TREATMENT OPTIONS
Dr Malouf is an expert in the treatment of varicose veins and other venous related diseases. His comprehensive and personalised approach to each patient, along with the use of state-of-the-art facilities, ensures that each of his patients will have the best and most effective treatment options that will suit their needs and provide them with the best possible results.
Each set of varicose veins is different and as such, the options for treatment will vary from patient to patient. If you wish to be advised on the most appropriate treatment, please call the rooms on 02 9387 6518 to schedule an appointment.
COMPRESSION STOCKINGS
Compression stockings come in different lengths, styles, thicknesses and strengths. These stockings support and compress the veins and muscles, making the legs feel better and hiding the varicose veins. Compression also promotes blood return back to the heart, particularly while you walk, which contracts your leg muscles. If Dr Malouf has asked you to purchase compression stockings, it is important that you have purchased them prior to your appointment so they are ready to be worn immediately following your treatment. It is important to get these garments fitted properly so they do not irritate the leg or affect with blood circulation.
ULCER CARE
Occasionally, varicose veins can lead on to leg ulcers. In such cases the underlying varicose veins problem needs to be treated as well as specific attention to the leg ulcer itself. Dr Malouf has a wide experience in the treatment of leg ulcers and he manages a clinic for leg ulcers at Blacktown Hospital. Management involves cleaning the ulcer, choosing an appropriate dressing to apply and then applying graduated compression to the leg from toes to knee. Cooperation is achieved with the patient’s GP and nurses to regularly dress and assess the ulcer. Dr Malouf will arrange for treatment of the underlying varicose veins and other contributing conditions.
MEDICATION
Medications and naturopathic supplements can help strengthen the vein walls, improve the symptoms of aches, pain, restlessness and cramps in your legs, and slow the rate of deterioration of the veins. These include Paroven, rutins, bioflavonoids, horse chestnut, gingko, or similar products from your pharmacy or from health food shops.
IMPROVING YOUR LIFESTYLE FACTORS
Thankfully, there are some simple steps you can take to enhance the blood flow in your legs and prevent your varicose veins from getting worse. Exercising regularly, or simply regular walking, will help increase blood flow through your leg veins to eliminate sluggish flow or pooling. Your leg muscles are your biggest allies, working against gravity to help your veins push blood to the heart. If your job requires extended periods of sitting or standing, it is important to take a break at least every half an hour to change position and stretch your legs to promote blood flow. Losing excess weight is an effective way to reduce the pressure in your varicose veins and stop new ones from forming as you are placing more stress on your legs if you are overweight or obese. There are also a lot of other benefits to losing weight than helping with varicose veins.
INJECTION TREATMENT
SCLEROTHERAPY
This involves injecting an irritating solution into the target area to inflame the lining of the blood vessel, causing the vein walls to stick together. This is then followed by compression of the veins using stockings or bandages to compress the inflamed vein walls, pushing them together to shrink the veins down and cause them to fibrose and almost disappear.
These injections can be performed directly while looking at the vein, or under ultrasound guidance. The use of an ultrasound assists in imaging the target vein which may not be visible to the naked eye under the skin. The vein can then be injected successfully with the solution.
After injection treatment, compression and mobility are important to obtain a good result.
SURGICAL
THERMAL ABLATION USING RADIOFREQUENCY
Radiofrequency thermal ablation is a minimally invasive procedure performed to destroy the trunks of the saphenous veins with heat generated from radiofrequency energy. This obliterates the inside of the saphenous trunks and stops the back flow of blood down the trunks, encouraging blood to start flowing to the healthy veins.
A radiofrequency probe is placed inside the diseased saphenous trunk at the base going up towards the groin. Energy is then applied to the probe to generate heat that destroys the vein wall from within as the probe is withdrawn downwards along the vein. This thermal damage to the vein leads to its immediate closure and over time, it will gradually undergo complete absorption by the body and disappear.
This procedure can be performed under general anaesthetic in hospital or, in some specific cases, under local anaesthetic in Dr Malouf’s rooms. Compression stockings are then applied to the legs following the procedure. Additional treatment may be required to treat the branching varicose veins and the superficial tributaries, as the laser does not treat them directly. This additional treatment may be in the form of sclerotherapy or mini-surgery to remove the tributaries.
SURGICAL REMOVAL OF VARICOSE VEINS
The surgical procedure of the stripping of varicose veins that was performed in the past, is rarely performed today. In these modern times the trunks of the saphenous (superficial) veins are closed thermally, that is with heat, from a catheter placed inside the vein. This stops the backward flow of blood in those veins and the veins are eventually absorbed by the body. In addition to the saphenous veins themselves, there may be large, branching and twisted visible varicosities that are better removed through tiny 1-2mm incisions. Dr Malouf will discuss with you if you would be more comfortable having this done under a general anaesthetic in hospital rather than undergoing treatment in the office under local anaesthetic.