s it dangerous to dismiss spider veins as a cosmetic problem?
Dr. Salama: The assumption that spider veins are just a cosmetic problem overlooks important medical implications. This is because around 15 % of treated spider veins reappear, which shows that simple cosmetic interventions are often not enough. Furthermore, up to 20% of these cases could be misdiagnosed, with the underlying chronic venous insufficiency not being recognized, which manifests itself through symptoms such as leg pain, swelling and skin changes.
What role does the choice of diagnostic procedure play?
Dr. Salama: Analyzing the potential limitations in the diagnosis and awareness of chronic venous insufficiency is instructive. Although ultrasound imaging is valuable, it has its limitations due to factors such as operator skill and specific vein characteristics. Sometimes small, superficial veins are difficult to evaluate. Incomplete vein mapping, i.e. mapping the visual map of veins on the surface of the skin using near-infrared imaging techniques, can result in smaller veins such as spider veins being missed.
Many symptoms of chronic venous insufficiency such as leg heaviness and mild swelling are often attributed to other causes and not immediately recognized as signs of venous insufficiency. Therefore, it is critical in leg rejuvenation to take a comprehensive approach that addresses not only aesthetic concerns, but also potential medical underpinnings of these vascular issues. This integrated perspective ensures that treatments are not only cosmetically effective, but also beneficial to long-term health.
What are the benefits of the examination & treatment protocol?
Dr. Salama: At LBCL Surgery & Vein Practice, we have established a comprehensive protocol for the diagnosis and treatment of unwanted or diseased veins, be it spider veins, reticular veins or the main trunk veins. Our leg rejuvenation journey begins with a detailed questionnaire in which we record all possible manifestations of chronic venous insufficiency as well as symptoms and signs to determine the severity of the condition in the affected individual. This questionnaire is not only to be completed at the first visit, but also has prognostic value and is used for follow-up. This is supplemented by a systematic medical history and a thorough ultrasound examination of the entire venous system, in which each section of the leg veins is examined in detail. If the findings are unclear or due to the limitations of the ultrasound, some patients undergo a second examination after two weeks under compression therapy in order to confirm the ultrasound findings and increase the specificity of the examination.
