Vein injection therapy

Varicose Veins and Spider Veins
(Telangiectasia)

First, if you don't do anything at all for these
veins, absolutely nothing of any serious
nature is ever going happen to you.
Secondly, there is no cure for varicose veins or
spider veins. But that does not mean they cannot
be treated. They can be treated but they cannot
be cured. No treatment, surgical or non-surgical,
should promise a cure.

New veins will grow and maintenance treatment is required every six months
after the initial intensive series of treatments. With regular follow-up and
maintenance, varicose veins and spider veins will continue to be controlled
without disfiguring scars.

Anatomy: The veins in the leg are made of two types: deep and superficial. The
deep veins are located within the calf muscles. These muscles contract
every time we "push-off" when walking, pumping blood inside the veins, back to
the lungs. The superficial veins are located under the skin and have no muscle
pump around them. These superficial veins drain into the deep veins.

Inside the deep and the superficial veins are valves which function as simple
flaps to prevent blood falling backwards with gravity When the veins become
stretched or "varicose" two things happen: they become longer and wider.
Because the veins are fixed to other veins at each end, they can only stretch by
becoming more twisted or tortuous. Secondly, when veins widen, the valves can
no longer meet in order to prevent blood from flowing back to the feet.

Q. What happens to the blood when you treat varicose veins and spider
veins? Do we run out of veins?

A. There is an inexhaustible supply of superficial veins and capillaries.
When you block some, others expand. Although they are all connected to each
other, the effect is minimal. To use an analogy, if you block the main highway in
New York, there will be no effect on the streets in California or even in the next
town although all of these roads are inter-connected.

Q. What is the cause of varicose veins?

A. The cause is a hereditary weakness in the vein wall. The weakness
can be aggravated by pregnancy and by the contraceptive pill (telangiectases).

Q. What are the symptoms of varicose veins?

A. Aching pain which is always relieved by elevating the leg. If the pain
is not relieved by lifting the leg, then the pain is due to some other cause such
as sciatica or a blocked artery. Swelling and ulceration around the ankle
and lower leg are not signs of simple varicose veins but are associated with
deep vein disease. Varicose veins are not life threatening nor do they cause
swelling of the ankle.. They get worse overtime. They can occur at any age, even
in children.

Treatment:

Varicose veins are visible because of the blood inside them. When the vein
is empty, they are invisible. This is the basis of injection therapy. It is
possible to ‘remove the veins’ by causing them to close by scar tissue induced
by irritating injections rather than surgically removing them or ‘stripping’ the vein
(see ‘Complications’ below). Injection of any irritant solution will cause the vein to
become inflamed and thrombose. Unlike the thrombus in a deep vein, which
occurs as a result of slowing of the circulation rather than inflammation, they are
firmly adherent to the wall. There is no chance of them flying off and causing
blockage of blood-vessels in the lungs.

If the veins are not compressed after the injection treatment, they will re-open. A
compression bandage is required after injection therapy so that the veins will
heal together by scar tissue and remain permanently closed.

Complications:

Allergies to the solution; rare and usually occurs after the second or third
treatment.

Small sores at the site of the injection which usually heal spontaneously over a
period of weeks.

Pigmentation or brown staining (common - 50%) at the site of the injection which
usually clears spontaneously over a period of months. Can occur after LASER
treatment as well. Can be treated by removal of thrombus in the vein which is
the cause of the brown staining.

Photo below: scars from multiple surgical excisions of varicose veins. The
varicose veins recurred.