Anterior(front) and Lateral(outside) left thigh varicose veins and Anterior and Lateral right thigh and knee Varicose Veins
A 37-year-old lovely teacher visited our clinic with bulgy varicose veins over the Anterior (front) and Lateral (outside) left thigh and Anterior and Lateral right thigh and knee. Her abnormal veins appeared when she was around 20 years of age and gradually got worse. She was suffering from night cramps. Her symptoms were getting worse with standing for long hours and were improving by elevation of legs which are the expected symptoms of varicose veins. She was worried about the appearance, symptoms, and possible health effects of these abnormal veins. In the past, she had a clot in left-sided varicose veins which was managed well by her GP and resolved.
On thorough examination, we noticed varices on both legs. Duplex Ultrasound (DU) examination was done during her initial visit with us to find out the source of these visible bulgy veins. The feeder into her left-sided surface varices was two veins call Great Saphenous Vein (GSV) and an anterior branch of GSV called Anterior Accessory of Great Saphenous Vein (AAGSV), the source of her R sided varicose veins was a muscle perforator (muscle branch).
Our approach was to treat the source of surface varices (GSV and AAGSV) 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 procedure.
The patient was required to wear compression stockings for a week (only during the day) and she resumed work within a few days with minimal discomfort. Following EVLA, Ultrasound Guided Sclerotherapy (UGS) was performed on her left leg to treat visible and non-visible abnormal branches of refluxing (abnormal) GSV and AAGSV. She tolerated UGS very well with minimum discomfort and no or little downtime. Her right thigh perforator was treated with a very small dose of cyanoacrylate glue (superglue) and UGS.
The photo was taken after 12 weeks post 3 sessions of the treatment cycle. She was extremely satisfied with both aesthetic and medical outcomes as her symptoms disappeared.