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14/Dec/2018

Daryll Baker  is a Consultant Vascular Surgeon at the Royal Free Hospital in North London, but he also see patients privately at the Wellington Hospital Spire Bushey and the BMI Hendon Hospitals

He can be contacted via email  daryllbaker@btinternet.com  or through his secretary on 02077227370

Varicose veins are those bluish-purple lumpy marks on the legs of more than half of us.  Not only are they unsightly, but can also be the cause of the heavy aching discomfort you get when you stand for any length of time, they can itch and throb and cause cramps at night.  Occasionally they also lead to more serious medical problems including leg ulcers and hard brown skin at the ankle, and blood clots.

There are different types of veins. Most people, in particular ladies, have fine “thread” or capillary veins, its just the amount that varies. These don’t stand out, but look like a  matting or purple pen marks. Although unsightly in the summer these are rarely associated with other medical problems. Several people have varicose veins which protrud out when they stand up. These are “trunk” veins and affect both ladies and men andcan lead to the other symptoms.

As there are new treatments coming on line all the time, if you have any worries that you may have varicose veins or their complications, you really should see an expert  vascular surgeon.

When you do, the doctor  will take a history and examine your legs. Usually an ultrasound scan of the veins is performed to highlight the underlying vein problem. Occasionally if the veins are suspected to be coming from the pelvis, which can happen after pregnancies,  an MRI is undertaken. Based on this the best treatment for you and your legs will be discussed with you before any intervention is decided.

For the thread veins it is usually possible to undergo “microsclerotherapy”. This is when  a small amount of solution is injected into the vein through a fine needle in the consulting rooms to clear the vein. Over the next few weeks the body then absorbs the vein leaving the leg clear of marks. Often more than one course of injections are needed and people come back intermittently for “top up” treatments. If the veins are really fine  a skin laser machine is used to clear them.

It is now rare for “trunk” varicose veins to be “stripped” out and the  usual treatment is to pass a wire up the defective vein and heat the vein so it shrivels up. The heat is generated by a laser or high radiofrequency. At the same time the lumpy veins  are removed via a small incision over them.  The procedure is usually under local anaesthetic, sometimes with sedation, but rarely a full general anaesthetic. It is very much a day case procedure and you will usually be back to normal within a couple of days.

Sometimes it is necessary to use other techniques, especially if the surgery is for recurrent varicose veins. This includes injecting a foam of glue (sclerosant) into the veins. If varicose veins are involving the pelvis veins and the symptoms are  appropriate occasionally it is necessary to block off the non functioning veins in the pelvis as well. This is undertaken while you are  awake in a special vascular theatre when a small catheter is placed from the neck and a fine  “coil” of wires placed into the non functioning pelvic vein.

If the veins are associated with skin thickening, brown staining or leg ulcers at the ankle it is common to manage this by wearing support stockings as well as surgery. The stockings  can also be used if you don’t want surgery for your aching veins or when you are travelling on a long haul flight. It is best to wear the ones that come up to the knee, they come in lots of different colours, sizes and strengths, so you can pick the one you want and if you wear them for any length of time they need to be replaced regularly.

Often people have concerns that the veins will come back. To minimise this it is important that you and your specialist work out exactly what symptoms you have and assess the likelihood of success of treatment. Sometimes you may opt just to wear stockings for a short period, but the newer surgical techniques are very good and your surgeon will advice you.

Make sure the expert you see undertakes all procedures so you get the treatment suitable to you and not just what they have available.


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14/Dec/2018

Knee dislocation is when the bones that come together at the knee joint are thrust out of place with great force.  It is very painful and an orthopaedic emergency.

The dislocation usually occurs as the result of a car accident or sports injuries when the knee is bent in an awkward position or over extended.

The area hurts considerably, the leg is swollen and sometimes can look out of place.

During such an injury  it is possible to damage the blood vessels running behind the knee joint.  The most important one  to worry about is the Popliteal artery  taking blood to the leg.  If this is  badly damaged, there is no blood going to the leg and the leg becomes ischaemic and at risk of needing an amputation.

Sometimes the blood vessel is not actually avulsed or transected but the bending damages  its lining  and clot develops  within it having the same effect of reducing blood flow to the leg.

However, although this can occur, it is rare, occurring in about 3% of people who have a full dislocation of the knee.  It is far more common in men than ladies,  and in the age range 20-40 years old

Although the arteries can be damaged, in a lot of cases surgical intervention is not needed and the leg swelling only needs to be observed to ensure it remain fine.  Of those who do have arterial damage, about 13% will need some form of surgical intervention.

The orthopaedic surgeon therefore keeps a very close eye on the blood supply to the leg after such an injury and usually requests a vascular surgeons opinion.  There are a number of investigations which can be  undertaken  such as a Doppler  ultrasound, CT angiogram or MRI.

If vascular surgery is needed, a bypass operation around the damaged vessel  can be considered.  Sometimes it is possible just to tack down the torn area.  Only very rarely (<0/1%) does this result in an amputation at the knee.

If you would like any further information, please email me and I will be able to send you recent clinical papers on this.

www.sydneyinsurancebrokers.com.au/758-2/kneecap-injury-2/

Management of Acute Knee Dislocation before Surgical Intervention


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14/Dec/2018

Peripheral vascular disease or hardening of the leg arteries causes blockages in these vessels. This affects the quality of life of over two million people in the world.  The severity ranges from severe cramping on walking quickly to  leg ulcers and gangrene.

One of the ways to improve the quality of life and reduce the progression of any ulcers or gangrene is to get more blood down to the legs.  This can be done by doing a bypass operation or opening up the blood vessels with an angioplasty, passing a balloon through the narrowing and opening it up.  Unfortunately, often after an angioplasty the blood vessel thickening up and narrowing down again and the symptoms come back.  To stop this narrowing down happening, a stent or spring can be placed into the vessel. A more recent development has been to apply a chemical to the balloon that reduces the the re-narrowing occurring  (that is intimal hyperplasia).

There are now several studies that show that, if the angioplasty balloon is coated with a chemical that can reduce this happening, the lumen of the blood vessel remains open for much longer.  With this new development gradually being introduced into the  day-to-day management of peripheral vascular disease, there is great optimism that the millions of people who suffer from it will be able to walk further and are less likely to develop gangrene.  A nice review article on this has recently been published and can be obtained free by clicking here. Alternatively if you are concerned please consult a specialist.


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14/Dec/2018

Heart disease is one of the leading causes of death. It is vital we adopt healthy habits to keep our vascular system healthy to help protect our heart and keep it strong.

Some simple lifestyle changes can go a long way in maintaining good vascular health. Take a look at the following five ways to keep your vascular system healthy.

1- Get active

One of the most effective ways to improve our vascular systems is to take regular exercise. Make it your goal to get a minimum of 30 minutes of exercise most days of the week to get the blood circulating round the body and the heart pumping.

Regular exercise such as walking or jogging helps improve the circulation in your legs, promoting the growth of new blood vessels.

2- Have a healthy, well-balanced diet

Replace sugary or fatty snacks with healthier options like pieces of fruit. Opt for fresh food instead of processed meals that loaded with salt. Eat the recommended five portions of fruit and veg each day and regularly consume oily fish.

3- Stop smoking

It’s never too late to stop smoking, which is a major cause of cardiovascular disease and causes approximately one in every four deaths. Giving up smoking is one of the best things you can do to improve your vascular health and keep your circulatory system and heart healthy.

4- Maintain a healthy weight

Being overweight significantly increases your risk of stroke, diabetes and heart disease. Losing even a little weight and maintaining a healthy weight can greatly improve your vascular health, give your heart function a boost, improve metabolism and lower blood pressure.

5- Keep iron levels balanced

Iron is a vital mineral for our circulatory system as it is needed to make haemoglobin, a primary component of red blood cells, which is required to carry oxygen. Consuming foods that are rich in iron such as spinach and red meat, can help our bodies have the iron they need. However, it is important not to consume too much iron, which can have a negative impact on the cardiovascular system.

It is advisable to talk to a doctor before you start taking iron supplements or embark on an iron-rich diet.

If you have concerns about vein disorders and would like to talk to a specialist in vascular health, get in contact with the Vascular Consultancy.


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14/Dec/2018

The common surmise that it’s only older people who suffer from varicose veins and spider veins bares little truth. Granted, age is a factor in the onset of varicose veins but whilst the risk increases after the age of 50, young people can get varicose veins as well.

One of the principle causes of varicose veins is hereditary. When this common condition is caused by hereditary, it can affect young adults and even teenagers.

Pregnancy is another leading cause of varicose veins, as is the use of birth control pills, obesity and hormonal imbalances during puberty and the menopause.

With this unsightly condition affecting all ages, treatment for varicose veins is not confined to older people.

It could be argued that treating varicose veins in younger patients is more effective, as younger skin is less disposed to scarring than more mature skin and healing rates are increased with younger patients.

Like with any condition, the sooner varicose veins are treated, the better.

If you are worried about varicose veins regardless of your age, speak to a vascular expert about the different treatment options available to you and which treatment is likely to be the best for the severity of your varicose veins.

Effective treatment for varicose veins include:

* Varicose vein surgery

* Endovenous laser

* Radiofrequency ablation

* Varicose vein avulsions

* Non-surgical treatments including compression stockings and the use of horse chestnut extracts

Help prevent varicose veins

Whilst varicose veins caused by hereditary is usually unavoidable, there are several lifestyle changes people of all ages can make to help avoid the onset of this common condition. These steps include:

* Getting regular exercise

* Watching your weight

* Losing weight

* Avoid wearing high heels

* Elevating your legs

* Avoid standing or sitting for long periods

If you would like to discuss varicose veins and the different forms of treatment for the condition, get in touch with the Vascular Consultancy, specialists in vascular health and providing effective treatment for vascular conditions including varicose veins.


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14/Dec/2018

Thread veins are tiny red and purple blood vessels that appear on the surface of the skin, predominantly on the face and legs. Resembling small spider webs, thread veins are also known as spider veins. Medically, the condition is referred to as Telangiectasias.

Several factors contribute to the onset of thread veins, including age, poor blood circulation, heredity, birth control pills, a history of blood clots, obesity, standing or sitting for long periods, hormonal fluctuations, and exposure to ultraviolet rays.

Whilst there is no ‘magic cure’ for eliminating thread veins, there are certain steps we can take to improve the appearance of these undesirable and pesky little veins.

Eat plenty of ginger

Ginger is well-known for improving the blood circulation and thereby giving the health of our veins a boost. Ginger also helps break up the blood protein fibrin, which congregates and builds up around less well-functioning veins. If you are taking medication for blood pressure, it is important to seek medical advice before taking supplementary ginger.

Enjoy a regular message

Now you’ve got an excuse to be regularly messaged! Message is one of the simplest ways to improve the circulation of the blood, which can help reduce inflammation and pain and if you suffer from thread veins, can improve their appearance.

Take regular exercise

Exercise is paramount to improving the blood circulation in our bodies, which is a leading cause of thread veins, particularly on the legs. Exercise gets the heart pumping blood around the body, improving circulation and giving the veins strength and support. Carrying out sensible amounts of exercise regularly, can make a notable difference to the appearance of thread veins.

Moderate exercise several times a week helps avert weight gain and obesity, preventing the onset of more serious venous conditions.

Elevate your legs

If you suffer from thread veins on your legs, one way to help reduce the severity of these tiny, unwanted veins is to elevate your legs regularly, to improve the circulation of blood to the affected areas and relieve the pressure in the veins.

Get your thread veins treated

If you are really concerned with the appearance of thread veins on your face or body, you could investigate having them medically treated, through micro-sclerotherapy or skin laser.

The Vascular Consultancy offers treatment for thread veins and other common vascular conditions. Contact the Vascular Consultancy to book an initial consultation about having thread veins medically treated.


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14/Dec/2018

Varicose veins, they’re just niggly veins that appear as we get older, which look unsightly but don’t do us any harm, right? Wrong! Whilst varicose veins can lead to nothing more than cosmetic concerns, for some patients, when left untreated, these unsightly blemishes under the skin can lead to several serious medical conditions.

Take a look at the following four reasons why you should never lead varicose veins untreated.

Venous leg ulcers

A venous leg ulcer can develop if there is an issue with the circulation of blood in the veins of the legs. As the NHS notes, people with varicose veins caused by malfunctioning valves, are amongst those most at risk from developing a venous leg ulcer. Symptoms of a venous leg ulcer include itching, pain and swelling in the affected leg.

Hyperpigmentation

Untreated varicose veins can lead to a condition known as hyperpigmentation. Hyperpigmentation is the darkening of the and discolouration of the skin, which can be caused by excess blood leaking into the tissues of the leg because of untreated varicose veins.

Lipodermatosclerosis

Lipodermatosclerosis refers a condition whereby the tissues in the legs stiffen and harden. This condition is believed to be caused by venous disease, such as venous hypertension and incompetence, as well as obesity. Someone suffering from lipodermatosclerosis can feel as if their legs are becoming progressively tender, making movement increasingly more difficult.

Deep Vein Thrombosis

Deep Vein Thrombosis (DVT) is condition to describe blood clots that develop in the veins. DVT typically occurs in a deep leg vein, or a larger vein, which runs through the muscles in the thigh and calf. DVT can cause swelling and pain and can potentially lead to other complications, such as pulmonary embolism and if the condition is left untreated, it can be life-threatening.

Treating varicose veins

There is a number of ways to treat varicose veins, depending on the severity of the condition. Treatment includes varicose vein surgery, radiofrequency ablation, endovenous laser, varicose vein avulsions, sclerotherapy and non-surgical treatment, such as using compression stockings.

Acting sooner rather than later can minimise the pain and discomfort caused by varicose veins and can help prevent more serious conditions from manifesting due to varicose veins being left untreated. To discuss the different kinds of treatment for varicose veins and which would be right for you, get in touch with the vascular health experts at the Vascular Consultancy.


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Daryll Baker is a Consultant Vascular Surgeon at the Royal Free Hospital London and Clinical Lead for North Central Region Vascular Services.

He read Medicine at Oxford University and trained in Vascular Surgery in Nottingham, London and Edinburgh. He obtained his research PhD from the University of Wales.

Contact

Wellington Hospital
34 Circus Road
London
NW8 9SG

020 7722 7370

Copyright 2016 The Vascular Consultancy