Case Studies

The vein clinic is at the forefront of vein treatments in WA and has the greatest experience of multiple vessel and combined Venaseal (glue) treatments. These amazing results were achieved with two new techniques we have pioneered. Firstly Venaseal adhesive (medical super glue) and secondly Ultrasound Guided Phlebectomy. This 59yr man presented with large symptomatic varicose veins. He had 20 yrs of discomfort and heaviness in his legs particularly towards end of day, night cramps and itchiness.

In view of his occupation as a cabinet maker and desire to have as little time off work and as fast a recovery as possible, a tailored two stage “walk in- walk out” treatment approach was employed. The first stage utilised the latest virtually painless endovenous technology of Venaseal medical adhesive (as recently featured on TV) for closure of the main malfunctioning veins through a single needle puncture on each leg. Treatment of both legs was completed in under 1.5hrs.

The second stage utilised combined sclerotherapy and ultrasound guided phlebectomy of the branch vessels under local anaesthetic. The use of ultrasound allows us to identify and remove residual vein fragments that may be left behind using traditional surgical techniques. These combined techniques allowed him to have the best of both non-surgical and surgical methods greatly reducing the need for further follow up treatments. Symptomatic and cosmetic improvement was immediate and cosmetic improvement will continue as minor bruising settles. A follow up is scheduled for 3 months time to ensure that these excellent results are maintained.

This 50yr old man had noticed increasing enlargement of varicose vein in his anterior calf over the last 5 years. The incompetent great saphenous vein (GSV) was the "feeder" for these varicose veins and was eliminated through a single IV puncture site using our latest technology 1470nm endovenous laser and special "radial" fibre which results in less bruising and discomfort than older style laser and cheaper "bare" fibres commonly in use.
2 weeks following treatment the "branch vessels" have reduced markedly in size without the need for invasive surgery (no GA, cuts, bruises or stitches). Ultrasound guided foam sclerotherapy was administered at 3 months to close the small remaining branches. These results were obtained with two treatments of less than 1hr each on a "walk in - walk out" basis without the need for any surgery.

Patient 3 is the younger brother of case 2. Although the visible veins are less pronounced than his brother, his symptoms were more severe and included heaviness, pain, restlessness, night cramps and itchiness in the leg. This case highlights the hereditary nature of varicose veins and the fact that the size of veins does not relate to symptoms. Symptoms may be present despite minimal or even no varicose veins.

39 yr old woman with 16yr history of pain, heaviness, tiredness, swelling, itchiness in legs. Advice from vascular surgeon following ultrasound elsewhere (said to have been done at specialised vascular lab) was that pelvic embolisation and stripping was required. Our investigations revealed no pelvic incompetence but an incompetent perforator vein and incompetence of the GSV & SSV on both sides. Patient delighted that no surgery or embolisation was required.

This 37yr woman experienced severe skin irritation for many months to the point that scratching caused bleeding of the skin. Steroid cream had provided only temporary relief. Ultrasound showed marked incompetence of the main superficial veins and large varicose veins were shown deep to the area of skin irritation despite no varicose veins being visible on the surface. This represents venous eczema due to “hidden” varicose veins, a condition that is frequently overlooked/misdiagnosed. Definitive treatment requires ablation of the refluxing veins that are causing the skin irritation.

This 53 yr old woman had many years of unremitting itch and skin irritation involving the medial and lateral calf of her left leg. Experiencing intermittent ulceration and only temporary relief from steroid creams.

Post treatment review at 6 weeks: Tripple Vessel EVLA (Endovenous laser ablation) utilising advanced Endovenous skills including TRLOP technique acquired during training with Professor Mark Whiteley. Ultrasound guided Foam sclerotherapy. Venous ulcers now healed (pigmentation persists) following ablation of great saphenous and 2mm incompetent perforator vein adjacent to ulceration.

59yr old woman with symptomatic venous reflux (great saphenous vein) and cosmetic spider veins. Symptomatic improvement and great cosmetic result following our three stage treatment protocol.

1. Treatment underlying major refluxing veins with endovenous laser
2. Treatment of branch veins and “feeder” veins with ultrasound guided sclerotherapy
3. Treatment of surface veins with microsclerotherapy