a surgical procedure performed under local anaesthetic. A tiny skin incision is made and a section of the vein is removed.

This method of vein therapy has been around for hundreds of years and almost all sizes of veins can be treated with this method.

Medical Adhesives

Medical Adhesives are an exciting new addition to the current methods of non-surgical treatments of varicose veins already available. Medical adhesives are essentially medical grade ‘superglues’ used to treat varicose veins. The vein will immediately solidify and produce an inflammatory reaction which destroys the vein wall.

Ultrasound Guided Sclerotherapy (UGS)

Ultrasound Guided Sclerotherapy is a very successful treatment that has been in use for many years. In this treatment, a medicine is injected into the vein, usually using ultrasound guidance. The two medications utilised in this procedure are polidocanol or fibrovein

Anesthesia or admission to hospital are not required, meaning you can continue with your day to day activities. This is a very successful therapy, particularly when treating small to medium sized veins.

Microsclerotherapy

Microsclerotherapy is used to treat very small veins and has been around since the 1920’s, but was made popular during the 1960s. Microsclerotherapy involves injecting a “sclerosant” into each vein with very fine needles.

Improvements are usually seen in a couple of weeks but up to 12 weeks may be needed to show to maximum effort. Multiple session are generally required for complete removal.

What are the questions to ask the Phlebologist in my consultation?

Some individuals find that visiting a phlebologist can be overwhelming, especially if it is your first visit. To ensure that you leave satisfied and get all of your queries answered, it may be useful to come prepared with some questions.

These may include: -Do I need to treat my varicose veins? -What causes varicose veins? -What treatments are offered here? -What are the risks associated with these treatments? -Will I need to take time off work?

What now?

If you are suffering from varicose veins or other venous diseases such as spider veins or reticular veins you should seek treatment as soon as possible. Venous diseases are usually progressive and if left untreated symptoms will generally worsen or more serious complications can occur.

Visit a trusted Phlebologists, such as Dr Ivor Berman from Specialist Vein Care, for a more informed decision on where to go in the future in terms of treatment or surgery.

Dr Berman is an experienced phlebologist and a Fellow of the Australasian College of Phlebology. He offers a range of vein removal procedures that are minimally invasive with minimal risk and low to no downtime. To make an appointment with Dr Berman call Specialist Vein Care on .  

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Causes of Varicose, Spider, and Reticular Veins

The main purpose of veins is to return blood from your body to your heart, so blood can be recirculated. Healthy veins have one-way valves that keep blood travelling in the direction towards the heart. For reasons that we don’t know the valves can fail. This usually occurs in the legs. This in turn allows for sluggish circulation in the involved veins. This leads to internal pressure and swelling, which causes the noticeably enlarged usually blue or red coloured veins at the skin surface.

While the direct cause of varicose veins is uncertain and anyone is at risk of developing them, there are certain factors that seem to increase this risk.  

These risk factors include:  

• Family history of varicose veins and/or blood clots
• Pregnancy can result in enlarged veins in your legs partially due to an increase in the volume of blood in your body  
• Obesity or being overweight can place added pressure on your veins
• Standing or sitting for prolonged periods. As your blood doesn’t flow as well if you’re in the same position for a long period of time.  
• Women are also more likely to develop varicose, reticular or spider
• Ageing.

Prevention:

It is hard to completely prevent varicose veins. But in order to reduce the risk it is important to improve your circulation and muscle tone. The same methods that you take to treat the discomfort caused by varicose veins can be applied to help prevent them. This includes: – exercising – maintaining a healthy weight – eating a high-fiber, low salt diet – avoiding high heels and tight hosiery – elevating your legs, and alternating you sitting or standing position regularly.

Signs and symptoms to look out for:

• Pain
• Ache
• Restless legs
• Itching
• “Heavy” legs
• Ankle swelling
• Skin discolouration
• Ulcers

In comparison to varicose veins, spider veins are smaller. They are found closer to the surface of the skin and are often red or blue in colour. They get their name Spider veins because they often look like a spider’s web.  

Which specialist do I see?

The causes and forms of varicose veins varies from person to person, therefore, it is important to seek uation from a vein specialist.

At Specialist Vein Care, Dr Ivor Berman (link) is a Phlebologist (Vein specialist) and Radiologist, who provides state of the art techniques in the diagnosis and treatment of vein disease, including Varicose, Reticular and Spider veins.  

Treatments

It is worth considering booking an appointment with Specialised Vein Care when self-care techniques such as exercise, lifting your legs while sitting and/or wearing compression stockings have not worked or even for aesthetic improvement.

We offer different treatments depending on your diagnosis, such as Endovenous Laser Ablation (EVLA), Ambulatory Phlebectomy (AP), Ultrasound Guided Sclerotherapy (UGS),Glue(Cyanoacrylate), Microsclerotherapy and Conservative treatment. (links)

To make an appointment today to have your venous disease assessed by Dr Berman, please phone (03) 9561 5155.

The post What causes Varicose, Spider, and Reticular Veins? first appeared on Specialist Vein Care.

The most common question and understandably the most troubling for people is whether Sclerotherapy “will permanently remove my varicose and spider veins”.

The gold standard treatment remains injection sclerotherapy which is highly as has been a proven effective therapy since the mid-1900s.

This procedure is usually undertaken for cosmetic purposes, but can in some cases improve related lower leg issues such as aching, itching and burning sensations.

Treatment Procedure

Prior to any treatment we routinely conduct an initial consultation to assess suitability and safety for the treatment and perform a duplex ultrasound. The ultrasound is performed to exclude/demonstrate underlying feeder veins and sometimes varicose veins which may not be visually evident. This is important as the presence of these underlying veins can alter outcomes and the best form of therapy.

The procedure involves injecting the problem veins with a medical solution through a very small/fine needle. Depending on the number and extent of the veins, the number of injections will vary, but usually 15 minutes is enough time to treat all the veins of concern.

What happens to the vein which has scarred?

Ultimately, the scarred vein will collapse due to insufficient blood flow, and will eventually be reabsorbed into surrounding tissue and fade away.

Other questions that are routinely asked are:

“Don’t I need these veins?”

The answer is no. These veins are of cosmetic importance only.

“How many treatments will I need?”

The answer is variable. Some people get a great result with one treatment and others may take several treatment sessions. It is not possible to predict with certainty how many treatment sessions any individual will require.

“Will they come back?”

The answer to this question is that the treated veins do not return. What happens is that over time most people will create some new spider veins. We are unsure of the reason and one cannot prevent this from happening.

Depending on the individual, the effects of therapy can be seen shortly after treatment but it can take up to 12 weeks to see the full effect..

Your medical specialist at Specialist Vein Care, will provide you all the information required if you’re deemed a successful candidate for the procedure.

Further detailed information on Microsclerotherapy can be found ​here​, or give the team at SVC a call and book in for an ​initial consultation​.

The post Does Microsclerotherapy Remove Leg Veins Permanently? first appeared on Specialist Vein Care.

This is fantastic news for those people suffering from varicose vein disease !!

Earlier this year the Department of Health has added to the Medicare Benefit Scheme the use of Medical Grade Adhesives (Cyanoacrylate).

What this means that there is finally a rebate available to patients who fulfil the required criteria for access to the Medicare Benefit Scheme.

At Specialist Vein Care we are proud to offer VenoBlock and VeinOff.

What is VenoBlock and VeinOff?

This is essentially medical grade superglue. The product is a form of cyanoacrylate, similar to that used in a host of other medical areas such as closing skin lacerations. It is used by orthopaedics, interventional radiologists to close off brain aneurysms and by dentists amongst others.

These adhesives are extremely safe.

Once injected into the diseased vein they act by sealing the vein which then disintegrates and gets reabsorbed.

Once injected into vein the glue sets within seconds.

Several veins can be treated at the same time.

VenoBlock and VeinOff are extremely efficacious with much published data backing up their effectiveness and safety.

Their specific uses vary slightly depending on the size of the vein, its length and its depth in the leg.

There are many advantages to this form of therapy including:

• Rapid treatment. Few minutes.
• No risk of skin burns or nerve damage.
• No need for tumescent anaesthetic, nerve block or general anaesthetic.
• No need for compression stockings.
• Immediate return to normal duties and activities.

At Specialist Vein Care, Dr. Ivor Berman and his staff are specialists in the diagnosis and treatment of vein disease, utilising minimally invasive procedures.

Depending on your particular circumstance, the best form of therapy would be determined.

We can discuss your particular venous issue, discuss options (including the potential use of Medical adhesives if appropriate), creating an individualised treatment plan if required.

To make an appointment today to have your venous disease assessed by Dr Berman, please phone .

The post Medical Grade Adhesives first appeared on Specialist Vein Care.

Although sometimes unsightly, depending on the individual situation, serious health complications may develop if left untreated. Of course, this is not necessarily the case in all people and many times once a person has been uated carefully a decision may well be made to avoid treatment. Nevertheless, when the early signs of varicose veins appear, it’s only natural that many people start exploring available treatments.

One of the mainstays of therapies that is used to eliminate small varicose veins is injection sclerotherapy.

What is Sclerotherapy?

Sclerotherapy, a minimally invasive treatment, is one of the most effective ways to treat smaller, surface level and often deeper varicose veins in the legs.

This is a method of therapy that involves injections of a sclerosant medical solution through an extremely fine needle, directly into the varicose veins. This causes the vein initially to collapse and over time be reabsorbed by the body and gradually disappear. There is ample venous reserve in the legs and treatment of these veins rather than impacting blood flow, actually serves to improve the circulation.

Whilst there are multiple ways to perform sclerotherapy, at Specialist Vein Care, direct vision and/or ultrasound guided sclerotherapy is regularly used to treat small to medium sized varicose veins. On occasion, several sclerotherapy treatments may be required to reach the desired results.

Every patient is unique and each patient needs to be carefully uated in order to determine the best treatment method. There are currently multiple non-surgical treatment methods available. Depending on the individual circumstance different treatment options and sometimes a combination of treatment options may be offered and required.

If injection sclerotherapy is performed if is reassuring to know that this is a form of treatment that has been available and has been used here in Australia and around the world for decades. This is a safe and effective way to treat varicose veins whilst eliminating the need for traditional vein surgery.

At Specialist Vein Care, Dr. Ivor Berman and his staff are specialists in the diagnosis and treatment of vein disease, utilising minimally invasive procedures such as sclerotherapy. As mentioned there is an array of other non-surgical treatment options that are available. Every patient that we see is carefully uated and the best treatment regime for each patient is determined and discussed.

To make an appointment to discuss your particular venous issue and to have your venous disease assessed by Dr Berman, please phone 9561 5155.

The post Will sclerotherapy eliminate small varicose veins? first appeared on Specialist Vein Care.

Whilst varicose veins may be seen as unsightly blemishes under the skin there is a very real risk of serious medical conditions developing if left untreated. Generally speaking, people with varicose veins will experience a variety of discomforts including pain, itchiness, swelling and fatigue in the legs.

Some varicose veins are more severe and will require medical treatment and generally patients present to a medical professional when the veins are bulging and painful. At this stage the likelihood of developing a secondary condition has significantly increased. The types of secondary conditions that are likely to cause significantly more harm to your health.

Excessive Blood Loss

Varicose vein trauma can vary from bruising from minor trauma through to a torn or bursting vein. If the skin is broken at the varicose vein excessive blood loss can occur requiring emergency treatment to stop the bleeding.

Blood Clots

Blood must keep flowing to prevent clotting and once the flow slows the chances of clotting increases. The risk of blood pooling in varicose veins can lead to blood clots forming. If the clot forms deep in the vein (deep vein thrombosis) patients can experience severe pain, swelling and difficulty walking. More seriously, the blood clots may break free and travel through the body to the lungs causing a pulmonary embolism, which is life threatening and in some cases fatal.

Ulceration

Inflammation around varicose veins that are not treated may lead to open wounds and in some circumstances ulcerate. Failure to treat ulcers can lead to the spreading of infection which can have a serious impact on your health.

Treatment of varicose veins will depend on the severity of the condition. Not all varicose veins will require treatment and with the right advice some varicose veins can be managed to prevent their advancement. However should a patient not see a medical professional the reality is that these symptoms will more than likely get worse.

Here at Specialist Vein Care, we have a variety of treatment methods to treat the damaged vein including endovenous ablation, ambulatory phlebectomy and ultrasound guided sclerotherapy. For further information or to arrange an appointment with one of our varicose vein specialists please call .

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The post A Current Affair – Non Surgical Management of Varicose Veins first appeared on Specialist Vein Care.

I sometimes get questioned as to why this is necessary and so important.

The reason is that management of the venous disease depends on identifying abnormal aspects to the vein disease not able to be seen at the skin surface and responsible for the clinical or cosmetically visual problem. A person can and not uncommonly does have classic signs and symptoms of venous disease with no visible abnormality at the skin surface. The only way to accurately determine the cause of a person’s problem and the best treatment methods are by performing an ultrasound duplex scan.

Also multiple different patterns of incompetent vein disease can result in a similar appearance of abnormalities at the surface.

If vein reflux is identified and contributory to spider vein disease, then in order to get a good outcome this needs to be treated either before or in conjunction with treatment of the spider veins.Treatment decisions based solely upon clinical uations are often fraught with errors and often accounts for unsuccessful outcomes.

Therefore, it is imperative that all patients undergoing uation for lower extremity varicose or spider vein disease undergo an ultrasound study of the superficial venous system to determine the pattern or patterns of incompetence prior to making any treatment recommendations.

The goals of the ultrasound examination is to identify all incompetent truncal and other veins and to determine whether they are responsible for the patient’s clinical problem.

The ultrasound examination should be performed with the patient either near vertical or in the standing position. Generally, the examination begins at the saphenofemoral junction (SFJ) at the groin, and proceeds down to the ankle.  A relatively standard protocol exists to ensure all relevant veins are examined. In addition to reflux, the truncal veins are measured as this has implications towards method of therapy. We also simultaneously examine the deep venous system as again this has implications with respect to treatment and outcomes. As the above examination takes time to perform, usually 30-60 minutes are required (one or two legs) to get an accurate complete picture

Ideally this should be performed by an expert vascular sonographer to ensure accuracy of the scan.  We regularly have to repeat scans at our practice due to inadequate or incorrect studies performed elsewhere.

If you have venous disease but are unsure whether these are of any clinical significance or if you have spider vein disease that worry you, please give us a call and organise an appointment.

We can discuss your particular venous issue, discuss options and create an individualised treatment plan if required. The venous disease that you have may well require reassurance only with no treatment required.

To make an appointment today to have your venous disease assessed by Dr Berman, please phone 9561 5155

The post Why is it important to perform a duplex scan in a patient with venous disease ? first appeared on Specialist Vein Care.

The good news is that in most people varicose veins are unlikely to ever cause them harm and that treatment is not essential !

For those who need or want treatment, a variety of non-surgical options are available.

It is important that people undergoing therapy understand that veins recur.Treatment really, irrespective of method is control not necessarily cure.I regularly hear the following: “I had my veins treated but they have come back”.This is both correct and incorrect. Veins that are removed are gone. There are new veins, yes, but these are not the same ones. What is happening is that over time, and commonly, new varicose veins grow.We do not know the reason for this.I often tell my patients that “One cannot treat veins that have not developed as yet”.

On average it is about 7 years between having ones veins treated and them returning to a similar degree.

So the best thing to do after vein therapy is to have an early follow up at 3-6 months and then 1-2 yearly, so that if treatment becomes necessary, the treatment is much easier and less involved. In other words keeping them at bay.

There is little one can do to prevent the recurrence of veins.It is also not possible to predict who is more likely to redevelop varicose and/or spider veins or when.

Patients for whom discomfort is the main problem can wear support stockings or compression socks. Elevation of the legs may relieve symptoms.General advice includes: Regular exercise – however there is no real supportive evidence that this helps.Keeping ones weight under control may reduce symptoms but be aware that excessive weight loss can make ones veins more visible!

Of course if veins are of concern from a cosmetic point of view they can be treated regardless of whether they are producing any symptoms.

There are published guidelines re the management of venous disease. These are the NICE guidelines as stated below: Timing of treatment ranges from routine to urgent. If one has a bleeding varicosity this requires immediate attention. If a varicosity has bled or is likely to bleed again, this should ideally be treated in the next few days/week. If there is an ulcer, treatment should be planned in the near future. These ulcers tend not to heal unless the underlying venous disease is attended too. Routine, means that the veins should be treated but this can be is something that be planned at a convenient time.

Referral guidance for varicose veins from the National Institute for Health and Clinical Excellence (NICE)

Emergency—Bleeding from a varicosity that has eroded the skin

Urgent—Varicosity that has bled and is at risk of bleeding again

Soon—Ulcer that is progressive or painful despite treatment

Routine—

Active or healed ulcer or progressive skin changes that may benefit from surgery

Recurrent superficial thrombophlebitis

Troublesome symptoms attributable to varicose veins, or patient and doctor feel that the extent, site, and size of varicosities are having a severe impact on quality of life

Also worth noting the following:

People are often reluctant or nervous to seek treatment as they do not wish for an operation or have heard about unpleasant experiences form others. Treatment these days is restively non-invasive and well tolerated with little if any downtime.

It one has concerns it is worth exploring. One does not necessarily require therapy and may just need reassurance. If treatment is warranted the individual situation can be assessed and discussed. Mostly fears about treatment are inappropriate and can be allayed by explanation and reassurance

Also remember that leg pain can be due to other reasons such as referred pain from the back. Careful history and examination will usually sort this out.

At Specialist Vein Care, Dr. Ivor Berman and his staff are specialists in the diagnosis and treatment of vein disease, utilising minimally invasive procedures.  We can discuss your particular venous issue, discuss options and create an individualised treatment plan if required.

To make an appointment today to have your venous disease assessed by Dr Berman, please phone 9561 5155.

The post What should people with varicose veins know? first appeared on Specialist Vein Care.

1. Has my exercise caused my varicose or spider veins?
2. Is it is safe to exercise?
3. What exercises are best to help prevent or slow the progression of my vein disease?
4. When one cannot exercise.

Today, we will attempt to answer all these questions. Plus, we will discuss other solutions if you are finding it difficult to exercise for any reason.

An article by S. Tabatabaeifar ^etal, published in 2015, looked at occupations and the development of varicose veins. They found that prolonged standing/walking and heavy lifting were a common cause and that there would be a preventive potential in more than 60% of all cases.

In general terms varicose veins are commonly associated with prolonged standing or sitting, pregnancy, a family history of vein problems, and with being overweight. Regular exercise and staying fit is helpful in preventing the development of varicose veins.

Has my exercise caused my varicose or spider veins?

There is very limited research with respect to this extremely common question.

Different doctors and allied health professionals will all have their particular answer to this question.

Overall we just don’t know!

From observation and basic principles some exercises are more likely to be associated with the development of varicose vein disease. Please see below.

Is it is safe to exercise?

Yes ! Exercise is the #1 healthy vein principle, but certain exercises are better for your veins      than others. As you exercise, blood is pumped back to the heart through contraction of the calf muscle. Therefore strong calf muscle promotes healthy blood circulation and will minimize vein disease.

What exercises are best to help prevent or slow the progression of my vein disease?

So given that exercise is beneficial, Legacy Healing Daytona provides exercises which are good for vein health. This rehabilitation center allows one to find unique ways to help people who are recovering from drug abuse as one of the main problem that arises in varicose veins.

Walking :  The best exercise is walking. Walking is a low-impact activity that stretches and strengthens your calf pump, thereby improving your blood flow.
Set a goal to walk 30 minutes a day, at least five days a week.

Cycling and elliptical trainers : These low impact exercises are great for exercising the calf muscle and improving calf pump blood flow without placing excessive stress on the veins.

Running : Running or jogging is also a fantastic aerobic exercise that gets the calf muscles moving.

Swimming : Fantastic low stress exercise. Body is horizontal !

THE BIG QUESTION: WHAT ABOUT WEIGHT TRAINING ?

This is contentious !

Lifting heavy weights and thereby straining increases intraabdominal pressure and general pressure on the veins in the legs. This can cause the veins to weaken and subsequently enlarge.

However, weightlifting is a great form of exercise in general with many health benefits and should not necessarily be avoided due to concerns with the development or worsening of varicose veins.

If you do lift weights:

• Use good lifting techniques: lower weight and high repetition routines.
• Alternate and change workouts. Eg.Change positioning of lower body exercises from standing to seated
• Exhale when you lift.
• Use weights that you can manage. Slowly increasing weight over time.
• Incorporate aerobic activity such as walking or riding a stationary bike as part of your regime. Wearing compression garments (e.g. stockings, socks) while weightlifting may be of benefit.

When one cannot exercise

Of course there are many reasons why somebody cannot exercise, such as being time poor or medical conditions which make exercising difficult or impossible.

Fortunately there are things that one can do:

• While sitting or standing, rock your feet back and forth on the ground from heel to toe thereby activating the calf pump.
• Wear graduated compression stockings or socks. Especially while travelling, or if your  occupation or lifestyle includes sitting or standing for an extended period, and during

At Specialist Vein Care, Dr. Ivor Berman and his staff are specialists in the diagnosis and treatment of vein disease, utilising minimally invasive procedures.  We can discuss your particular venous issue, discuss options and create an individualised treatment plan if required.

To make an appointment today to have your venous disease assessed by Dr Berman, please phone 9561 5155.

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