Due to the complex nature of venous disease, a ‘one size fits all’ approach doesn’t work. Although there are patterns of veins that we may recognize as being associated with certain conditions, ultimately, a detailed examination using ultrasound, vein lights and physical examination must be performed to find the root cause of your condition.
Are these treatments covered under MSP or insurance?
Although all of the procedures and techniques that we perform are Health Canada approved and are well established in Europe and in the US, aside from surgical ligation/stripping and ambulatory phlebectomy, they are not currently covered under MSP. Your extended insurance may provide additional options however this depends on the type of insurance you have.
How long before I can return to normal activity?
Recovery times may vary for each patient and depend upon many different factors. Your physician will discuss recovery times other post-procedural information with you. The following are general guidelines for returning to normal activities.
For treatment of smaller branch varicose veins, using sclerotherapy or ambulatory phlebectomy a patient may return to normal activities within 24-72 hours. Surgical ligation/vein stripping requires the longest recovery time before returning to normal activity: typically between 4-6 weeks.
When can I exercise?
You can walk/move about (ambulating) immediately following the procedure. Ambulating is encouraged to help minimize bruising/swelling; however, patients who have undergone surgical ligation/stripping should refrain from strenuous exercise (such as heavy lifting) for at least 3 weeks.
How long do I have to wait before I travel?
Many of our patients have hectic schedules and busy lifestyles. The amount of time that we recommend before returning to air travel will depend upon the procedure/treatment and the established treatment plan. We generally recommend that our patients wear a compression stocking while traveling by air. Your physician will discuss recovery time and air travel during your consultation.
Will there be any bruising?
Bruising is most prominent with the surgical techniques like vein stripping and less prominent with the minimally invasive, endovenous techniques.
Don’t I need the veins in my legs?
Everyone has numerous veins in their legs that facilitate the return of blood to the heart for re-oxygenation. The blood is then redistributed throughout the body. These veins can be classified as superficial veins (i.e. close to the skin surface) or deep veins (i.e. deep within the muscles of the legs). A varicose vein is one that has become diseased and is no longer capable of assisting the heart with the movement of blood (back towards the heart); as a result, other veins in the vicinity must compensate. In essence, these diseased veins or varicose veins are superfluous and can safely be removed without compromising the other functioning veins in the leg.
What is the difference between Varicose Veins and Deep Vein Thrombosis?
A varicose vein is a vein with dysfunctional valves, in which blood can flow backwards (rather than back up to the heart). Blood begins to pool within the vein, causing it to enlarge as well as become more tortuous. Varicose veins are most common in the superficial veins of the legs. Deep vein thrombosis (DVT), is a condition where blood clots form within the deep veins of the leg, thereby restricting normal blood flow.
Veins can be classified as superficial veins (i.e. close to the skin surface) or deep veins (i.e. deep within the muscles of the legs). Varicose veins most commonly occur within the superficial veins.
What are varicose veins?
Chronic venous insufficiency (CVI) occurs when your veins are no longer functioning efficiently. Veins have one-way valves that facilitate the flow of blood towards the heart and prevent backflow (venous reflux). When these valves malfunction (valvular incompetence), blood begins to pool within the affected vein. Varicose veins often occur in the legs due to the increased distance from the heart and gravity further slows upward flow. The visible veins in your legs are similar to a living tree, with roots, a trunk, limbs, branches and leaves. In some cases, treatment may be as simple as trimming the branches (small reticular veins), or leaves (spider veins) because the tree trunk and roots are healthy. In other cases, where there is a problem with the tree trunk or the root (perforator and saphenofemoral junctional insufficiency), more elaborate therapies may be required (foam sclerotherapy, endovenous therapy). Our comprehensive assessment process will help us put together a customized plan that is best suited for your condition.
Healthy valves keep blood moving in one direction. Diseased valves cause blood to move in both directions, elevating venous pressure.
What is the difference between spider veins, reticular veins and varicose veins?
All three of these conditions are caused by the same hemodynamic dysfunction: chronic venous insufficiency (CVI). Chronic venous insufficiency occurs when your veins are no longer functioning efficiently. Veins have one-way valves that facilitate the flow of blood towards the heart and prevent backflow (venous reflux). When these valves malfunction (valvular incompetence), blood begins to pool within the affected vein. Varicose veins often occur in the legs due to the increased distance from the heart and gravity further slows upward flow.
Spider veins: are the smallest type of diseased vein in this spectrum, appearing as a nest of blue or red tiny veins just under the surface of the skin, which do not protrude from beneath the skin.
Reticular veins: are larger than spider veins but smaller than varicose veins; they are usually about 2 mm in diameter and often blue or purple in color. As with spider veins, reticular veins do not protrude from beneath the skin.
Varicose veins: are the largest type of disease vein in this spectrum and appear as dilated, tortuous veins that protrude from beneath the skin.
Will my varicose veins come back after treatment?
Studies have demonstrated that approximately 95% of the veins that we target with sclerosant, glue or heat will remain closed. Our treatment plan is intended to treat all visible veins and also the underlying causes of those visible veins. Due to the fact that varicose veins have a genetic component (i.e. run in the family), there is a 15% chance of new veins forming at 5 years.
Why do I have varicose veins?
Genetics and age are both large contributors to the formation of varicose veins. If you have a family member who suffers from varicose veins, you are more likely than others to develop varicose veins in your lifetime. Varicose veins are also more likely to develop in those over 50 years of age and is more prevalent in females than in males. People with occupations that require long periods of standing (e.g. lecturers, restaurant servers) are more likely to develop varicose veins as well.
What can I do to improve my venous health?
A few quick tips:
Regular exercise that includes using the calf muscles (running, walking etc) to encourage venous return via the deep system.
Consider wearing compression stockings during extended travel or extended periods of standing.
Avoid crossing your legs (this can cause damage to the valves and encourage veins to enlarge and engorge.
Increase venous tone through your diet: flavonoids have been shown in some studies to improve venous tone and health.
How do we differ from ‘Hair and Vein Removal Laser Clinics’?
Many of the ‘Hair and Vein Laser Clinics’ are not physician run or physician operated and rely on a ‘one size fits all’ laser that has been primarily designed for hair removal or skin treatment. Some of these lasers (operated by technicians, not nurses or physicians) have additional modifications that allow for the treatment of very-fine spider veins; these lasers are not an effective form of vein removal/treatment and are potentially harmful to people with darker skin-tones. These clinics are not registered with the British Columbia College of Physicians and Surgeons and operate in non-accredited facilities.
EVA Vein Care is a physician-operated clinic that specializes in venous disease management and treatment. Our physicians and nurses have over 40 years of combined experience using minimally-invasive, image-guided therapies in hospital-based practices at Vancouver General Hospital and the University of British Columbia Hospital. Our physicians utilize the latest techniques, they teach within the Faculty of Medicine at the University of British Columbia, and are active in medical research.
When choosing a vein care clinic, what should I consider?
As a patient, the best way to become informed, empowered and confident about your treatment plan is to ask questions - lots of them. Our initial assessment is comprised of two parts: 1) an evaluation of your venous health; 2) a discussion about: your goals, timelines, the available treatment options and the associated costs.
When choosing a vein care clinic, here are some questions to consider:
How much knowledge and/or experience does my physician/healthcare provider have?
During the consultation, did my physician/healthcare provider discuss my venous health and the treatments available to me in a clear, concise manner that I can understand?
Who is providing the assessment to determine the extent of my condition? Are they qualified to make a medical diagnosis?
Does the clinic offer several different therapies/treatment options or do they primarily use/offer a limited number of therapies?
Following the assessment, is my treatment being performed by a physician or a registered nurse?
Why is the term ‘laser vein therapy’ misleading?
The concept of using lasers—as a technological innovation that would revolutionize healthcare —captured the imagination of the general public in the 1990’s. As such, many clinics adopted the term ‘laser’ in naming their facilities to impart confidence among potential patients. Today, lasers are widely used within healthcare and there is no doubt that lasers have improved the safety and efficacy of various types of procedures. Within the realm of varicose vein therapies, ‘laser treatment’ can be a confusing term because there are two types of lasers commonly used, but they are fundamentally different.
The two different types of lasers used for the treatment of varicose veins:
Superficial lasers: typically used for hair removal or skin therapies. Superficial lasers used to treat varicose veins are primarily designed to treat (superficial) veins of less than 0.2mm. Superficial lasers and are not appropriate for the treatment of any vessels larger than 0.2mm.
Endovenous lasers: are dedicated fibre optic tipped catheters that go inside the blood vessel through image-guided techniques. When the laser is pulsed-on, the lining of the blood vessel is cauterized which causes the blood vessel to scar and close down. This technique is also known as EndoVenous Laser Ablation (EVLA) or EndoVenous Laser Treatment (EVLT). EVLA/EVLT was developed in the early 1990’s and although still commonly used, EVLA/EVLT has largely been supplanted by more advanced techniques such as Radiofrequency Ablation (known as ClosureFast™) and Cyanoacrylate Coaptation/Ablation (known as VenaSeal™). VenaSeal™, ClosureFast™, and EVLT/EVLA are all endovenous procedures and are only performed by specially-trained/qualified physicians.