Treatment options for Varicose Veins

VNUS Radiofrequency for Treatment of Varicose Veins

Innovative VNUS Radiofrequency, Laser and Other Options for Treatment of Varicose Veins

• Treatment options for Varicose Veins

  Broadly speaking, varicose veins can be treated in two main ways:
  • Conservative treatment of varicose veins.
  • Surgical management of varicose veins
  • Traditional open surgery
  • Minimally invasive surgery (Laser EVLT or Radiofrequency VNUS or foam sclerotherapy techniques)

• What are the conservative or medical treatments of varicose veins?

  The main way to help is to reduce the high pressure of the blood in the veins. This will help prevent your veins getting worse and relieve your symptoms. There is nothing that you can do to permanently remove the veins.

  • You can leave varicose veins alone; many people have varicose veins for many years without almost any ill effect. The NHS websites indicate that most varicose veins require no treatment but it goes on to reveal that "varicose veins rarely cause complications".
  • Some people decide to wear support stockings (hosiery) for their varicose veins. Hosiery provides external pressure to the vein and encourages the blood to travel up the leg. It may be helpful if you are unable to avoid standing for long periods of time. Medical compression hosiery is also available in made to measure standards.
  • Exercising regularly causes the muscles in your thigh and calf to contract, which helps the blood move along the vein and up your leg. Walking is a good exercise to help the veins. Sitting or standing for long periods of time puts extra pressure on your veins as the muscles are not contracting as much. Raising your feet when possible uses gravity to drain the blood out of the veins.
  • Losing excess weight reduces the work that your heart has to do which in turn reduces the pressure on your veins and arteries.
  • Look after your skin and prevent excessive dryness by using water based creams such as E45. Only moisturise after washing and drying the skin.
  Where possible, worried patients with varicose veins should seek the opinion of their general practitioner or vascular surgeon.

• What are the benefits of surgery over conservative management?

  Conservative measures mentioned above such as compression stockings will control symptoms and may prevent progression of varicose veins. They do not, however, treat the condition and require a lifelong of adherence to the wearing of the compression stockings. However, some patients would rather not have an operation and are quite happy wearing support stockings; equally even the minimally invasive endovenous surgery may not be appropriate for the very elderly or those with multiple medical problems. However, the vast majority of patients with varicose veins are suitable candidates for one or other form of surgery. They will gain benefit from treatment of their veins, long lasting improvement of symptoms, and the prevention of possible skin ulceration.

• What defines success in surgical treatment of varicose veins?

  Nowadays, modern varicose vein treatment is less invasive. It means that varicose veins can often be treated effectively under local anaesthesia in an outpatient setting with much improved results.

  The success of any procedure is measured by:

  • Effective removal of the varicose veins responsible for symptoms
  • Early complications (such as infection, bleeding, pain, deep vein thrombosis, haematoma)
  • Late complications (numbness, scarring, discolouration, nerve damage, and recurrence of veins)
  • Acceptability by patients

  It is very difficult to ascertain the exact complication rates of open surgery as up till perhaps a decade ago many operations were also performed by general surgeons not specialised in vascular surgery. Since then, most of the varicose vein operations are being performed by vascular surgeons. In fact, before proceeding to varicose vein surgery it is imperative that all patients ensure their procedure is being carried out by a vascular surgeon (with sufficient experience especially if considering minimally invasive surgery).

• Varicose Veins surgery and deep vein thrombosis (DVT)

  Deep vein thrombosis (clot in the deep veins ; or so called "economy class syndrome") results in pain and swelling and may result in long term ankle swelling, discomfort and skin problems. The risk of DVT after varicose vein surgery is small, but may be higher if you have had DVT in the past or have a familial tendency for excessive clot formation. Use of oral contraceptives and hormone replacement therapy is said to increase the chances of DVT after any surgery. For these reasons some patients would be advised to receive an injections of anticoagulant (blood thinner) medication prior to surgery and are encouraged to move around soon after surgery.

  Patients with varicose veins do not per se develop a DVT. There are, however, rare circumstances in which extensive an DVT can make varicose veins worse.

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