New Techniques
Treatments For Large Varicose Veins
Modern Vein Treatments
New ways to treat varicose veins.
Surgical treatment used to be the only way to treat varicose veins. This is done under general anaesthesia and requires a week off work for recovery. In the last few years minimally invasive treatments have largely replaced surgery. These can be performed under local anaesthetic followed by a swift return to normal activity. The Vein Clinic now offers modern methods of treatment to all patients.
Minimally invasive treatments.
These treatments are carried out in a consulting room or treatment room under local anaesthetic. More than one session is usually required to complete the treatment. Afterwards you can walk away and continue most activities as usual. Little or no time is required away from work.
EVLT (endo venous laser ablation) and VNUS Closure (RF ablation)
VNUS Closure uses a wire passed along the vein from the knee or calf towards the groin to treat large varicose veins in the thigh. The progress of the wire is monitored using ultrasound imaging. When the wire is in position the end of the catheter is heated electrically and the vein is destroyed. Gradually the wire is removed from the leg until all of the diseased vein is destroyed. During EVLT a laser fibre is passed along the vein and used to heat the vein in order to destroy it. Lots of local anaesthetic solution is injected around the vein before heat is applied during laser and VNUS treatments.
Good Points
- Stripping of the vein is avoided and there is less discomfort and bruising after the operation.
- This treatment is usually done with local anaesthetic so general anaesthesia is avoided.
Bad Points
- These methods can only be used to treat the major superficial veins. Prominent varicose veins need surgical treatment or can be managed by foam sclerotherapy.
- VNUS Closure is generally unsuitable for the treatment of recurrent varicose veins following previous surgery.
- Thermal damage to nerves in the skin may occur due to the heating effects of the treatment.
Ultrasound Guided Foam Sclerotherapy
This method is used as an alternative to surgery for large varicose veins. The main surface is vein is injected with a special foam under ultrasound guidance. The foam destroys the lining of the vein and a firm bandage is applied to the leg. This type of injection is suitable for treating the main surface veins as well as varicose veins. The procedure does not require an operating theatre and is usually carried out in a consulting room or treatment room. The injection causes only trivial discomfort.
Good Points
- Stripping of the vein is avoided and there is little or no discomfort after treatment.
- There is less bruising than following surgery.
- There is no need for general anaesthetic, incisions in the leg or an operating theatre.
- Re-treatment for further varices is simple.
- The cost of treatment is much less than for surgical treatment or for either VNUS Closure or Laser treatment.
Bad Points
- Some bruising and lumps remain after treatment but these resolve slowly over several weeks. An excellent final result can be expected.
- Occasionally phlebitis may affect some of the treated veins.
Creams and Pills
A range of creams to rub on thread veins and pills to treat vein problems is advertised from a number of sources.
Good Points
- Some of the pills may reduce aching from varicose veins.
Bad Points
- No medication of any type removes varicose veins – whatever the suppliers may say!
Laser Treatment for Thread Veins
- This works well on the face and upper body. In the legs it is much less effective than injection treatment. The world’s leading vein experts do not use lasers in the management of thread veins on the legs.
Conclusions
There are no magic treatments for varicose veins! Surgical treatment has been largely replaced in our practice by EVLT and VNUS Closure techniques combined with foam sclerotherapy.
Microsclerotherapy is the best available treatment for thread veins and small varices. VNUS Closure and Laser Treatment are alternatives for large varicose veins. These methods reduce the extent of incisions made in the legs as well as post-operative bruising. They are more expensive than surgical treatment.
Ultrasound guided foam sclerotherapy is useful in patients who wish to avoid surgery altogether. The final outcome will take a little longer to achieve but admission to hospital and general anaesthesia are not needed. This is very inexpensive compared to surgery. Lasting freedom from varicose veins can be expected when this treatment is done in expert hands.
Several of the new methods are available in the Vein Clinic. Please ask for details.