Wednesday, 29 July 2015

Why is Good Circulation Important?

Normal circulation involves blood carrying oxygen being pumped from the heart into the tissues via arteries and then returning de-oxygenated blood carrying other waste products from the tissues back to the heart through the veins. Your arteries might be in good health but if your veins are not working properly and leaking back into the tissues due to varicose veins then in the long term tissue damage to your lower legs can occur leaving you at risk of varicose leg ulcers later in life.  

Walking compresses the deep veins in the leg muscles and this pumps the blood out of the legs. This is the most important mechanism to improve clearance of venous blood out of the legs. If you sit on an aeroplane for a long flight you might be aware of some ankle swelling because you haven’t been walking.

People with venous disease will often find relief from their swollen feet and ankles and alleviation of tired and aching legs by elevating their legs at the end of the day.

There are many and varied medications and devices marketed as circulation boosters (e.g. the brand Revitive).   Medical Graduated Compression Stockings have Evidence Based Medicine to support their use to improve leg vein circulation and improve leg vein health.  

But these methods only provide temporary relief and do not prevent tissue damage from occurring in the long term. An Ultrasound investigation can establish if your aching or swollen legs are caused by poor venous circulation. 

The price of the initial consultation at our Vein Clinic in Brisbane and Toowoomba includes a venous duplex ultrasound examination for which there is a medicare rebate. 

Sunday, 19 July 2015

Natural Remedies to treat Varicose Veins and Spider Veins?

Horse chestnut, grape seed, Ginko biloba, coumarins and flavonoids. Even skin wraps for varicose veins. And there are a lot more!  There seems to be any number of herbal and home remedies which are available for the treatment and removal of spider veins and varicose veins.  Some of these products are cheap and others not so cheap but all seem to guarantee quick pain free removal of your veins with guaranteed results.

All these products are termed Veno-active drugs (VAD) or Phlebotonic drugs.  They are mostly derived from plant extracts.
Such groups include:
·         Benzopyrones (Coumarine, Flavonoids, Oxerutin, Rutin, Rutosides,                     Diosmine),
·         Saponins (Horse chestnut and Butcher’s extract)
·         Other plant extracts (Gingko Biloba, Maritime Pine extract, grape seed)
·         Synthetic products or the Quinons ( naftazone and calcium dobesilate)
·         Xanthine derivatives (Pentoxifylline )
There seem to be various modes of action depending on the individual drug.  Beneficial effects include reduction in capillary leakage and anti-inflammatory effects by scavenging free radicals. Improvements in venous tone and on the lymphatic system have been proposed.

But what is the level of scientific evidence?

At a recent International Phlebology conference that I attended, Veno-Active Drugs (VAD) were one of the topics of discussion.
Pentoxifylline, Sulodoxine and micronized purified flavonoid fraction (Daflon®) have demonstrated some benefit to patients with Chronic Venous Disease in a few trials.
However “strong recommendations with Level 1 evidence” cannot be made about the use of any of the wide range of Veno-active drugs available in the treatment of Chronic Venous Disease at the moment.

Until more evidence is gathered sclerotherapy and Endothermal ablation remain the most successful and proven methods of removing varicose veins and spider veins.