Frequently Asked Questions

What is Chronic Venous Insufficiency (“Varicose Veins”)?

A condition where veins have trouble sending blood from your legs back to your heart. This is due to the valves in the veins being damaged, malfunctioning, or absent. As a result, when you are upright, blood pools in your legs to cause chronically high blood pressure in the veins. 

This can cause a number of things:

• Pressure to spread to surface veins => spider veins, reticular veins, varicose veins

• Vein walls become leaky and fluid leaks into soft tissues => leg swelling

• Iron deposits from blood into skin => skin discolouration

• Chronic inflammation => aching, pain, scarred skin and soft tissues

• Severe cases => leg ulcers, clots, bleeding, infection

What Veins are Affected?

Culprit vein systems you can’t see:

• Superficial venous insufficiency (Problems with veins closer to the skin surface)

  • Thigh Veins (long saphenous vein / anterior accessory saphenous vein)

  • Calf vein (short saphenous vein)

• Deep venous insufficiency (Problems with deeper veins in the legs)

  • Femoral vein (thigh level)

  • Popliteal vein (knee level)

Surface veins you can see:

• Varicose veins (bulging, twisted, veins that rise above the skin, >3mm diameter)

• Reticular veins (flat blue or blue-green veins just under the skin ,1-3mm diameter)

• Spider veins (Tiny, thin blue or red lines on the skin surface, <1mm diameter)

What are the Treatment Options?

Deep venous insufficiency => no operative option, requires compression stockings

Superficial venous insufficiency

• Keyhole surgery (endovenous ablation such as radiofrequency ablation, sclerotherapy)

• Open surgery (“stripping”)

Surface veins

• Varicose veins

  • Ultrasound-guided sclerotherapy (injections)

  • Phlebectomy

• Spider and reticular veins

  • Microsclerotherapy

  • Surface laser

Compression is also an option in less severe cases or where the risks of intervention are too high


What is Radiofrequency Ablation?

Radiofrequency ablation is an effective and minimally invasive treatment for varicose veins. It uses heat to scar the wall of the faulty vein, causing it to collapse and close. Under ultrasound guidance, the radiofrequency ablation electrode is inserted into the vein. Additional local anaesthetic fluid is injected around the length of the vein being treated. Ultrasound is used to place the radiofrequency ablation electrode in the correct position, and the vein is treated by withdrawing the probe at set segments until the entire vein is adequately treated. The vein then blocks and is then dissolved by the body over time. Nearby blood is redirected back to the heart by healthy surrounding superficial and deep veins.


What is Open Surgery (“Stripping”)?

The operation involves making cuts either in the groin area or behind the knee to access the problematic superficial system veins where they connect to the deeper veins. During the surgery, these connections will be tied off (ligated). In some cases, the affected superficial system vein may need to be removed through a process called "stripping," which involves carefully pulling the vein out through a small cut lower down your leg.


What is Phlebectomy?

These are small incisions to pull out surface veins under direct vision or ultrasound guidance. 


What is Sclerotherapy ("Injections")?

Sclerotherapy involves using a small needle to inject a solution which contains an irritating substance (the sclerosant) into the vein in question. Ultrasound guidance is used. Dr Shan uses aethoxysclerol which is a safe sclerosant and has well-documented use in varicose veins. The sclerosant solution then causes the vein to become scarred and collapse. This vein then fades with time. No local anaesthetic is used for this procedure as it requires very small needles and does not require an incision.
 

Potential reasons not to have sclerotherapy:

• Patent foramen ovale or atrial septal defect (small hole in the heart that allows blood to flow between the right and left upper chambers of the heart)

• Known allergy to the sclerosant

• Current systemic infection or infection at the treatment area

• Residual or acute clots in the leg being treated

• Severe arterial disease in the legs

• Pregnancy

• Active ulcer over vein being treated

• Poor mobility

• Prior history of stroke, visual disturbance, or neurological event with sclerotherapy

What Treatments and Combinations are Best?

Dr Shan will discuss the ideal treatment options with you during your consult. This will be tailored to your symptoms and the outcomes you wish to achieve. Minimally invasive procedures are usually offered to avoid the need for open surgery or “stripping”. This allows for a much faster recovery and less risk of complications, whilst maintaining a high success rate. 

Dr Shan performs well-established surgical techniques that may help improve both the appearance of your legs and any symptoms you may be experiencing. As with any surgery, there are some risks involved, and recovery typically takes 2 weeks. The success of the treatment can vary from person to person, and there is a possibility that new varicose veins may develop over time. Maintaining a healthy weight and staying active may help reduce the risk of future varicose veins developing. You will receive detailed pre-operative instructions which should be followed to help ensure the best possible outcome. 

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Is Health Insurance Required?

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Health insurance is not required to access services at the ShanVascular Veins Centre. A valid Medicare card will be required to claim Medicare rebates. 

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What are the Costs?

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The cost of the procedure will depend on your specific condition and ultrasound imaging. Dr Shan will discuss all the options with you to determine that ideal treatment combination. A detailed quote and informed financial consent are provided prior to all procedures. Dr Shan's team is more than happy to go through this with you if you have any questions. Please note: health insurance does not fund outpatient procedures. However, Medicare rebates can be claimed with a valid Medicare Card.