Hello I am Dr Haroun Gajraj director of the VeinCare Centres in the southwest of England.
I received a very interesting question via the website this week from a lady called Heather
in Dorchester.
She said that she had had her veins treated 20 years ago and that they had come back even
worse than ever -- why was this and could she have anything done about it?
Well, about 30% of people I see now have already had vein treatment and their veins have recurred.
And there are 3 main reasons why this happens Heather.
The first is that they had inadequate treatment at the initial procedure.
Either they had the wrong procedure done, or they had the correct procedure done incorrectly.
Now let me explain a bit about that.
In my opinion, everyone should have an ultrasound scan before they have anything done to their
veins at all.
An ultrasound will allow the specialist to look at the deep veins, the superficial veins
and their connections and with this information specialist will be able to identify the root
cause of the vein problem.
Once the specialist has this information he can then formulate a treatment plan.
It is also very important that the treatment itself is guided by ultrasound actually during
the procedure.
So the specialist can confirm that the correct veins are being treated.
Also, after the treatment and at the follow-up visit ultrasound should be used to confirm
that the procedure that was intended has in fact been done satisfactorily.
So, by using ultrasound in these 3 ways, at the initial assessment, during the procedure
and at the follow-up you get better initial treatment.
Now the second reason why veins can come back Heather is a process called neovascularization.
Now this is a fancy medical term just to say that the veins regrow after the older traditional
procedures such as surgical stripping.
Now until we had ultrasound scans readily available surgeons didn't really believe that
veins could regrow after they had been tied and removed.
But we now know that this is a particular feature of surgical stripping and veins will
regrow the raw ends want to re-grow and rejoin.
And this is a very important cause of recurrence.
Fortunately, it is not a feature of the newer treatments that we have on offer.
Now the third reason why veins recur is a genetic pre-disposition.
Unfortunately, veins tend to run in families and people can inherit a weakness of their
veins from their parents and there is very little you can do about that.
However, there are things you can do in terms of lifestyle changes.
You can watch your weight, perhaps avoid standing for long periods of time and you can consider
wearing good quality medical grade compression hosiery.
All these things will reduce the chance of veins recurring after satisfactory treatment.
But there's nothing you can really do about any genetic predisposition to veins that you
might have inherited from your parents.
So there it is Heather those of the 3 main reasons why veins come back and I think in
your case you probably had an inadequate procedure because 20 years ago we were not using ultrasound
scans very widely and you had a procedure surgical stripping which does tend to stimulate
neovascularization.
Can you have more treatment?
Well yes of course you can.
If veins have recurred and you have faulty valves in those veins and you've got a condition
called reflux then we can identify that accurately with ultrasound and we can make sure that
any future treatment is targeted at those veins.
So thank you for that question Heather.
That's one of the commonest questions that I get asked in fact and I am glad to be able
to help you with that.
Now if you have a question that you'd like to ask me, do get in contact with me via the
website -- I would love to hear from you.
You can post your questions and I will get back to you.
Thank you for watching my video and I look forward to hearing from you soon.