UGS is a safe and effective method for the eradication of varicose veins. Unlike surgery there is no need for hospitalization or a general anaesthetic, there is also no downtime or need to take time off work.
A consultation will be booked with Dr. Nolan in which you will need to bring your completed medical questionnaire. This will usually have been emailed or posted to you prior to your appointment. If not, we ask that you arrive 15 minutes prior to your appointment to complete it. The Doctor will examine your veins, perform a duplex ultrasound scan to map any abnormal veins and explain the procedure of UGS including costing. You may elect to proceed with treatment on the day, book a subsequent appointment, or elect not to proceed with further treatment.
The actual UGS treatment takes approximately 30 minutes.UGS is performed using ultrasound technology to locate the hidden abnormal veins and allow the Doctor to safely and accurately inject the veins with a sclerosant foam.
This sclerosant foam damages the inside lining of the vein – the bodies natural healing mechanism then gradually converts the vein to scar tissue. A number of injections may be required and these can be associated with a slight burning sensation that usually lasts for a few minutes. The needles used are very fine so there is very little discomfort from the injections themselves. The sclerosant becomes diluted within a short distance from the injection site and, therefore, is unlikely to damage any normal veins.
Following the injection procedure, you will be fitted with a compression stocking (or two if both legs are able to be treated) and be asked to walk normally for 30 minutes. The reason behind this is to get blood pumping through the major veins in the leg, it also helps to alleviate any discomfort following the procedure. After your walk you are free to leave.
You are able to drive yourself to and from your appointment and you can go straight back to your normal duties and work if you wish.
You are required to wear the compression stocking for 2 weeks after UGS. A follow up appointment will be made on the day for approximately 2 – 4 weeks. The stocking can be removed after 2 weeks of wear. At the follow up appointment the treated veins are scanned to ensure that they are starting to heal and have responded to treatment. It is quite normal for treated veins to be quite lumpy and tender with overlying brown pigmentation when the stocking is removed. This is a normal aspect of the healing process and indicates a successful outcome. The appearance of the treated vein rapidly improves over a few weeks with continued improvement expected over several months
There are a number of possible side effects seen with Ultrasound Guided
Sclerotherapy that are considered a normal consequence of successful treatment.
Stinging sensation – Some stinging may be experienced at the time of treatment – this usually settles within minutes. Many patients find treatment almost painless
Bruising will disappear over a couple of weeks.
Blood trapping can lead to tender lumps along the course of the treated veins. It is harmless but may make the vessels more noticeable in the first few weeks. Trapped blood can be drained at review appointments if troublesome. Persistent lumps all eventually disappear as the body converts the veins to scar tissue.
Aching in the legs for the first few days can occur after treatment. This more commonly occurs when larger veins are treated and usually is relieved by walking. You may take panadol or anti-inflammatories such as Nurofen or or Voltaren. Most people do not require any pain relief.
Pigmentation is the appearance of brown marks on the skin located over or near the treated veins. This is a consequence of both UGS and spider vein treatment. Pigmented areas are composed of haemosidirin (a form of iron) that can become trapped in the skin. Some pigmentation is to be expected and is a normal consequence of treatment. Pigmentation gradually fades and disappears completely, although faint pigmentation lasting more than 12 months has been reported in 5% of cases.
There are a number of possible complications that can occur with UGS even when the greatest of care is taken. Fortunately the majority of these are relatively minor and amenable to treatment
Phlebitis is the appearance of tender, red, swollen areas and is due to inflammation (not infection) of the treated veins. It may be associated with tender lumps along the line of the veins. Phlebitis can be treated with anti-inflammatory medication (Voltaren rapid, Nurofen, Brufen, Act-3, etc.) and improves with walking and continued wearing of the compression stocking. Please contact the clinic if you suffer excessive tenderness.
Matting is the development of an extremely fine network of spider veins likely to occur on the thighs. Matting usually improves spontaneously and it also responds to injection sclerotherapy. Some may persist despite further treatment
Swelling of the leg or ankle occurs occasionally and will usually settle with time. It tends to arise from inflammation of the treated veins, particularly if phlebitis is also present. Wearing the compression stocking, walking, and elevating the leg will all help to alleviate the swelling.
Numbness of the skin is rare and temporary, usually in the calf area. It is due to irritation of nerves that lie in close proximity to a treated vein.
Migraine sufferers may find that injection of sclerosant can precipitate a migraine although this is uncommon. Taking a mild analgesic or anti-migraine preparation can provide relief.
Ulcers of the skin are rare and usually appear as small painful sores within two weeks of injection treatment. They tend to be slow to heal. They occur from sclerosant passing from veins into small associated arteries.
Allergic reactions to injection of the sclerosant solution are rare but may be serious or life threatening. Should you feel any abnormal sensations during treatment such as itchiness, nausea, or shortness of breath, don’t hesitate to tell Dr. Nolan who will provide appropriate treatment.
Deep vein thrombosis is a clot in the deep venous system – not in the treated varicose veins. This potentially serious problem is extremely rare if the compression stocking is worn as directed and daily walks undertaken.
The approximate risk is less than 1:2000 for UGS patients (The risk of DVT with vein surgery is significantly higher). If you are considered to be at increased risk of DVT (because of prior history of DVT, strong family history of vein thrombosis, certain medical conditions or are taking particular medications) you can still undergo UGS but may need to be treated with blood thinning medication. Dr. Nolan will discuss this with you in more detail. Deep vein thrombosis may lead to clots in the lung (pulmonary embolism) which can be a life threatening condition requiring hospitalization. Symptoms of deep vein thrombosis and pulmonary embolism include a markedly painful swollen calf unrelieved by walking, unusual shortness of breath or chest pain. If you experience any of these symptoms please contact the clinic straight away.
Intra-arterial injection is an extremely rare(1:10,000) complication that can result in significant muscle and skin damage. This now rarely occurs due to the use of ultrasound to place the needle accurately when injecting.
Pregnancy and breast-feeding – UGS is best avoided when pregnant or breastfeeding even though there is no documented evidence to suggest that it is unsafe. Veins that appear in pregnancy can be treated before the next pregnancy to avoid a further deterioration in symptoms.
There may be a small increased risk of DVT when on these medications. This depends on dose, duration of treatment and other medical conditions. Dr. Nolan will discuss this with you if there is a problem.
The majority of patients undergoing UGS will only require one treatment on each leg to eliminate their varicose veins. About 10% of patients will need some additional treatment (usually to a segment, not the entire vein). This is more likely when very large veins are treated. However, even with the most skilled therapist, there are a small number of people whose veins don’t respond well to treatment.
It is important to remember that there is no permanent cure (including surgery) for varicose veins as this is a lifelong condition. Totally new veins can appear with time, therefore the treatment is directed at the current problem.
In order to ensure the success of your treatment it is essential you follow these instructions
Concession card holder
(i.e. Pension card, Health care card etc.)
Cost of treating varicose veins
$950
Medicare rebate What you will get back
$95.00 - $215 depending on safety net
Cost of treating varicose veins
$900
Medicare rebate On second leg
$95 - $215 depending on the safety net
This is an ‘all in cost’ and covers all consults, scans and follow up appointments apart from the compression stocking which costs $60
If you have Private Health cover with ‘Extras’ you may get most of the stocking costs back.
Non-concession card holder
Cost of treating varicose veins 1st leg
$950
Medicare rebate
$95
Cost of treating varicose veins 2nd leg
$950
Medicare rebate
From $95 - $200 depending on Medicare safety net
The only additional cost is the compression stocking $60– you may get some of this back on Private Health cover ‘extras’
If you have any further treatment, such as sclerotherapy to spider veins, the cost will generally be $450 which will generally attract a Medicare rebate of $95 for larger veins
The Medicare safety net means that more money can be claimed back from Medicare. Once an individual or family has spent over a certain amount on out of pocket medical expenses for the calendar year the Medicare rebate can increase to up to $250 (approx.) for each procedure. Singles, couples, families and concession card holders all have different thresholds for claiming the higher rebate. You will need to contact Medicare if you want more information about your safety net.
Now located at:
43 Glen Osmond Road
Eastwood SA 5063
