Medial (inside) left and right (bilateral) legs varicose veins
A 38-year-old man who was a chef visited our clinic with bulgy varicose veins over the medial aspect of both his legs. He noticed these abnormal veins in his early 20's and stated they were gradually getting worse. He had heaviness, cramp, restlessness, and itchiness of his lower legs. His symptoms went worse by standing long hours or hot weather conditions and were improved by rest, elevation, and wearing compression stockings which are typical symptoms of varicose veins. He was worried about the appearance and health effects of these abnormal veins. His symptoms started affecting his job as a chef (which requires standing long hours in a warm environment).
On thorough examination, we noticed varices on both legs. Duplex Ultrasound (DU) examination was done during his initial consultation with us to find out the source of these visible bulgy veins. The source of surface varices was a truncal vein called Great Saphenous Vein( GSV). Both his GSVs were refluxing (blood flows in the wrong direction). Our approach was to treat the source of surface varices by performing Endovenous Laser Ablation (EVLA) technique under local anesthesia which has a very promising success rate in treating big truncal veins (up to 95% effective if done properly by experienced hands), it was performed as an outpatient, walk-in walk-out. The patient was required to wear compression stockings for a week (only during the day) and he resumed work within a few days with minimal discomfort. Following EVLA, Ultrasound Guided Sclerotherapy (UGS) was performed to treat visible and non-visible abnormal branches of refluxing (abnormal) GSV. He tolerated UGS very well with minimum discomfort and/or little downtime.
After the photo was taken 12 weeks post 3 sessions of the treatment cycle. He was extremely satisfied with both aesthetic and medical outcomes as his symptoms disappeared.