Manadr’s Symposium Series: Modern Management and Treatment of Chronic Venous Insufficiency and Varicose Veins

The key take home points from the one hour talk were:

1. CVI and varicose veins are primarily medical conditions which are progressive in nature and can cause complications such as deep vein thrombosis or venous leg ulcers.
   
   
2. ⁠Patients in Singapore usually present at a later stage with skin changes because they or their primary doctors believe it is a cosmetic issue.
   
   
3. Before any treatment is considered all patients require a Duplex ultrasound scan to confirm the diagnosis of valvular superficial venous reflux, the extent and severity of the problem, any concomitant deep vein problem which may influence outcome and map out the vein anatomy to guide which is best way or device to treat the problem.
   
   
4. Patients with varicose veins do not tend to get on with compression stockings in Singapore because of the temperate climate and tend to opt for surgery.
   
   
5. Surgery is now in the form of minimally invasive or keyhole procedure with minimal downtime. Patients can be operated under just local anaesthetic and sedation in the majority of cases and can walk immediately and go home the same day.
   
   
6. Open surgery with big cuts in the groin and stripping of the faulty truncal vein is no longer the gold standard of care.
   
   
7. Hybrid interventions using a combination of devices such as endovenous microwave and venaseal (medical glue) ablation termed the Venowave Technique can be used simultaneously to optimise patient outcome and minimise pain and bruising post-operatively.
   
   
8. With the newer techniques, recurrence rates are very low and reintervention rates are low.
   
   
9. At the Vascular and Endovascular clinic we offer a complete range of solutions to varicose veins problems including the cosmetic aspect as we have the new Candela laser at our Mount Elizabeth orchard clinic that can be used after the truncal reflux has been ablated for spider veins and the QS laser at our Gleneagles branch for the brown pigmentation associated with venous stasis.