Welcome to the Vascular and Interventional Centre. The mission of our centre is to raise the bar in cutting-edge treatment options for patients in Singapore and the surrounding areas. We believe that our skills, knowledge, and dedication to patient care provide us with a unique program offering comprehensive minimally invasive services for venous disease. Our vision is to arm patients and their primary care providers with the most information available for treating them. We believe that people should know and understand the treatment options that are available for them before receiving treatment. Our vision is now a successful reality, and we can offer the most modern techniques for the treatment of varicose veins in a ‘same day’ centre.
Varicose veins are enlarged, twisted veins caused by poor circulation, often leading to discomfort or swelling in the legs. One in three men and one in two women suffers from problematic veins. With the help of these procedures performed through small puncture holes of 2-3 mm from advanced forms of saphenous venous disease, we manage to solve this problem and relatively simply return to a normal life. The exclusion of such patients from the operation using the cuff is a cardinal change that is happening globally. It is now known through evidence-based medicine that stitching to a column is a poor gold standard and should only be done if endothermal ablation is not available. It is impossible to rely on close varicose veins to be treated according to the principle of cutting, as the appearance of new areas of blood leakage is determined by genetic origin, habits, and hormones. We try to give as much information as possible to the patients who come to us for a second or third opinion so that they can independently make the final decision. We also believe that this should provide an additional means for ongoing professional training and exchange of practical experience. We will inform internists about new methods of minimally invasive treatment and practical technical advice on most of them.
Significance of Minimally Invasive Procedures
Varicose veins surgery, such as vein stripping or endovenous laser treatment, removes or seals damaged veins to improve circulation and reduce symptoms. Minimally invasive techniques for treating varicose vein disease represent an efficient solution, reducing postoperative pain to a minimum level. Patients return to their normal lives faster in comparison to classic surgery. The small surgical wounds heal in the following days with just a small chance of minor scarring, particularly with the introduction of new techniques. All our procedures are minimally invasive and are associated with the least postoperative complications of a medical character. The minimally invasive laser and radiofrequency methods allow for treating small and large veins that are either on the leg skin surface or deeper under the skin and fat. A recent study unambiguously confirmed that new minimally invasive methods represent the future in vein treatment due to their high efficiency, lower complication and side effect rates, and significantly shorter recovery after treatment. The improvement of clinical results and the increase in patients’ quality of life is confirmed by numerous written and oral testimonials. Before each treatment, we always listen to our patients and explain in detail the treatment options. Their satisfaction is the highest recognition for our work. The current developments in medical devices and systems have made this possible. Therefore, all developing and developed countries have been witnessing the emergence of innovative centers for the treatment of circulatory system diseases.
Understanding Varicose Veins
Varicose veins treatment includes options like compression therapy, sclerotherapy, and minimally invasive procedures to alleviate pain and improve appearance. Varicose veins are enlarged, bulging veins that twist and turn, appearing as green, blue, or purple in color. They are most commonly found in the legs or lower extremities of the body. Superficial veins, located in the fatty layer of the skin, are more prone to becoming varicose. Due to underlying valve dysfunction somewhere within the veins, varicose veins develop. The direction of blood flow to the heart in the venous system is regulated by one-way valves that open to let blood move in and close to prevent blood from flowing backward. Subsequently, when the muscles contract, blood can only move in the direction of the heart; hence, blood cannot escape from re-entering the veins, as this would result in the blood being stopped between two valves or, because of gravity, an excess amount of blood can cause pressure.
Common causes of varicose veins include inherited factors, female hormones, pregnancy, obesity, prolonged standing, and leg injury. Due to the inability of young adults to inherit varicose veins, a large percentage of older individuals have some variant of varicose veins. More or less, 40% of females and 24% of males are affected by varicose veins. Furthermore, population-based studies have suggested that the incidence of varicose veins in developed countries was around 5% to 10% among males. In addition, a study found that varicose veins affect 7% to 60% of females and 2.5% to 56% of men. Symptoms associated with swollen veins include sensations of pain, heaviness, swelling in the calves, and itching. Varicose veins also have the potential to affect an individual’s psychological health and cause body image issues.
Symptoms and Risk Factors
Common Symptoms and Presentation: The following are the most common symptoms of varicose veins. They include aches, heaviness, burning, pain, or itching in the legs. There is a continuous complaint of swelling in the legs as well as discomfort in the legs when exposed to heat. Patients also notice red or ruddy skin color in the legs. They also notice the appearance of twisted, bulging veins that are usually blue or dark purple in color, thus making them visible through the skin. The condition is usually a response to pooled blood in the veins. Inflamed veins are also a characteristic feature and are seen mostly at the back of the leg surface, but in some cases, they can be found elsewhere. Occasionally, there is mild pain or discomfort with one dilated, twisted vein.
Risk Factors: A person is at a higher risk of having varicose veins when they reach old age. There are certain factors such as varicosities of the deep veins or a history of blood clots in one or more deep veins located in the same leg. When these two factors co-exist, there is an increased risk of developing an advanced form of varicose veins. A family history of varicose veins in immediate family members is also a factor that can lead to a higher risk of a person getting varicose veins. About 22-52% of adults are recorded to have varicose veins. The condition is usually twice as common in women as in men. Some of the contributing factors include pregnancy, a prolonged standing or sitting nature of work, being overweight, and taking certain drugs that contain components of estrogen or progesterone. Estrogen and progesterone play a major role in maintaining pregnancy and achieving other health benefits in women who have reached menopause. If vein valves are damaged, the body can adjust to this by rerouting the blood supply to other veins that are healthier. However, this system has limitations.
Traditional vs. Minimally Invasive Treatments
For many years, newly diagnosed patients with varicose veins faced two surgical options: vein stripping and ligation, or vein crossectomy saphenous ligation and stripping. Both options were shown to be extremely effective: less than 5% of patients complained of pain 5 years later. The downsides of these treatment options for new patients with varicose veins were the relatively long time interval until their full working state had returned, ranging up to 2–4 weeks for stripping operations, as well as another 4 weeks for postoperative follow-up visits. The potential hospitalization rates were high, resulting in a similarly high social burden. On the other hand, new treatment innovations have offered minimally invasive techniques for these patients. For example, there is endovenous laser therapy, which makes use of radiofrequency ablation or ultrasound-guided foam sclerotherapy.
Services Offered by Vascular and Interventional Centre
The Vascular and Interventional Centre is known for its comprehensive approach that puts the patient first. Services available fall into several overarching areas, starting with assessment. Also known as diagnostics, these tools are critical for understanding what your veins and vein health look like. Accurate assessment of problem areas helps focus treatment and identify conditions that may lead to less than optimal outcomes. As a patient of Vascular and Interventional Centre, you can trust that you’ll never be pushed into any kind of diagnostic or treatment plan. Diagnostic testing choices are personalized to your unique, natural existing varicose veins and relevant patient factors. Diagnostic testing in our office often includes a detailed physical examination and standard in-office ultrasound evaluation.
The term varicose veins refers specifically to a condition in which great saphenous veins of the leg become swollen and twisted. However, we typically use the term varicose veins to describe any swollen or distended surface vein of the lower leg, many of which go by the names spider veins, reticular veins, and varicose veins. Offered minimally invasive treatments for varicose veins include endovenous laser therapy, sclerotherapy, ultrasound guided sclerotherapy, and sclerotherapy with foam. These treatments are offered on an outpatient basis in our state-of-the-art operating room. There are also conservative treatments for varicose veins, which are executed outside of the body using devices that offer pressure and orthosis. Finally, there are surgical treatments, integrally involving invasive procedures with an incision. However, requiring general anesthetic, the majority of patients choose to undergo a minimally invasive procedure for the management of their varicose veins. The decision of which one is best is one that together, you and your doctor can best make by weighing the test results and considering personal lifestyle.