FAQ about varicose vein treatments in Montreal

In general, varicose vein treatments have a very low complication rate. For injections, the most feared complications are drug allergy (rare), phlebitis (rare) and intra-arterial injection (also rare). For endovenous laser or phlebectomy procedures, you will also be advised of the risk of localized numbness in the event of sensory nerve damage (uncommon) and the risk of bleeding (rare). It may happen that superficial reddish veins appear during the treatment of larger varicose veins. These are treated by superficial injection afterwards.

Immediately after treatment for superficial varicose veins, there is no contraindication to continuing with your regular physical activities. For treatments of wider varicose veins, we will recommend you to refrain from doing strenuous sports activities for the week following the treatment, such as jogging, tennis, etc. On the other hand, regardless of the treatment you have received, walking is always indicated, and is even favorable for healing.

The number of sessions obviously varies depending on the extent of the varicose vein disease. Each treatment plan is individualized for each patient. A majority of patients will need injections only, spread over several sessions. Others will need needle phlebectomy or endovenous laser ablation, in the case of an incompetent saphenous vein, for instance.

Treatments last about ten minutes on an average, and the number of injections varies depending on the problem being treated.

For most people, the answer is no. The injections are subcutaneously administered, like during blood tests. When the product is injected, you can sometimes feel a little momentary burning sensation.

The circulatory system is made up of two types of blood vessels, arteries and veins, which form a continuous network. Thus, the oxygenated blood is pumped by the heart via the arteries to the extremities of the body, it then returns to the heart via the venous network. The contraction of the muscles of the lower limbs allows blood to flow back to the region of the heart. For example, when walking or running, they contract and exert natural pressure on the veins, pushing blood up the body. However, when the muscles are resting, blood tends to flow naturally down the body. Fortunately, the veins have one-way valves that only open when blood returns to the heart. If, for various reasons, some valves are damaged, blood can no longer flow in just one direction. The blood stream then flows naturally down the body, causing congestion and dilation in the diseased vein and its collateral branches. This condition is called venous insufficiency. Over time, the vein can become irreversibly deformed and become an apparent varicose vein. Varicose veins are sinuous and swollen. They can be skin-colored, blue or green, and can appear anywhere on the legs. Up to 40% of women and 20% of men suffer from symptoms caused by varicose veins. After they reach their 50s, one out of two people will have varicose veins.

In addition to being painful and unsightly, varicose veins could inevitably get worse over time and cause major health problems. Here are the main medical complications that can occur if venous insufficiency is left untreated: • Varicose ulcer • Skin pigmentation, eczema • Bleeding • Phlebitis and pulmonary embolism

In a varicose vein, blood flows in the wrong direction and stagnates, apart from bringing in its share of potential complications. This is why a varicose vein is a burden on venous circulation. Fortunately, the healthy veins around a varicose vein tend to adapt naturally and allow efficient blood circulation regardless. Thus, when we remove a varicose vein, we are actually removing an incompetent vein, and we force the blood to flow only through the healthy veins.

Phlebitis or thrombophlebitis is an inflammatory condition that occurs inside a vein and leads to the formation of a clot. Sometimes there are very few symptoms and it gets detected very late. However, superficial phlebitis usually manifests itself as a red, painful cord below the surface of the skin.

• Heredity • Excess weight • Pregnancy • Prolonged periods standing • Trauma • Phlebitis

Venous insufficiency is a chronic condition, that is, it constantly continues to evolve over time. New varicose veins can appear at any time during your life. From one individual to another, the degree of severity of the disease can vary widely. It depends on the risk factors that affect you. This is why it is recommended to get regular medical check-ups done.

This surgical procedure involves ligating and removing the diseased saphenous vein on a wire using at least two incisions. It is performed under general or epidural anesthesia. More invasive than the endovenous laser technique, this technique is losing more and more popularity within the medical profession. Indeed, it causes more postoperative pain, and involves a more difficult convalescence. However, it remains the only technique covered by the Régie de l'Assurance- Maladie du Québec (RAMQ). If this technique proves to be the only possible option, the patient is referred to a hospital setting.

1- Notify the doctor of any other procedure to undergo or trip planned shortly after the laser or phlebectomy 2- Warn him, if this is your case, of taking aspirin or any other anticoagulant. In some cases, you may be prescribed anticoagulant treatment.

a) You can eat and drink normally b) Bring loose, comfortable pants for your ride home c) As it is possible that you will receive sedation, it would be better to ask someone close to you to accompany you home after the procedure (if you do not receive sedation, you can drive yourself car, but preferably over a short distance) d) Your leg must be shaved (and not waxed) at least two days in advance and no cream must be applied in the 24 hours preceding the intervention.

The approximate time in the surgical room is two hours. The procedure begins with the marking of your leg under ultrasound guidance. Once on the operating table, previously covered with sterile sheets, your leg is brushed with an antiseptic solution. Here are the steps for inserting the laser fiber into the vein: a) Under ultrasound guidance, a venipuncture is performed using a needle b) A catheter used to insert the laser fiber is introduced into the vein. Although it is possible to perceive a slight sensation, the insertion of the catheter is not painful c) The laser fiber is inserted into the catheter, the end of which is positioned at the beginning of the endovenous ablation; d) An anesthetic solution is injected along the entire length of the vein e) The laser is turned on, and the laser fiber is gently extracted along the vein (this part takes about five minutes) f) If necessary, the anesthesia is continued and the varicose branches are resected by needle phlebectomy during the phlebectomy, it is possible to feel a slight sensation, but again, no pain.

Adhesive bandages are first applied to the treated areas, and a medical stocking is put on over it and must be kept for 48 hours.

From the end of the operation, it is recommended to walk regularly every hour for periods of 10 to 15 minutes in order to accelerate blood circulation and prevent the formation of clots. On the other hand, avoid practicing intense physical activities (eg jogging, tennis, etc.). An anti-inflammatory (usually ibuprofen, such as Advil® or Motrin®) is prescribed for ten days. You must wear a medical stocking approximately seven hours a day (except at night) In the first 48 hours, if you shower, you must avoid getting your bandage wet. To do this, cover your leg with a wrap or a plastic bag. If, inadvertently, it is soaked, dry it immediately with the hair dryer. It is normal to have bruising and to feel some tenderness or tightness in the treated area. These can last from two to four weeks. Avoid exposing your leg to excessive heat (e.g. hot bath, sauna, sunbathing). In the event of sun exposure, apply a factor 60 sunscreen to the treated area. A follow-up visit with your phlebologist is mandatory five to seven days following your procedure. He will then perform an ultrasound check and remove your dressings if necessary.