A 36-year-old well fit man presented to Dr Omarjee for advice regarding non painful large bilateral varicose bulging veins on his thighs and legs. These veins were worsening visually and were bothering him socially and at work. He liked to wear shorts a lot and was starting to wear pants to hide his venous varicose veins.
He initially had a thorough medical assessment with Dr Omarjee, which involved a duplex venous ultrasound to assess the underlying anatomy of the veins on his lower extremities.
The patient had his options discussed with him and after thorough discussions, he opted for a non-surgical option called Ultrasound guided foam sclerotherapy. This treatment has been safely performed for over 25 years in Australia and abroad. It is a relatively non-painful minimally invasive procedure that is walk-in-walk-out and is highly effective. Most patients can return to work the following day.
The procedure involves small needles (or cannulas) inserted in strategic sites of the thigh and/or leg relating to the varicose vein pathology to be treated under ultrasound guidance. A liquid sclerosant (drug made from a salty and sulfur mixture is usually utilised) is converted into foam via a technique called the Tessari method. The foam sclerosant is injected into the varicose veins and induces the vein walls to collapse and ‘stick” together, which induces the body to remove them over time.
A graduated compression stocking is essential for a period of time after the treatment.
Vigorous exercise is not encouraged for a short time period, but daily walking is essential for 30 minutes (minimum/day). An ultrasound assessment is performed 1 week later to assess the response to treatment. The number of visits/treatments is dependent on the size of and pattern of the varicose veins.