Treatment Options for Varicose Veins
Varicose veins are caused by failure of the valves within the superficial veins of the legs. When these valves become incompetent, blood flows backwards (venous reflux) instead of returning efficiently to the heart. Over time, increased pressure within the veins causes them to become enlarged, twisted and visible beneath the skin.
Venous disease exists on a spectrum. Some people develop only small spider veins, while others experience aching, swelling, skin discolouration, eczema, bleeding varicose veins or venous leg ulcers. Previous deep vein thrombosis (DVT), pregnancy, family history and prolonged standing may all contribute to the development of chronic venous disease.
Vascular Assessment and Duplex Ultrasound
Before any treatment is recommended, a detailed vascular assessment and duplex ultrasound examination are essential to identify the underlying cause and pattern of venous reflux. At Northern Sydney Vascular, duplex ultrasound is performed on-site by accredited vascular sonographers and reported by Dr Igor Banzic. Vascular ultrasound is bulk billed for Medicare cardholders with a valid GP referral.
Conservative Management
Compression Stockings
Graduated compression stockings improve blood flow by reducing pressure within the superficial veins and assisting blood to return towards the heart. They can reduce symptoms such as aching, heaviness and swelling, although they do not eliminate varicose veins.
Compression therapy may be recommended:
- While awaiting definitive treatment
- During pregnancy
- For patients who are not suitable for intervention
- After vein procedures to assist healing
Lifestyle Measures
Early venous disease may also benefit from:
- Regular walking and calf muscle exercise
- Weight management
- Avoiding prolonged standing or sitting
- Elevating the legs when resting
These measures help reduce symptoms but do not reverse damaged veins.
Endovenous Thermal Ablation (Laser or Radiofrequency)
Endovenous thermal ablation has become the preferred treatment for most patients with saphenous vein reflux.
A small catheter is inserted into the affected vein under ultrasound guidance. Laser or radiofrequency energy is then delivered to seal the diseased vein from the inside. Blood naturally redirects through healthy veins.
Benefits include:
- Minimally invasive treatment
- Performed through a tiny skin puncture
- Minimal scarring
- Rapid recovery
- Excellent long-term success rates
- Return to normal activities within days for most patients
Surgical Treatment
Open surgical treatment may still be appropriate in selected patients, particularly those with complex anatomy, recurrent varicose veins or disease not suitable for endovenous techniques. Surgery is performed in hospital under anaesthesia and may involve ligation of the refluxing vein together with removal of visible varicose veins.
Choosing the Right Treatment
Every patient is different. The most appropriate treatment depends on:
- The pattern of venous reflux
- The size and location of affected veins
- Previous vein procedures
- Symptoms and severity of disease
- Overall health and activity level
A comprehensive duplex ultrasound assessment allows Dr Igor Banzic to determine the cause of your varicose veins and recommend the most appropriate evidence-based treatment plan. Many patients benefit from minimally invasive endovenous treatment, while others may require a combination of procedures to achieve the best long-term outcome.
