If you are a varicose vein sufferer, there is a bewildering array of potential treatments available. In the UK, some surgeries and treatments can be funded by the NHS, however as this is considered to be more of a cosmetic problem rather than a serious medical one, it is often dependent on what can be dealt with under the terms of any medical insurance that you hold.
Compression Stockings are the traditional way of treating varicose veins and work by compressing your legs to help to improve the circulation. The compressing action is particularly noticeable at the ankles and become looser the further up the leg you go.
The reason for the tightness at the ankles is to prevent the pooling that occurs as a result of the vein valve failure and to encourage the blood to move back towards the heart. While this treatment can greatly improve your physical comfort there have been mixed results in clinical trials with regard to their ability to actively prevent varicose veins from forming, however this could be due to the fact that many people are unwilling to wear them as they can be uncomfortable and are not the most stylish leg wear.
All of the following out patient and surgical treatments work according to the same basic principle – when a superficial vein is shut off, the blood supply reroutes to make up of the absence of the damaged and now blocked vein.
Sclerotherapy & Foam Sclerotherapy is the injection of a liquid or foam into a vein that promotes the scarring of and eventual closure of the affected. The veins are located and mapped using a technique known as Doppler Ultra Sound. The technique also helps to ensure that the sclerotherapy is not going to make the veins being treated worse by injecting into the wrong area. This is a relatively quick and painless procedure that can be done as an out-patient, allowing you to return to work immediately after the treatment.
One of the most radical surgical interventions for varicose veins is Ligation and Stripping. While this cannot be described as major surgery, several weeks’ absence from work may be required to recover to give your legs the opportunity to heal properly. Two small incisions (2 inch/5 centimeter are made, one at the groin and one at the ankle or knee, exposing the affected vein.
This vein is then tied off, cut and stripped from inside the leg. A very thin needle is threaded through the vein to do this. This technique is chiefly used when varicose veins are having a serious effect on mobility, are causing significant pain or have had a rupture or bleed that has rendered the vein unstable.
There are also some newer techniques available however to a certain extent the jury is still out regarding their long term effectiveness. Radiofrequency Ablation uses heat generated by using radiofrequencies to heat a tiny catheter placed in the affected part of the leg to cause the vein to collapse and close, working like cauterisation to seal the vein shut.
This works quite effectively but the treatment itself can result in some minor and temporary burning to the skin and a sensation of pins and needles.
Endovenous laser treatment (EVLT) also uses a catheter to assist in the process of sealing off the varicose vein, however in this instance, the catheter is used to feed a tiny laser through to position it near the very top of the vein. Effectively working down the vein, the laser fires, causing it to seal and is drawn through, closing the vein as it goes.
This is a relatively new technique which is not available everywhere at the moment. It also can be quite expensive but on the positive side has had some excellent patient feedback as a result of limited side effects and short recovery times.
Phlebectomy is another technique that can be used however this technique is more likely to be used on spider veins and very minor varicose veins.
Tiny incisions are made (too small to require stitches) through which the affected vein is sealed off and removed. This is often the preferred method of vein removal as there is significantly less trauma to the patient and the recovery is also significantly better than with ligation and stripping.