live your life without pain

Often we formulate the impression that our legs are bound to have some enlarged twisted veins as we age, however, that is not true. Aging does not mean that you have to live in pain as you grow older. Nexus Vein Centre promotes early recognition of your symptoms and early intervention to treat your health condition. Know the options that you have and take charge of your health!

UP TO DATE TREATMENT OPTIONs
Endovenous Therapies

Treatment choices include:
1. Graded compression stockings

Stockings compress the foot, calf and thigh to prevent distention in the veins. This helps to control the swelling and associated symptoms but does not cure the problem.

2. Endovenous Interventions

Newer and less invasive techniques allow our Surgeon Dr Lee Chee Wei to ablate the Long Saphe-nous Vein (LSV) and treat the reflux without making a large skin incision.

This includes:
• Endovenous Laser Therapy (EVLT)
• Radiofrequency Ablation (RFA)

3. Alternative treatment

The traditional approach of treating LSV incompetence is to surgically remove the LSV via two inci-sions, one in the groin and another in the lower thigh. This is usually done under a General Anaesthetic Post-operative pain is usually higher after surgery, compared to Endo-venous Interventions.

01

evlt
EndoVenous Laser Therapy
Utilising laser energy

It involves delivering laser energy within the LSV to cause it to shrink over time. Once the LSV has sclerosed, blood will no longer be able to flow in the vein. This will prevent any venous reflux and will reduce the pressure in the veins in the legs.

In this procedure, the LSV is not removed or stripped. Over time, the vein will shrink and become non-functional.

How is it done?
The Long Saphenous Vein (LSV) in the inner thigh is localised with an ultrasound scanner.

A local anaesthetic injection is given and a sheath is placed inside the LSV.

The laser fibre is then introduced into the sheath and passed up to the Sapheno-Femoral Junction (SFJ) at the groin.

A solution of saline and some medication will be injected around the LSV under ultrasound guid-ance. This helps to prevent skin burns.

Once the tumescent injections are completed, pulses of laser energy are fired along the laser fibre.
At the tip of the fibre, the laser energy converts to heat. This causes damage to the inner lining of the vein. The inflammation that is triggered in the LSV will cause it to eventually shrink and scle-rose.

The prominent varicosities in the lower thigh and calf are then surgically removed through small in-cisions measuring about 5mm.These small wounds are then closed with special Steri-strip dress-ings. No sutures or stitches are required.

After the procedure, the leg will be bandaged with crepe bandage.

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venefit
Radio frequency ablation
Utilising radiofrequency energy

A Radiofrequency catheter is passed up the Long Saphenous Vein (LSV). The RF energy is converted to heat energy at the end of the probe and causes inflammation of the LSV. This leads to eventual shrinkage and sclerosis of the LSV over time. Once the LSV is closed off, there will no longer be any more reflux in the veins.

How is it done?
The procedure is similar as EVLT. After the radiofrequency catheter is introduced into the sheath and passed up to the Sapheno-Femoral Junction (SFJ) at the groin, it is then energised and this causes the last 7cm of the catheter to heat up to 120 C.

This causes damage to the inner lining of the vein and the inflammation that is triggered in the LSV will cause it to eventually shrink and close off.

The prominent varicosities in the lower thigh and calf are then surgically removed through small incisions measuring about 3-5mm. These small wounds are then closed with special Steri-strip dressings. No sutures are required.

After the procedure, the leg will be bandaged with crepe bandage.

What to expect after surgery?
01

The bandages can be removed after 48 hours and changed for post-op compression tube stockings that will need to be worn for the first 2 weeks. The stockings will prevent leg swelling and reduce the risk of bruising after the surgery.

02

During this period, the patient is encouraged to walk around to avoid deep vein thrombosis (DVT). Generally, the patient will be advised to walk around at home for the first 2 weeks after surgery. Excessive physical activity may lead to increased bruising along the medial thigh.

03

Avoidance of strong sun exposure and ultraviolet (UV) radiation is advised for the first 2 weeks as this may cause permanent darkening of the surrounding skin, or hyperpigmentation.

04

With either EVLT or Venefit, the laser energy or radiofrequency energy causes the LSV to become inflamed. Therefore, for the first 6 to 8 weeks after the procedure, the patient may feel a hardened cord-like vein along the inner thigh, especially in the lower half where the LSV is closer to the skin.

What are the Risks & Complications?

The common complications associated with this procedure include:

  • Bruising especially along the inner thigh
  • Palpable cord-like Long Saphenous Vein (LSV) along the inner thigh
  • Skin burn from heat transmission from the laser fibre to skin
  • Saphenous nerve injury, leading to patchy numbness along the lower inner thigh
  • Bleeding and haematoma (clot) formation at the stab wounds
  • Wound infection
  • Recurrence of varicose veins, approximately 3-5% in 5 years
  • Deep vein thrombosis (DVT)

    In general, the risk is Low.

WHY ARE THESE SURGICAL TREATMENTS RECOMMENDED?
  • Surgery is usually performed as a Day Surgery Admission, which means you do not need to be admitted overnight after the surgery unless requested.
  • It is usually performed under Local Anaesthesia with Monitored Sedation. The anaesthetist will administer medication intravenously to keep the patient sedated and unaware during the procedure.