Dr. Russ





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Varicose veins


Spider-burst (Capillaries)

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Spider-burst (Capillaries)

Spider-bursts in the legs are a specific form of varicose veins. Cosmetically they may be very disturbing for the patient, and are not easy to treat. The patient develops bunches of “black-and-blue marks”, for instance, in the external aspect of the thigh, with “flames” extending upward, or stellate and fan-shaped enlarged capillaries.

In one third of cases the ultrasound investigation provides no further information. However, in two thirds of cases one finds marked feeding veins. Bunches of spider-bursts adhere to these veins like the tuft at the end of a lion’s tail. Spider-bursts in the inner aspect of the knee may be the first sign of varicose veins arising from the groin. The treatment usually consists of three steps. First, the larger afferent veins must be removed surgically. As a rule this is done on an out-patient basis, using local anaesthesia. Quite often, microsurgery by the hook technique is sufficient. The second step concerns very small afferent veins. These are eliminated, or sclerosed, by injection. The patient needs to wear a compression bandage for two days.  
Click: Spider-burst / Capillaries
Click: Spider-burst / Capillaries
  The third and final step concerns the spider-burst itself. In the past one used sclerosing injections for this purpose as well. The procedure was occasionally successful and failed now and then. Besides, the risk was that some of the injected substance would miss the target and the patient would develop persistent brown spots on the leg. Spider-bursts can be eliminated in a much better way by means of Neodym YAG-LASER: the application of a specific wavelength of light causes the laser ray to deliver its energy mainly to the red blood cells and, by this detour, damages the adjoining wall of the extended capillaries. Warmth, carefully dosed and exactly applied in a specific location, solders the spider-burst.

It is important to know that laser impulses are perceived as pinpricks. Browned or tanned skin is not sufficiently transparent and is therefore a hindrance to laser treatment.

In general, Laser treatment is a tightrope walk between insufficient application and burns. Even when used carefully, small fissures may occur in some cases, but heal within a few weeks without leaving any traces.

The course of treatment for a spider-burst

Click: Spider-burst treatment 1
Click: Spider-burst treatment 2
Click: Spider-burst treatment 3
Click: Spider-burst treatment 4
1.) Spider-burst at the initial examination
2.) Typical reddening immediately after the laser treatment
3.) A few days later the laser-treated spider-burst might be more noticeable than it was before the treatment
4.) Preliminary result after about 3 months

Laser treatment is a means of removing any blood flow through spider-bursts. However, the fine walls of the vessels remain in the skin – like shadows of the original condition. Therefore, one should rightly anticipate an improvement of about 50% as far as the success of treatment is concerned. With additional treatment at intervals of 1 to 2 years, however, one may expect nearly complete cure of the condition over a longer period of time.

Dr. Russ © 2014