Modern Vein Treatments
Providing the Right Treatment for your Varicose Veins
Varicose veins and thread veins The first thing is to seek the advice of a specialist in vein treatments. He will usually examine your legs clinically and undertake colour duplex ultrasound examination.
In patients with thread veins and little blue veins on the surface of the leg, injection treatment (microsclerotherapy) is probably the best solution.When there are big veins on the surface of the leg which stick out when you stand up, surgical treatment or one of the newer varicose vein treatments is required.
These are little pink veins in the skin which often come with small blue veins beneath. The best thing for this type of veins is injection treatment (microsclerotherapy) aimed at the thread veins. This type of vein is sometimes treated by lasers, but this does not work as well as injections and is also more painful. Creams and other preparations rubbed on the skin make no difference to this type of vein.
Treatment of varicose veins Large varicose veins of this type have traditionally been treated by surgery. More recently, a number of new methods have been described. These include ultrasuond guided foam sclerotherapy which destroys veins by a chemical method. There are several thermal ablation techniques in which the veins are heated to destroy them. The most commonly used thermal methods are endovenous laser ablation and radiofrequency ablation. In general our patients prefer minimally invasive techniques.
Available Treatments for Large Varicose Veins
Surgical treatment of varicose veins Varicose vein surgery is done in hospital, usually under a general anaesthetic. When you wake up, the veins are gone! Afterwards the legs are usually bruised and uncomfortable. This takes 2 – 6 weeks to resolve.
Modern surgery for varicose veins is done through small incisions so only very small scars remain, and these fade with time. It is usually necessary to be off work for 1 – 2 weeks after an operation for varicose veins. Medical insurance companies usually cover this type of treatment if it is done for varicose veins causing symptoms. This treatment is most appropriate for large, extensive varicose veins but can be used in any type of varicose veins.
Vein ablation treatments are done in hospital and can be performed under local or general anaesthesia. A fine catheter is inserted into the main surface vein through a needle. The vein is then heated to destroy it. Afterwards any varicose veins are removed through small incisions made in the leg, in the same way as would be done during surgical treatment. After the treatment is complete there is still a little bruising but far less than after surgery. The treated leg is much more comfortable and normal activities can be resumed within a day or two. Medical insurance companies usually cover this type of treatment if it is done for varicose veins causing symptoms. Vein ablation is most appropriate for both large, extensive varicose veins as well as more modest varices.
Ultrasound guided foam sclerotherapy of varicose veins Ultrasound guided foam sclerotherapy can be done in the clinic and requires no anaesthesia since it causes only minor discomfort. Injections of foam are made under the guidance of an ultrasound machine which shows the location of the main varicose veins. At the end of the treatment, a firm bandage is applied to the leg. No time off work is required and most activities can be resumed immediately. After the completion of treatment, some lumps and bruising remain and these can take several months to disappear.
Medical insurance companies usually cover this type of treatment if it is done for varicose veins causing symptoms. Foam sclerotherapy is most appropriate for all types of varicose veins but is best for small or modest varicose veins. It is especially useful in people who have previously had varicose vein surgery or who have medical reasons for avoiding any treatment under general anaesthetic.
Which treatment is best?
We offer our patients any treatment they prefer, however, most opt for the less invasive treatments. Ultrasound guided foam sclerotherapy can be completed in one session of 30 minutes for each leg using a little local anaesthetic with almost no discomfort. This is the most popular treatment and is undertaken in the consulting room or clinic. RF ablation and laser ablation are popular but take a little longer to complete. These are a little more technically complex and we usually perform these procedures in a treatment room. These treatments need much more local anaesthetic. Surgical treatment is much less popular these days since it necessitates a general anaesthetic during a day case admission to hospital. The recovery period is longer following this treatment since it causes more bruising and discomfort than any of the other treatments. The main point is that a skilled Vein Specialist will achieve an excellent outcome using any of these treatments. The available published scienttific information suggests that the long term outlook is very similar from all of these teratments.
In summary, for large varicose veins all of these treatments work well and the final outcome will be the same. Minimally invasive treatments preferred by most patients require the least time away from work and normal activities. However, these treatments leave the veins in the leg where they are slowly absorbed and the time taken to get to the final outcome is usually longer than for surgical treatment where the veins are removed. Minimally invasive treatments often leave some bruises and lumps in the leg which take several weeks to resolve completely. Surgery causes bruising which resolves in 4-6 weeks but also leaves some tiny scars which can take several months to disappear.