Significant varicose veins of medial aspect of both legs
A 57-year-old man who visited our clinic was suffering from significantly bulgy varicose veins over the medial aspect of his legs. His veins first started appearing when he was in his 40s and gradually got worse. He and his family were concerned about the appearance and effects of these abnormal veins.
On thorough examination, we noticed significant varices on both legs, the left side was worse than the right side. Duplex Ultrasound (DU) examination was done during his initial visit to find the source of these visible bulgy veins. The source of surface varices was deeper truncal veins called Great Saphenous Vein (GSV) and a left thigh perforator (muscle branch).
At first, our approach was to perform Endovenous Laser Ablation (EVLA) technique under local anesthesia. This procedure has a very promising success rate in treating large truncal veins (up to 95% effective if done properly by an experienced hand). It was performed as an outpatient, walk-in walk-out procedure.
The patient was advised to wear compression stockings for a week (only during the day), he resumed his work within 1-2 days with minimal discomfort. Following EVLA, Ultrasound Guided Sclerotherapy (UGS) was performed to treat visible and non-visible abnormal branches of refluxing (abnormal) GSVs and a small dose of cyanoacrylate (medical glue) was used to seal the left thigh perforating vein. He tolerated EVLA, Cyanoacrylate glue and UGS very well with minimum discomfort and or little downtime. The photo was taken after 16 weeks post 4 sessions of the treatment cycle.
At the 16 weeks review, his legs looked normal as per photos. He was extremely satisfied with both aesthetic and medical outcomes.