All information on this page is supplied by our partner, provider of the treatment, The Vein Centre.
What are Varicose Veins?
Varicose veins are twisty, bulging veins on the legs caused by an increase in the normal venous pressure. They tend to get larger and uglier with time and are normally uncomfortable typically causing tired legs, itching, throbbing, restlessness and aching. They can bleed, especially in the elderly, after relatively minor trauma. The increased pressure often causes skin damage and in many patients actual ulceration of the skin occurs which takes months to heal without appropriate treatment.
Varicose Veins can also appear elsewhere in the body. In the scrotum, for example, they cause a “bag of worms” swelling called a varicocoele which can be painful and reduce fertility. In the female pelvis they are responsible for much undiagnosed pelvic pain, as well as obvious vulval and clitoral varices. Both these types of varices can be easily treated by an outpatient technique called embolisation.
How can varicose veins be treated?
The main difference in technique between our minimally invasive treatments and surgery is that in the latter the main superficial vein (great saphenous) is stripped out and removed altogether whereas in our methods the vein is totally destroyed ‘in-situ’ (where it lies). The outcome is the same but the destruction of a vein can be achieved very much more easily than its removal.
MINIMALLY INVASIVE TECHNIQUES
There are two main techniques (RF ablation (VNUS Closure®) and Laser Ablation (EVLA or EVLT)) both of which have been extensively studied and been shown to be both safe and effective and to produce very encouraging results, even for difficult recurrent varicose veins.
Why should I treat my Varicose Veins?
There are three main reasons not to ignore varicose veins and to get the underlying problem which is causing the increased pressure treated:
- Varicose veins are unattractive. Many people are seriously affected by the looks of their veins. They will not show their legs in public and indeed often even to their partner. This has an adverse effect on sport participation and enjoyment of holidays and other leisure activities. In some it can affect their careers and we have seen many actors and models (both sexes!) who "needed" their legs to look better. Most patients are delighted with the appearance of their legs after our treatments.
- Varicose veins hurt. As mentioned above it isnt actually the varicose veins that normally cause the symptoms but the increased pressure. Nevertheless most patients with varicose veins suffer from various symptoms which can also affect lifestyle. Common symptoms are tired legs, itchiness, throbbing, restless legs, and aching. These symptoms usually resolve very quickly after EVLA and RFA.
- Varicose veins can lead to serious skin damage and ulcers. Although most patients with varicose veins don't get ulceration, most leg ulcers are associated with varicose veins and caused by the same problem that causes varicose veins. Treating the varicose veins properly removes this cause and dramatically reduces the risk of leg ulcers.
What happens during the procedure?
Both techniques, EVLA and RFA, rely on accurate preop mapping of anatomy and blood flow by colour duplex ultrasound and use of ultrasound to guide the instruments during the procedure.
A full explanation of the treatment options, including potential complications and success rates, will have be given at your initial consultation. You will have been asked to sign to give your consent to the proposed treatment. You will be introduced to the nurse who will be at your side throughout the procedure, which will take place in a small treatment room. Music of your choice will be available. You can bring your own music on an MP3 player if you wish.
You lie down on a couch with head up slightly, the skin over your leg is cleaned with antiseptic solution and sterile drapes placed over your leg. A small injection of local anaesthesia will be given to numb the skin over the inside of your knee. A small sheath (thin walled plastic tube) is inserted into the vein to be destroyed usually just below the knee. Using an ultrasound image to guide the instruments the doctor then places a laser fibre or the RF catheter through the sheath and up to the vein in the groin. Local anaesthetic solution is then carefully injected around the vein along its whole length. The power is then turned on and the fibre or catheter slowly withdrawn. Once the length of the vein has been treated the sheath is withdrawn, a compression stocking will be applied and after a cup of tea you are allowed to leave, take a fifteen minute walk and get back to normal activities.
What are the side effects or risks?
Very few complications have been described. Potential problems include deep vein thrombosis, deep vein trauma, skin burns, nerve injuries and laser eye injuries. In practice these are all very rare, or have never yet been reported.
A problem common to all interventional radiological procedures is that occasionally it proves impossible to get access to the vein and the procedure needs to be cancelled and rescheduled. This is a nuisance but no lasting damage will have been done. As this is very unlikely in our hands (no such need in last 500 cases) you would not be charged for the repeat procedure.
You will have to keep your stocking on for one week in total. You may take a bath after three days and then every day. Let us know if you want to order more than one stocking per leg. Many patients find a second pair of stockings helpful.