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AstraZeneca vaccine and varicose veins

by – April 15, 2021

Ever since the first concerns about blood clots after the AstraZeneca Covid vaccine were raised in the news, we have had increasing numbers of telephone calls and e-mails from concerned patients.

The main concerns seem to be:

  • Does the risk of blood clots increase if I have varicose veins and the AstraZeneca vaccine?
  • Can I go ahead with my varicose vein treatment after the AstraZeneca vaccine?

We will look at each of these in turn:

Does the risk of blood clots increase if I have varicose veins and the AstraZeneca vaccine?

Having varicose veins increases the risk of clots in the leg veins. Blood clots can occur in veins if one or more of the following factors occur:

  • the blood constituents change
  • the blood flow changes
  • the vein wall changes

In varicose veins, there are 2 of these factors. Blood flow changes because blood falls back down the incompetent veins, a process called “venous reflux”. Also, the vein wall stretches because of this reverse blood flow. Therefore, there are two good reasons why blood can clot in varicose veins.

When this happens, it is called “superficial venous thrombosis”. However, it is more commonly known as “phlebitis“. This is because the clot makes the veins inflamed – they go hot, hard, tender and red.

Because of this inflammation, many doctors erroneously give antibiotics that have no effect. The proper treatment is to have a duplex ultrasound scan to see the extent of the clot. If it is near a deep vein and potentially going into the deep vein, the patient needs anticoagulation. If, however, the clot is away from the deep vein, then pain relief and support stockings are needed.

Therefore, one of the reasons we treat varicose veins with the new endovenous techniques under local anaesthetic is to stop superficial venous thrombosis (“phlebitis”).

In the millions of doses given, there has been no significant rise in the numbers of patients developing superficial venous thrombosis (“phlebitis”) in varicose veins.

As such, the current advice is that if you have varicose veins, there appears to be no increased risk of thrombosis in your varicose veins by having the AstraZeneca vaccine.

Can I go ahead with my varicose vein treatment after the AstraZeneca vaccine?

Following on from the important points above, the answer is “yes”.

The reason is that there is a significant risk of developing clots in varicose veins if you do not have them treated. As the risk of getting clots in varicose veins after the AstraZeneca vaccine has been shown to be insignificant, the biggest risk of getting superficial venous thrombosis (“phlebitis”) or clots in the varicose veins is by leaving the varicose veins untreated.

Therefore, if you wish to reduce the risk of getting clots in varicose veins, the simplest way is to have them treated by local anaesthetic endovenous surgery. If the varicose veins have been totally ablated, as they are in The Whiteley Protocol, then the blood flow goes back to normal and there is no abnormal vein wall left. Hence, after successful treatment, there is virtually no risk of developing superficial venous thrombosis (“phlebitis”).

One caveat to this is that if the veins are treated using old-fashioned techniques such as stripping, or under a general anaesthetic, the risks of deep-vein thrombosis (DVT) are higher. As such we would not recommend this. All the patients treated at The Whiteley Clinic are treated as walk-in, walk-out patients treated under local anaesthetic only. This keeps the risk of deep-vein thrombosis (DVT) or other clots to a minimum during any surgical procedure.

So, in answer to the question above, if you have varicose veins the sooner they are treated the lower the risk of getting clots in the leg veins (provided the treatment is walk-in, walk-out and under local anaesthetic). Delaying treatment because of worries of the risks of AstraZeneca vaccine are more likely to cause a problem than having the AstraZeneca vaccine and the varicose veins treated.

In conclusion:

The very rare but severe blood clots that have been associated with the AstraZeneca vaccine seem to occur predominantly in younger women and the blood clot is in the head veins around the brain.

It appears that these patients seem to get these clots even with low platelets suggesting that it may be a response of the immune system to the vaccine.

However, with regards to leg varicose veins there has been no reported link of any increased risk of clotting. Leaving the veins untreated naturally increases the risk of clots. As such the optimal way to reduce clots is to get the varicose veins treated by local anaesthetic walk-in, walk-out techniques as soon as possible regardless of having the AstraZeneca vaccine or not.

We hope that this information is useful to patients who are concerned about their varicose veins or varicose vein treatments. However, we are always happy to answer any other questions about varicose veins, leg ulcers, pelvic congestion syndrome, thread veins and the AstraZeneca vaccine.

Links of interest:

Oxford-AstraZeneca vaccine: What to know about side effects

AstraZeneca vaccine: Denmark stops rollout completely

Please note: the information given in this article was accurate by the available research data that has been published up to 15 April 2021, the date it was written. If there are significant changes, this article will be updated.

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