Inject. Glue. Seal. And the patient is able to go home within an hour of a procedure to get rid of the pesky and unsightly varicose veins. Unlike conventional treatments that can leave patients in pain for weeks, this new minimally invasive procedure uses a superglue-like substance to treat the condition. Since Singapore General Hospital (SGH) started offering it last year, more than 100 patients – the most in the region – have opted for it.

Before treatment, patients are given a small injection of local anaesthetic in the leg. The surgeon then inserts a catheter into the affected vein under ultrasound guidance and injects a medical-grade superglue, known as cyanoacrylate, at various points to seal the vein. The superglue has been used in a wide variety of surgeries and treatments since the 1950s.

“This is a good treatment option for the active or time-strapped Singaporeans, and especially for ladies who are worried about post-treatment scars. Treatment is simple, painless, and fast – just glue, seal and put an adhesive bandage over a 3mm puncture in the leg. There is minimal or no bruising at all and patients can resume their normal activities immediately without needing to wear compression stockings afterwards,” said Dr Chong Tze Tec, Senior Consultant, and Head, Department of Vascular Surgery, SGH.

Other varicose veins treatments include surgically stripping the entire vein that leaves patients in pain for weeks after the procedure; or ablation, which uses radiofrequency or laser that is converted to energy to seal the vein. This requires tumescence or a liquid layer injected around the vein and that can be uncomfortable for the patient. In rare cases, the patients’ skin may darken, especially in slim patients whose vein is very close to the skin. Some treatments also require multiple injections and have a longer recovery time.

Veins in the lower limbs are most commonly affected as standing and walking increase the pressure in the veins of the lower body. At the same time, if the veins have weak valves, blood will flow backwards, pooling and enlarging the vein instead of flowing towards the heart.

Most individuals do not experience any symptoms in the early stage, although some may gradually experience throbbing in the legs, aches and pain, discolouration, or rashes and ulcers on the ankles. Swelling becomes noticeable as the condition advances, and at this stage, treatment is also more difficult. One study suggests that around 30 per cent of varicose veins patients will have serious problems within six years if they do not have the problem seen to. There is also a possibility that the vein will rupture, causing heavy bleeding.

Varicose veins tend to occur among the elderly, the overweight, during and post-pregnancy with blood circulation changes, and those who have to stand for long periods of time, including sales personnel and teachers, etc. The condition is also more common among individuals with a family history.

SGH’s one-stop ambulatory varicose veins clinic is located within the Diabetes and Metabolism Centre. Patients can be diagnosed and treated on the same day in the clinic or the day surgery suite.

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Carol Ang
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