This information is in addition to the detailed patient information personally provided by Mr Ponosh.
Please refer to to the Royal Australasian College of Surgeons Vein brochure also provided.
Varicose veins are dilated and tortuous superficial skin veins. This results from increased pressure in the venous system arising from the main draining veins in the leg not functioning properly. For a variety of reasons including gender, family history, childbirth, prior deep vein thrombosis and a number of other factors, the valves in these draining veins fail causing blood to pool and increased back pressure. This causes the skin veins to dilate and become varicose.
A common treatment for varicose veins is contemporary open varicose vein surgery. This consists of ligating (tying off) the draining veins in the groin and/or behind knee through a 2-3 cm incision and removing the draining vein to the knee. A number of small avulsion incisions (1-2mm) are then made over the varicose veins to “tease them out”. This is usually conducted under a general anaesthetic at St John of God Subiaco or Hollywood Private Hospital with one nights stay.
Another method often utilised is radiofrequency ablation (RFA). This involves a more minimally invasive technique in which a catheter passed through the non-functional draining vein under ultrasound guidance. The catheter delivers thermal energy to the vessel wall causing it to contract and collapse. This is conducted under local anaesthetic in the rooms as an “walk in-walk out procedure”. As discussed at your consultation, whilst the cause of your varicose veins are treated, your varicosities are not directly treated. In many instances they resolve completely following this treatment, however additional injection sclerotherapy may be required for the complete resolution of all varicose veins.
The procedure will take approximately 1 hour, although the duration of attendance varies. Both techniques are widely used, low risk and have very similar long term outcomes and durability. Mr Ponosh will discuss the best option for you.
Anaesthetic Complications
Are extremely low utilizing local anaesthetic. Please discuss if you have had any prior reactions to local.
Deep Vein Thrombosis (DVT)
Is a very rare complication manifested as significant pain and swelling. This risk is reduced by a preventative pre-procedure injection as well as maintaining mobility and your stockings.
Please advise us if you have a personal or family history of DVT.
RFA can not be conducted within 4 weeks of long haul flights.
Bruising
There is usually bruising along the vein that was treated and this resolves over a number of days
Infection
This is extremely rare.
Tender Lumps
These may reflect clotted varicose veins which occur as part of the procedure. This is usually not a concern. Occasionally they may become inflamed (phlebitis) and may require additional minor medical therapy and anti-inflamatories.
Pain
In almost all cases it is minimal.
Nerve Injury
The thermal energy from the RFA can very rarely interfere with the nerves that supply the skin surface can be damaged. This can cause numbness and tingling in the skin. This usually resolves within 3-6 months.
Recurrence
New varicose veins can develop and therefore it may be necessary to have further intervention in the future.
Cosmetic Issues
Whilst your leg will be dramatically improved by vein intervention, it is impossible to achieve perfection. Additional sclerotherapy or topical laser may be required.
Skin Staining
This may occur along the path of the RFA. It is rare and fades in almost all cases over 3-6 months. In some cases it may persist for over 12 months in rare instances.
Skin Burns
Extremely rare
Failure of Treatment
This is rare. Failure of the technique is reported at less than 2%.
To relieve pain, take simple analgesics such a regular paracetamol
Compression stockings : A form will have been provided to you by the rooms to obtain these stockings PRIOR to your procedure ONLY from the recommended supplier.
To be worn : Continuously for 4 days
Not to be removed for bathing/showering (Hospital Nursing staff will provide advice for bathing options)
Then during the day for 10 days
Contact Mr Ponosh’s Rooms or see your GP if you have :
Remove dressing on day 4 after procedure.
Monitor for signs of infection including redness, swelling, pus and heat. See your GP if these symptoms develop.
A routine ultrasound will be undertaken at 2 weeks. A form will be provided to you for this. We will only contact you following this scan if required.
A letter will be sent to your GP and/or referring doctor advising them of your management.
The rooms will contact you the day following your procedure to ensure all is well and address any concerns.
We will see you in the rooms in approximately 6 weeks following your procedure.
If any concerns arise or you would like to see Mr Ponosh earlier please contact the rooms on 9386 6200 and we will see you as clinically indicated.
Some small residual varicose or spider veins may persist. Mr Ponosh’s will discuss additional management options with you at your follow-up review.
Please contact Mr Ponosh’s rooms on 9386 6200 or email admin@ponoshvascular.com.au to discuss and queries or questions.
