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The venous system in the lower extremity is composed of deep and superficial veins connected with each other through multiple communicating or perforator veins. The deep veins are the principal vessels which are responsible for delivering blood back to the heart from the legs. The superficial veins consist of two major trunks called the long and short saphenous veins. The superficial veins eventually drain into deep veins, either through perforators or through their main saphenous trunks at the groin or the back of the knee. The deep veins are fairly stable but superficial veins exhibit a great variety of permutations in their anatomy so that no two legs are the same. The advent of ultrasound scanning technology has enhanced our understanding of venous disease and revolutionized the treatment of varicose veins by allowing the visualization and treatment of diseased vein segments at their source.
At The Vein & Laser Clinic, every patient presenting with varicose veins undergoes an in-depth assessment of their circulation, following which a treatment plan is discussed with the patient. The investigations undertaken may consist of a screening auscultation with a hand-held bidirectional doppler, which can quickly determine if the major trunks or the deep veins are affected. Further studies with real time duplex imaging as well as colour doppler are then used to 'map" the entire system of diseased veins. Surgery, endo-venous laser (The Vein & Laser Clinic does not perform EVLT) and sclerotherapy are not antagonistic to each other but are complementary options that may be combined, depending on the pattern of varicosities exhibited in a particular patient.