Who should have treatment?
Varicose veins can be an inherited condition due to weaknesses in the vein wall or valves. Other factors which can bring the condition on include pregnancy and being overweight. Although commonly thought to be a cause of varicose veins, occupations involving long periods of standing do not tend to cause the condition, but can aggravate the symptoms.
Not all patients with varicose veins will need treatment. Adjusting one’s lifestyle by losing weight, as well as wearing support tights or elastic stockings and trying to avoid long spells of standing, can help to alleviate aching symptoms, although these will not cure the underlying problem. In order to improve appearance, alleviate symptoms, treat developing skin changes and ultimately to prevent or aid in the management of venous ulcers, more definitive, surgical treatments must be carried out.
Below, we have listed some of the most common techniques for treating and removing varicose veins.
Ligation and Stripping
It is well known that traditional methods used to treat varicose veins can often cause discomfort. Surgery normally consists either of saphenofemoral ligation (where a cut is made at the top of the groin above the main varicose vein) or short saphenous ligation, with or without stripping, and phlebectomies (removal of the vein). Alternatively, varicose veins can be treated by sclerotherapy, an injection treatment which shrinks the blood vessel, although this has been associated with a high recurrence rate.
Recently, however, there has been widespread use of the less invasive duplex ultrasound to assess the deep and superficial venous systems, allowing treatment to be much more focussed, as well as reducing the likelihood of trauma. The Duplex Ultrasound machine works by assessing the direction and speed of blood flow, whilst producing a direct ultrasound picture of the enlarged veins on a screen. This allows the specialist to map the distribution of veins.
Compression stockings are specially designed to apply pressure to your legs to improve your circulation. They work by encouraging the blood to flow upwards towards your heart by being tighter at the ankle and progressively looser towards the thigh.
Radiofrequency ablation is carried out under local anaesthetic and uses radiofrequency energy to heat the wall of the vein, which is reached by a small cut above the knee. A catheter with a probe to send out the radiofrequency energy is then inserted into the vein using an ultrasound scan. As the energy is emitted, the walls of the vein begin to collapse, resulting in a complete closure and seal of the vein. The blood then reroutes naturally to a healthy vein in the area. After the varicose veins treatment is completed, patients may have to wear for compression stockings for several weeks.
Endovenous laser treatment
Endovenous laser treatment uses a catheter which is inserted into the top of the vein. A laser is then beamed down the vein and delivers quick releases of energy which heat up the vein and seal it closed. The laser is gradually moved down the vein using an ultrasound scan in order to close the whole length of the vein.
Transilluminated Powered Phlebectomy
Transilluminated powered phlebectomy involves the surgeon making small incisions in the leg, in order to insert a special light (an endoscopic transilluminator) underneath the skin to identify which varicose veins require removal. Once detected, the affected veins are cut and then removed through the incisions using a suction device.
Ashtead Hospital is one of Surrey’s leading private hospitals with an excellent reputation for delivering high quality healthcare for self pay/insured and NHS patients.