Varicose Vein Treatments

 

In the last ten years, the treatment of varicose veins has been revolutionised by the use of ultrasound to accurately assess and diagnose the abnormal structure and function which causes varicose veins in each individual patient. Once the cause has been identified we can plan the best treatment for you.

Our decision will include considerations of your past medical and surgical history, general health, lifestyle, work commitments and the aims of treatment.

It is important that we are realistic about what is likely to be achieved by varicose vein treatment, and I will take time to explain what your treatment involves and what we can expect from it.

Traditional varicose vein surgery

Usually requires a general anaesthetic, with incision at the groin and “stripping” of the main superficial vein in the thigh, along with multiple small incisions (stab avulsions, also called phlebectomy) to remove most of the large lumpy veins.


This is usually a one session treatment which may still be the best option for some patients with widespread lumpy veins. The need for general anaesthesia and groin incision tends to delay return to normal activities.

 

Options available:

Endovenous Laser Treatment (EVLT)

Usually done  in an operating theatre with local anaesthetic, no groin incision is needed and the main superficial vein in the thigh is treated with laser generated heat, sealing the vein and taking the pressure off the large lumpy veins. EVLT can be combined with other treatments e.g. phlebectomy  or foam sclerotherapy.


This is usually a one session treatment, but can be supplemented with phlebectomy or with foam sclerotherapy to allow treatment of extensive varicose veins over a few sessions . The use of local anaesthetic and avoidance of groin incision allows earlier return to normal activities.

 

Radiofrequency Ablation (RFA or VNUS Closure)

As with EVLT usually done under local anaesthetic in the operating theatre, but uses radio-frequency generated heat to seal the treated vein and take pressure off large lumpy veins. This can be combined with other treatments e.g. phlebectomy or foam sclerotherapy.


This is usually a one session treatment, but can be supplemented with phlebectomy, or with foam sclerotherapy to allow treatment of extensive varicose veins over a few sessions . Reports and experience suggests that RFA treatments may be associated with less thigh discomfort than laser ablation. The use of local anaesthetic and avoidance of groin incision allows earlier return to normal activities.

 

Ultrasound-guided foam sclerotherapy (UGFS)

For patients where foam sclerotherapy is the main treatment, the procedure is done under local anaesthetic in the consulting suite or treatment room. A small amount of sclerosant solution is mixed with air to create a foam, which is carefully injected into the veins identified as “feeding” the lumpy veins, using ultrasound guidance. The foam tends to remain in contact with the lining of the veins much longer than the same sclerosant in liquid form, improving the effectiveness of sclerotherapy.

Except for the need to wear dressings and a stocking, (sometimes with bandaging) patients can get back to most normal activities very soon. UGFS is particularly useful in patients with recurrent varicose veins.


This is a simple out-patient treatment which allows for rapid return to normal activities. This treatment can be particularly useful for patients with recurrent varicose veins. The treated veins can take several weeks to settle before the full benefit of is seen.

Clarivein


A new & potentially exciting technique which combines the benefits of UGFS with some features of the catheter-based techniques (EVLT & RFA), but can be done in the Consulting Suite, without the need for a laser-safe or theatre environment.


This treatment allows early return to normal activities, and can be quickly performed in the out-patient setting .

VenaCure EVLT™ is a Registered Trade Mark  of Angiodynamics 
VNUS Closureand Venefit™ are Registered Trade Marks of Covidien
ClariVein® is a Registered Trade Mark of Vascular Insights