These are blood vessels that return fluids, including excess water and other waste products, from all around the body back to the heart. They are most commonly affected by “incompetence” meaning reflux resulting in varicose veins. They are also frequently affected by “thrombosis” meaning clotting or compression.

Varicose Veins

Superficial veins are blood vessels close to the surface typically in the legs and arms that return blood back to the deep veins. They depend on valves to support flow of blood back from the ground up to the heart against gravity, so once the valves are not working, it results in reflux. This initially appears as spider veins or varicose veins which can bulge, become unsightly or even painful. Over time, this can develop into extra fluid around the ankles (oedema), changes to the skin and even ulceration. Sometimes, it can result in clotting (thrombophlebitis) or bleeding.

Treatment is tailored to your specific problem. Smaller spider veins can be injected (microsclerotherapy). Larger veins may be suitable for a keyhole procedure (radiofrequency ablation and ultrasound-guided sclerotherapy), while very large veins may still require surgical removal (ligation and stripping).

Deep Vein Thrombosis (DVT)

Deep veins are blood vessels deep in the legs, arms and other body cavities that directly return blood back to the heart. Thrombosis means clotting, however whilst it is useful to stop bleeding outside of the blood vessels, it is potentially harmful when it happens inside the blood vessels. It can break off and travel to the lung (pulmonary embolism) which can be imminently life-threatening. Or it can cause long term scarring of the veins with later problems with painful walking (claudication) or skin breakdown (post-thrombotic syndrome).

Treatment is always done in conjunction with a haematologist (blood specialist) which most often involves special blood thinning medications. Some DVTs can benefit from keyhole surgery to remove the clot and stretch open the affected vein (venoplasty and stenting). Sometimes, it requires open surgery to remove any structures compressing the vein that may be contributing to the problem.