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YOUR BLOOD
247
February15
Did You Know?
• Arteries carry blood from the
heart to the rest of the body,
while veins carry blood back
to the heart and lungs for
oxygenation.
• Venous blood is usually dark
red; veins only look blue
because our subcutaneous fat
absorbs low-frequency light
and reflects high-frequency
blue light.
• In our legs, blood is collected
in the superficial veins and
delivered to the deeper
veins that run inside our calf
muscles; calf muscle action
helps drive the blood upwards
against gravity, and one-way
valves within the veins prevent
it from flowing back the wrong
way.
• Faulty valves can cause blood
to pool in the superficial veins,
causing them to distend and
become varicose.
• Truncal varicose veins are
larger but still superficial veins;
spider veins are smaller, more
superficial varicose veins that
are closer to the skin.
W
e know that the term
varicose veins includes
everything from the tiny
“spider veins” – those fine,
bluey-purple threads that form a pattern
something like a spider’s web on the
skin, particularly the skin of the legs – to
thick, worm-like, bulging lumps, often
found behind the knees. DR IMRAN
NAWAZ tells us more.
Can superficial spider veins turn
into the larger, truncal varicose
veins if left untreated?
No, spider veins can never become
truncal varicose veins – so patients
should not be frightened into getting
treatment for this reason alone! The
most common reason for treating spider
veins is cosmetic; far less commonly, it’s
Jacek Chabraszewski, Guniita | Dreamstime.com
Never
By Verne Maree
Rest assured that the desire to
get rid of unsightly superficial
veins – be they larger, thicker
and relatively deeper, or smaller
and closer to the skin – is no
reflection on your own depth
or superficiality as a human
being! From painful varicose
and annoying spider veins
to life-threatening deep vein
thrombosis, here’s our roundup
of vein-related advice from three
specialists in Singapore.
in Vein
to relieve discomfort in the area where
these veins are.
The general term varicose veins
describes dilated and tortuous veins of
any size that result from a failure of the
valves within them. When the deeper
superficial veins or their tributaries
are affected, these appear as large
or
truncal varicose veins
. When tiny
surface capillaries are affected, these
become
spider veins
. Intermediate-
sized varicose veins, which appear
greenish and fairly large, but not bulging
and rope-like, are referred to as
reticular
veins
.
Two or even all three of these types of
varicose vein can co-exist at the same
time in the same leg, so treatment could
possibly involve a variety of different
methods that are used to tackle veins
of different sizes.
What is the best way to treat
large, truncal varicose veins?
The best method is
endovenous
ablation therapy
(EVA) delivered by an
energy device using either laser (EVLT)
or radiofrequency (RF). Laser and
RF are equally effective and produce
near-equal results – notwithstanding
manufacturers’ claims to the contrary!
Compared with previous methods
such as surgical stripping, the advantage
of EVA is that it can be done in the clinic
or as a day surgery and needs only
local anaesthesia. There is only a small
puncture around the level of the knee,
with no incisions or scars. The patient
gets up and walks immediately after the
procedure, and the post-operative pain
is minimal.
How many treatments are
required?
Straightforward cases generally require
only one treatment to the main reflux
source (for example, the great saphenous
vein). Tributary veins that are not resolved
by the initial treatment can be touched
up later by one or two sessions of simple
injection sclerotherapy.
Are there any new treatments in
the pipeline?
While there is always a constant search
for better treatment methods, those
currently being evaluated are yet to be
proven to be more effective than what is
already being routinely practised.
The Vein Centre
1 Orchard Boulevard
#11-03/4 Camden Medical Centre
6733 0377 | tvc.sg