Vascular Surgery Clinic

Dilated tortuous veins are called varicose veins.

How can it affect me?

They generally do not cause any symptoms but some might complain of ache in the legs after a long day. They can be unsightly or might cause ulcers in a proportion of patients.

Can this be treated?

This can of course be treated. The main goal is to prevent ulcers which can cause major morbidity.

What are the types of treatments available?

This can be treated with compression stocking which will not make them disappear but might prevent progression. But compliance is a major problem in this method of treatment. The other methods are to perform an operation which will entail a small cut in the groin tiny cuts from knee down. This is still the gold standard treatment.

This can also be treated with laser surgery or radio frequency ablation where a wire is passed into the vein which treats this condition. This is treatment is more expensive compared to regular surgery and results are nearly as good as surgery. Not all varicose veins are suitable for this method of treatment. There is also a minimally invasive method called ultrasound guided foam sclerotherapy this is cheaper but might need repeated injections.

Recent trials of shown the ultrasound guided foam sclerotherapy may be equivalent to radio-frequency ablation. There are newer therapies like steam, glue and Clarivein. We have to wait and watch to see which of these will become main stream procedure for varicose veins.

Diabetic foot syndrome is a complication of diabetes. The blood supply to the nerves are affected. The syndrome is due to it's effect on sensory, motor and autonomic nerves.

I have been diagnosed to be have diabetes recently, how should I look after my feet?

Diabetics have 4 times likely to develop peripheral vascular disease and 5 times likely to develop critical limb ischaemia.

The risk of lower limb amputation 10-16 fold higher in a diabetic.

What can you do?

Blood sugar control is paramount.  Blood pressure control is important.

Inspect feet everyday for sores, cut and ulcers.

Report problems even if painless.

Wear comfortable foot wear

Make sure there are no foreign bodies in your shoes before you wear them.

Diabetic foot syndrome is a complication of diabetes. The blood supply to the nerves are affected. The syndrome is due to it's effect on sensory, motor and autonomic nerves.

There are several newer therapies like the VAC dressing, platelet rich plasma etc., which have assisted in limb salvage. But, none of them are superior to the scalpel.