VEINS TREATMENT

Dr Adrian Ling provides vein treatment in Melbourne for a number of venous conditions, including varicose veins, spider veins and Deep Vein Thrombus (DVT).
Varicose Veins Treatment

Varicose Veins

Varicose veins are large, twisted veins visible under the skin’s surface that have become engorged due to the pooling of blood because of faulty valves. They are usually treated using minimally invasive techniques such as  VenaSeal Glue, Radiofrequency Ablation or Endovenous Laser.

Reticular Veins

Smaller than varicose veins but larger than spider veins, reticular veins measure around 1 to 3mm in diameter and have a blue to greenish colouration.

Reticular Veins
Spider Veins

Spider Veins

Similar to varicose veins, spider veins are smaller, less apparent clusters of tiny blood vessels visible under the skin’s surface. They often resemble a spiderweb and can be found on the legs or face. Sclerotherapy is the best treatment for spider veins.

Deep Vein Thrombus

Deep Vein Thrombus (DVT) occurs when a blood clot is produced in a deep vein in the body. It is usually asymptomatic but can be life-threatening if a clot breaks off and makes its way to the lungs, causing a Pulmonary Embolism (PE).

Deep Vein Thrombus (DVT)

Why Do Varicose Veins Develop?

Although there is no known cause of varicose veins, it is believed that risk factors like strong family history, obesity, hormonal imbalances due to puberty or pregnancy or a sedentary lifestyle can all increase the likelihood of their appearance. They usually occur due to faulty or leaky valves that allow blood to pool in the legs. This increased pressure causes the veins, blood vessels and capillaries to bulge, resulting in varicose veins.

How are Vein Problems Treated?

There are several minimally invasive veins treatments, such as sclerotherapy, Venaseal Glue, Endovenous Laser, and Radiofrequency Ablation. Surgery may still be an option in some circumstances. The treatment recommended to you will be based on your history and medical condition after a consultation with Dr Ling.

Frequently asked questions

What is the function of veins?

In order to understand what varicose veins are, it is important to know what normal veins are.

Whereas arteries are blood vessels that carry blood away from the heart to organs and tissues, veins are blood vessels that carry blood back to the heart from organs and tissues.

In the legs, there are 3 types of veins:
1. Superficial veins just below the skin surface. These veins can often be seen or felt. In healthy veins, these are ‘low pressure veins’ because they manage low pressure flow within their walls.

2. Deep leg veins – located in the muscles, these are ‘high pressure veins’ that are squeezed by the muscles when we walk, to eject blood against gravity all the way back up to the heart.

3. Perforator veins – these are connecting veins that transmit blood from the superficial veins to the deep veins. They cross through the layer of connective tissue (fascia) that separates the muscle from the skin.

What is the function of the valves in the veins?

The valves are made up of two leaflets that act like a one-way valve.

When the leaflets are ‘open’, the blood is allowed to pass upwards through them.

When the leaflets are down ie meet each other in the centre, then blood is prevented from passing back down.

What are reticular veins?

Reticular veins are larger than spider veins, measuring 1-3mm in diameter. Also known as feeder veins, they are the dilated blue/green veins beneath the skin.

Vein doctors: what is the difference between different vein practitioners?

Choosing a doctor to treat your veins can be confusing! This is especially the case in Australia because anyone with a basic undergraduate medical degree can open a vein clinic i.e. there are no government regulations concerning the minimum qualifications required for vein treatment.

The following aims to help you understand how different “Vein doctors’” training in venous disease may differ. This could mean that your treatment advice may significantly differ depending on the type of training and expertise a doctor has.

An overview of the different types of ‘Vein Doctors’ is provided for your information below:

Vascular and Endovascular Surgeon
A ‘Vascular and Endovascular Surgeon’ is a qualified medical specialist with advanced post-graduate training. To practice vascular surgery in Australia, they must have fulfilled certain criteria in order to receive their Fellowship of the Royal Australasian College of Surgeons in Vascular Surgery, which is formally recognised by the Australian Medical Council.

Vascular Surgeons have formal advanced specialist training in:

  • Endovenous (minimally invasive) and open surgical treatment for varicose veins, venous occlusive disease (such as DVT) and other venous pathology throughout the body.
  • Endovascular (minimally invasive) and open surgical treatments for arterial conditions such as peripheral vascular disease (blocked arteries).
  • Furthermore, a Vascular Surgeon has formal training in the medical treatment of venous and arterial diseases.

Therefore, a vascular surgeon can offer patients a very comprehensive array of treatments for vascular problems – venous and arterial – as well as the knowledge to recognise the ‘less common’ pathologies that may present with varicose veins.

By seeing a vascular surgeon, a patient can be confident that ‘all their bases are covered’.

Phebologist

A ‘phlebologist’ is a broad term for any practitioner who treats veins, usually varicose veins. The pre-requisite is a basic medical school degree.

However, in Australia, there is no formal recognition of phlebology as a distinct medical specialty by the Australian Medical Council (AMC). Therefore there are no prerequisites for further training or qualifications to call one’s self a phlebologist.

Although membership to a phlebology college, society or group may sound ‘prestigious’ to the lay-person, it is important to understand what this actually means:

– A phlebologist who does not hold an Australian Medical Council-recognised specialist qualification does not have admitting rights to a public or private hospital. Therefore in the event of a complication, their patients must present to emergency to be cared for by a specialist such as a vascular surgeon.

-Futhermore, patients can not use their private insurance to be treated by a phlebologist unless that phlebologist also holds AMC-recognised specialist qualifications. Therefore treatment recommendations may be biased to ‘outpatient’ treatments only.

Radiologist/Interventionalist

A ‘radiologist’ or ‘interventionalist’ is a qualified medical specialist with advanced post-graduate training. To practice radiology in Australia, they must have fulfilled certain criteria in order to receive their Fellowship of the Royal Australian and New Zealand College of Radiologists, which is formally recognised by the Australian Medical Council.

They possess endovascular skills in treatment of venous and arterial conditions. However, they do not have formal training in medical treatment of vascular disease or vascular health, nor do they have surgical training in venous or arterial disease.

General surgeon

A ‘General Surgeon’ is a qualified medical specialist with advanced post-graduate training. To practice general surgery in Australia, they must have fulfilled certain criteria in order to receive their Fellowship of the Royal Australasian College of Surgeons in General Surgery, which is formally recognised by the Australian Medical Council.

They do not have training in endovascular or endovenous surgery, and are not trained in medical treatment of vascular disease or vascular health, or surgical treatment of arterial disease.

What does this mean for you as a patient?

A vascular surgeon must undergo many years of rigorous advanced specialist training through the Royal Australasian College of Surgeons. Vascular surgeons are not only trained to recognise when other vascular issues may be co-existing but in addition, they would have the skills to treat those conditions as well.

A Vascular Surgeon is be able to provide you with comprehensive care.

What can Dr Ling offer me?

Peace of mind. The advantage of seeing Dr Ling is that you can be assured that you are receiving treatment that is comprehensive and tailored to your needs.

“When all you have is a hammer, everything looks like a nail”.

Since Dr Ling performs a very wide range of treatments (his ‘venous tool belt’ has many tools including sclerotherapy, Venaseal Glue, Radiofrequency and Endovenous laser ablation, endovascular stenting and coiling and surgery), he is able to offer you a balanced opinion about what would be best for you. The advantage for you is that you can rest assured that all treatment possibilities would be considered for you.

In addition, as a qualified Vascular and Endovascular Surgeon, Dr Ling has endovascular and surgical skills, plus expertise in diagnosis and treatment of medical vascular health problems (venous and arterial diseases). Therefore, Dr Ling is able to diagnose – as well as treat – other vascular problems. For instance, when Dr Ling sees a patient who has a non-healing ulcer, he is able to diagnose any underlying venous as well as arterial issues and in addition, he has the skills and expertise in treating this.

Furthermore, Dr Ling often performs ‘hybrid’ procedures, that combine different techniques of endovascular and open surgery. This often means he can offer you a comprehensive and appropriate treatment approach that is tailored to your specific requirements. This results in less procedures and ‘returns for further treatment’, with resulting quicker return to normal activities and daily life.

Which treatments does Dr Ling perform?

Dr Ling is qualified and very experienced in various forms of varicose vein treatments, including:

  • Sclerotherapy
  • Venaseal Glue
  • Radiofrequency ablation
  • Endovenous laser ablation
  • Surgery
  • Endovascular coil embolisation for pelvic congestion syndrome