Mon - Fri 9am-4pm (WA Vascular Centre)

Author: troppusadmin

February 2, 2023

VARICOSE VEINS & SURFACE VEINS (or “Spider Veins”) ARE NOT THE SAME!

Surface Veins

Telangiectasia (Reticular veins) or Spider veins, these are small capillaries which twist and turn and are visible under the skin. Either type can be either bluish/purple or red in colour. They usually form distinct networks or webs – the larger are termed Telangiectasia, and if very tiny- are often termed Spider Veins:

  • most often predominately of cosmetic importance
  • usually harmless, but can cause localised discomfort
  • Diagnostic Duplex scans are required as overall, at least 20% of these “surface veins” – telangiectasia – (the larger veins – 88% * ) or – less commonly with spider veins, have underlying deeper varicose, not always visible. (* ref: Ruckley, C. V.; Allan, P. L.; Evans, C. J.; Lee, A. J.; Fowkes, F. G. R. (2011). “Telangiectasia and venous reflux in the Edinburgh Vein Study”. Phlebology 27

Thus, Duplex Ultrasound scanning, is necessary before planning to treat surface veins. as if any existing larger underlying varicose veins are treated first, most of the overlying telangiectasia , and, less commonly spider veins, may disappear. following Duplex/Visual Guided Sclerotherapy.

If, however, the superficial telangiectasia or spider veins are treated first, they will inevitably return or even increase in severity.

However, both telangiectasias and especially spider veins, do not respond very well and often not to the patient’s expectations and have an increased tendency to recur or worsen to an appreciably greater extent, than may be inherent for the larger conventional varicose veins, and surface veins may require ongoing future treatments to control.

Treatment of Surface Veins

  • Sclerotherapy
  • Laser for Surface Veins
    Laser treatment is often less effective than sclerotherapy, particularly in comparison with treatment for telangiectasia or reticular larger surface veins.

Subsequent to laser treatment, there may be some redness, bruising, itching, swelling and there may also be permanent skin tone changes.

August 21, 2019

Scans can be done at all sites.  All your information will be on file as a patient of Dr Then’s.  Most of the scans take from 45 minutes to 120 minutes. If it will be longer our staff will advise you at the time of making your appointment.

All of our vascular ultrasounds are non invasive and external and these scans records images and diameters of your internal organs.

More Information Coming Soon.
August 21, 2019

More information coming soon.

August 21, 2019


Dr Then carries out different procedures that can effectively reduce the various veins if they are detrimental to your health. Varicose veins are usually a medical condition that affects the smaller veins in the body therby causing them to be seen superficially. Varicose veins are most common on the legs and feet although they can occur anywhere on the body.

What Are Varicose Veins?

Varicose Veins

Varicose veins are dilated blood vessels which are abnormally prominent, often tortuous and bulging. They have a red or bluish colour and vary in size from barely visible surface veins, to large varicose veins. These veins can become unsightly and may produce a dull aching or burning sensation of the legs after prolonged standing, which can, in many cases be quite severe.

The leg veins normally have one-way valves in them so that when the muscles contract and squeeze the veins, the blood can only go one way, and that is up the leg, in normal veins. In varicose veins the valves are not functioning properly (which is usually inherited [familial], and much less frequently following damage to the valves by trauma), so that, in these veins, in the upright position, gravity causes blood to reflux and accumulate in the legs.

This causes increased pressure within the varicose veins, which causes further stretching of the walls of the veins, (as well as fluid to collect in the lower leg,) which produces pain, and causes nearby normal valves to also stretch and not function, which, in turn, causes the varicose veins to continually worsen.

This incompetence of the valves in the veins commonly affects the superficial or saphenous veins (just deep to the skin) which are not essential for the blood to circulate properly in the legs, much more frequently than the deep veins (which are the most important), within the muscles in the legs.

As these varicose veins are abnormal and in fact allow the blood to flow in the wrong direction down the leg (instead of directing blood flow up the leg), the swelling and aching of the legs is worse at the end of the day and in fact is found in at least half of the adult female population (and 20% of men), who have this common problem.

Generally varicose veins are not dangerous but may cause the following problems;

  • The cosmetic appearance may cause embarrassment when the legs are exposed.
  • Painful symptoms such as dull throbbing, heaviness and tiredness, aching pain, cramping, burning, itching or restless leg syndrome may occur. However, these symptoms may also be due to other conditions, and not necessarily associated to the varicose veins.
  • Skin changes of bluish discolouration, discomfort of warmth, itchiness and varicose eczema, and pigmentation (due to haemosiderin from extravasated red blood cells) may occur. In severe cases the tissues underlying the skin can become damaged, pigmented and woody (lipodermatosclerosis). In a small number of cases, the skin may break down causing long standing, difficult to heal varicose ulcers.
  • Bleeding may occur not uncommonly, especially from very superficial varicose veins and can occur unexpectedly as this may be painless and just due to minor trauma. Blood loss can be considerable unless direct pressure is applied and maintained.
  • Blood clotting may occasionally occur, in the superficial varicose veins themselves, or quite rarely, in the deep veins of the leg, which can cause the potentially serious complications of a deep vein thrombosis.
August 21, 2019

Dr Then treats an extensive number of patients with leg ulcers which may or may not be painful. There may be swelling, redness, dry and scaly skin, brown discoloration or itchy rashes associated with an ulcer.  A leg ulcer is an area that has lost its covering layer of skin so that the tissues underneath the skin are exposed. It begins a result of trauma or an injury to the skin or may appear spontaneously.  Common causes include venous insufficiency, peripheral arterial disease and diabetes. Ulcers that are not healing despite appropriate dressings should be assessed by Dr Then, your vascular surgeon to identify and treat the underlying cause.

More information coming soon.

August 21, 2019

Dr Then treats an extensive number of patients with diabetic foot / feet.  Patients experience changes in their feet as a result of Diabetes. Diabetes can damage important tissues in the foot including skin, nerves and arteries. This damage can lead to reduced sensation, changes in the foot shape and blood flow reduction causing ulcers and infections which if untreated may lead to amputation.

More information coming soon.

August 21, 2019

Dr Then stocks a good range of stockings in his main rooms for patients’ to purchase for use post day procedure and post-surgery.

Please speak to our staff on your requirements and customised fitting. 

More information coming soon.

August 21, 2019

Dr Then can treat anginas with an arterial bypass which involves grafting an artery or vein within the body surgically to relieve a blockage or weaking. The graft allows a higher rate of blood flow to the heart, relieving the patient of angina discomfort.

Angina is the lack of blood flow to the heart muscle (myocardium) causing discomfort for the patient or it can also be experienced as a result of blockage or weakeneing in the arteries. The blockage or weakening needs to be removed or the artery wall strengthened to restore normal blood flow.

More information coming soon.

August 1, 2018

Dr Then carries out angiograms / angioplasties for his patients in hospital.

An angiogram is a minor procedure of the arteries and veins in the body and carried out in the Catheter Lab in hospital. Dye is injected into the vein or artery via the groin or arm. Once the dye has been injected images are taken of the blood flow to analyse abnormalities or blockages. These images are then used to plan further intervention if and when required.

An angioplasty is a procedure of the arteries and veins in the body to improve blood flow. A deflated balloon is inserted through the groin or arm via a catheter. Once the balloon is in place it is inflated several times for a few seconds to open up the vessel and improve the blood flow. This procedure is performed to unblock a vein or an artery which has been blocked by plaque (fatty deposits on the wall of the vessel).

More information coming soon.

August 1, 2018

Dr Then can treat aneurysms surgically where the aneurysm is cut off and the blood vessel is sewn back together to the effect of its original state. An aneurysm is a small extension of an artery or vein within the body. It is a blood filled pocket attached to a vein or artery. An aneurysm can occur as a result of a disease, usually as a defence mechanism, or as a weakening in the blood vessel wall.

More information coming soon.