Varicose veins affect up to three out of ten of the adult population in the UK. Unfortunately, most patients cannot have these dealt with by the NHS due to lack of funding.
Varicose veins are formed when the tiny valves in the veins stop working properly and blood accumulates in the vein causing them to become swollen. They usually occur in the legs as the vein pressure is highest there due to standing.
You will be aware you have varicose veins as this is often a visual condition but it can also cause aching legs, swollen ankles, a burning or throbbing sensation, muscle cramps and also itchy and thin skin over the swollen vein itself, local clotting of the veins with inflammation (thrombophlebitis), bleeding or ulceration.
After taking your history and performing an examination Mr Darby will determine which is the best treatment from a range of options. It is often necessary to perform an ultrasound scan of the veins. Commonly this can be done in the clinic by Mr Darby or in the specialist vascular ultrasound department. There is a risk of recurrence with all vein treatments and this will be discussed with you.
There are now a range of options available. The actual treatment will depend on where the veins are, how bad they are, the type of anaesthesia you would prefer and a balance between the invasiveness of the intervention and the recurrence rate.
Mr Darby uses Radiofrequency Ablation (VNUS, VENEFIT) to obliterate the vein in the leg without a surgical cut in the groin or the conventional removal of the vein (stripping). This is not suitable for all patients but causes less post surgical pain and bruising. The technique involves passing a narrow probe up the inside of the vein.
This is effectively the same as ‘laser’ treatment in which the tip of the probe is slightly different. However, there is evidence to suggest that the VNUS technique is less painful than laser. More information can be found here.
Conventional surgery is very effective and has a low recurrence rate and this option will be discussed with you and the advantages and disadvantages compared to the alternatives shown above and below.
With both conventional surgery or Radiofrequency ablation small incisions or injections may be needed to remove the actual bulging veins in the lower leg.
Foam Sclerotherapy can be used to treat the large vein in the thigh. In this technique a strong chemical irritant is injected up the vein under ultrasound guidance. This is the least invasive treatment and can be carried out in the outpatients. You should be aware that this technique has a lower success rate and may require several repeat therapies and scans.
Liquid Sclerotherapy is suitable for smaller varicose veins, sclerotherapy involves injecting a chemical into the affected vein which seals them closed. Over the process of a few weeks the damaged vein which is no longer filled with blood is obliterated and then will fade away. This procedure is done in the clinic room and usually takes about 35 minutes. More than one session may be required.