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Video

Voiceover:
April came to see Dr Pixie about unsightly thread veins on her leg.

Dr Pixie:
So, April, if you want to roll up the trousers for me, and let’s have a look.

Voiceover:
She has been referred to Mr Constantinos Kyriakides for a series of injections that will relieve her problem.

Mr Kyriakides:
The plan today is to proceed with what is known as micro-injection sclerotherapy, which is the use of a special chemical that is injected in the vein and causes the vein to effectively shrivel up, and then it disappears.

Mr Kyriakides:
Do you see this?

April:
Yeah.

Mr Kyriakides:
Are you impressed?

April:
Yeah. Wow.

Mr Kyriakides:
How about this one? Now you see how the…

April:
Oh, it’s making me fill up.

Mr Kyriakides:
Really?

April:
Sorry.

Mr Kyriakides:
That’s, that’s okay. I know you’ve suffered with this for a while now.

April:
It just looks…so different. It’s amazing.

Voiceover:
After the first session of treatment, the intricate technique has been successful.

Mr Kyriakides:
Now, what we used today was Fibro-Vein, and, and what it does, it actually inflames the inside wall of the vein and makes the vein effectively clot off or close. And because the vein is then, for lack of a better term, dead, it gets absorbed and then disappears from the skin or the underlying tissue, and no longer shows.

Voiceover:
During the sclerotherapy procedure, Mr Kyriakides has discovered that she has a more serious underlying problem in her left leg, and has asked her to come back for further treatment.

Mr Kyriakides:
I found that the valves in the main superficial vein in the leg were not functioning, uh, properly.

Voiceover:
This means that she will need to undergo a procedure called endovenous laser ablation, under local anaesthetic, to close off the leaking vein.

Mr Kyriakides:
You’ve got a couple of veins down here…okay, which are stemming from the main vein, which are slightly too big to, uh, to inject, so what I’m going to do is, I’m going to mark them, and I’m just going to take them out under the same local anaesthetic, okay?

Voiceover:
Mr Kyriakides uses an ultrasound scanner to locate the veins feeding into the leg.

Mr Kyriakides:
So now what I’m looking at is the junction of the vein that’s causing the leak to the main vein. So this is how far up I want to be in terms of sealing the vein. And we’re going to be working up here, and we’re going to be working down here. But the laser fibre is going to thread up all the way to the top of the groin, and that’s where I’m going to be marking up there, the junction. So the laser fibre, when it starts working, it will seal up the vein, pardon me, from the top, all the way down to where it comes out, okay? So that is why we no longer need to be, with this technique, we no longer need to be, um, making a cut in the groin.

Mr Kyriakides:
Your left leg, we know we’ve got two types of problems. One is the visible veins that you have under the skin, but also the vein that runs underneath the skin that’s a bit deeper, visible with ultrasound, which is effectively leaky. The valves in that vein are leaky. So what is happening is that the blood is pooling down into the leg as opposed to going upwards, and that is the reason you are getting the more superficial veins in the skin visible. So what I’ve done so far is to mark the course of the vein, the offending vein. And we’ll prep the leg, I’ve put some Emla cream, otherwise known as magic cream, on the skin, and what that does is it numbs the skin a little bit, because this procedure does involve a handful of injections through the skin.

Voiceover:
Then he uses the ultrasound scanner to work out an entry point for the laser fibre, and inserts a sheath into the vein.

April:
I feel fine so far, it’s not…

Mr Kyriakides:
It’s meant to feel good.

April:
Yeah, of course! It’s not uncomfortable, it’s not painful, it’s fine.

Mr Kyriakides:
This is the laser fibre, okay, this whole thing is the laser fibre that I will be running inside that sheath I showed you. And the tip of the laser fibre, this bit here, is the active bit, that’s the bit that actually seals off the vein. Okay, it’s got a little light that guides us through as we work, and you can see it kind of running up the skin, underneath the skin.

Voiceover:
A fluid buffer is then put down the vein to help numb the inside of the leg…

Mr Kyriakides:
The fluid is going in now.

Voiceover:
...and compresses the vein onto the laser fibre, giving it a better contact and also helps to reduce bruising.

Mr Kyriakides:
How are you doing, April?

April:
Okay, I’m fine.

Mr Kyriakides:
Once the laser is fired, I slowly pull back the laser fibre at a set rate, and that seals off the vein, uh, along its course.

Voiceover:
To clear up the smaller veins, Mr Kyriakides performs a procedure called a phlebectomy.

Mr Kyriakides:
A phlebectomy is a procedure whereby one punctures the skin over the offending vein, and then uses a crochet hook to pull the vein out—effectively just rip it out. All finished.

Voiceover:
Nine weeks later, April is back to update Dr Pixie on her progress.

Dr Pixie:
Let’s see these legs! They’re pretty good, aren’t they?

April:
Yeah, and I think once the bruising’s gone, it’ll be even better.

Dr Pixie:
All around here you were covered in these very very fine veins, and it’s just gone.

April:
Yup.

Dr Pixie:
It’s amazing, isn’t it? It just disappeared!

April:
Yeah, yeah, it looks really good.

Dr Pixie:
So there’s lots of things you can do now, that you couldn’t do, before.

April:
I’m looking forward to going on holiday and trying my new legs out.

Dr Pixie:
For the first time in ten years.

April:
Yeah.

Dr Pixie:
Good girl.

April:
Yeah.

Dr Pixie:
So, April, enjoy being pain-free and most of all, enjoy the summer.

April:
I will do, thank you.

Dr Pixie:
You’re very welcome.

April:
Thank you.

Read the video transcript

April appears in the EB clinic suffering from unsightly thread veins that she has had for ten years. Dr Pixie sends April to see vascular specialist Mr Constantinos Kyriakides, who carries out a course of micro injection schlerotherapy to which we see some instantaneous results leaving April a tad emotional. However in the process it is discovered that April’s veins in her left leg are not working as they should and April undergoes further procedures under local anaesthetic to seal a leaking vein and pull out some small visible ones. 9 weeks later April returns to visit Dr Pixie to show off her new legs that are a marked improvement enabling April to finally go out in a skirt after ten long years.

Patient Name: April Nicklin
Condition: Thread Veins
Specialist: Mr Constantinos Kyriakides, Consultant Vascular surgeon
Hospital: The Private Clinic
Length of procedure: 2 × 1 hour Sclerotherapy sessions followed by approx 1 hour of surgery

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Comments and Questions

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I have unsightly varicose veins on my right leg that start in my abdomen and go right down to my knee, my right calf is three inches wider than my left, my leg is constantly sore, extremely itchy and feels heavy sometimes, but because i suffered from a blood clot in that leg 2 years ago my GP is reluctant to offer me any treatment, What are my options?





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I have had some thread veins since being a teenager but since giving birth to my first child 11 weeks ago I seem to be developing more and more. My thighs are scattered with them. They seem to get worse with my period when my legs now ache terribly too. I went to my doctor who basically told me to learn to live with it. He had no sympathy despite me being an emotional wreck at the appointment and informing him that I am suffering pain with them. Is there anything I can do to get some help? I'm so worried that my body will be covered in them. I am considering vein wave but am worried there may be an underlying issue and don't want to make it worse.





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can anyone help, I havea lot of thread viens on my legs. where can I get proper treatment, this problem is depressing me,i hate wearing trousrs

Is there any creams that can be used to help get rid of thread veins?





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i have facial thread veins what is the best creams to use and are they affective as laser treatment is to expensive for me

Hello everyone i have been reading your comments and i am suprised about the negative feedback of schlerotherapy as i had my legs treated a while back and i was very pleased with the result the pain was minimal and quick. i suffered no after effects except slight scratches on the treated areas for about a week then my legs looked great after. of course the treatment does not prevent more from occuring and i have some more now and also apparently i have an awful patch which cannot be treated because it does not have a feeder i really wanted advice about how to get rid of this.





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I have veins showing all over my chest shoulders and arms/biceps.Iv had them since a young age/ birth and they are very unsightly.they are blue and makes me look like a road map.im so embarrassed that I dont take my top off in public.cant go swimming or on holidays.i really just want to be normally.Im so depressed and fed up.Can any1 help me please.





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I'm 18, and I've noticed over the past few months these lines on the inside of my thighs, when I am standing they are purple and very noticeable, but when I sit down, they are transparent and lumpy. I am very self conscious about these lines as I can't enjoy summer in shorts and skirts as I would like to because these lines are very visable when I walk and stand up. Please help





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Hi I've always had broken veins all over my legs and also I have very veiny boobs and arms :( is there not anything you can do about this? I know there are treatments for broken veins but what about these deep blue veins on my boobs and top of my arms! I'm so self conscious about it.





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Lauren, have a chat to specialists in this field.. Start with a Doctor see why it is the way it is and not a condition elsewhere.. Blood flow ect.... Then ask him about specialist that deal with this cosmetically once you know medically you are ok...Also, try using Pharmacies for advice for cover ups creams.. I use a non greasy bronzer on my legs as I have spiders all over one leg..and that works a treat for me, so much so I am contented with that level pro activeness..

Has anybody had ipl treatment for thread veins on legs? I got my first treatment done about 5 days ago n still have the marks where the laser went.is this normal.worried incase this has burnt my skin.anyone had a similar experience and what did you do?





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hi i am going on holiday in july and have varicous veins on my legs my right exapecially how can u cover them so i want be inbarrised to wear my bikini





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My main veins in my legs are varicose, they are uncomfortable when it is hot and they itch, I have a support stocking on to help but they are getting worse.





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