Varicose Vein Service
Varicose veins affecting the lower limbs are common in the Western World. They can cause disfigurement, disability and impairment in the quality of life and can affect all ages. Surgical treatment is often required for a variety of indications (reasons), and over 40 000 operations were performed for varicose veins in the NHS in England and Wales during 2003/04.
However over the last 10 years with advances in technology several non-invasive treatments for varicose veins have been developed and we now have a variety of different options available for treating symptomatic varicose veins. In addition to this, non-invasive imaging by ultrasound scanning gives us a much better understanding of the site and severity of the varicose vein disease and helps us to decide on the best form of treatment for each individual patient.
Wide range of non-invasive treatment optionsShow [+]Hide [-]
In Newcastle we are able to offer a full range of treatment for varicose veins, thread veins and venous ulcers. These treatments include:
- Radiofrequency ablation
- Laser ablation
- Sclerotherapy including Foam Sclerotherapy
- Compression therapy
These treatments are outlined below and further information on these treatments is available from the Northern Vascular Centre.
SurgeryShow [+]Hide [-]
Operations for varicose veins are usually performed under general anaesthetic. The operation performed will depend on the site and extent of the varicose veins. Operations for varicose veins include one or more of the following procedures:
- Tying of a vein in the groin
- Stripping of a vein in the thigh
- Tying of a vein behind the knee
- Multiple avulsions of varicose veins (Multiple avulsions are performed using a special hook so that the varicose veins can be removed through very small incisions) and
- Re-operation in groin or behind knee for recurrent varicose veins.
Most patients can be operated on as daycase patients which mean you can come in and go home the same day without the need for an overnight stay.
Radiofrequency Ablation (RFA)Show [+]Hide [-]
Radiofrequency energy or “radio waves” is a form of electromagnetic energy. A catheter (wire) capable of delivering this type of energy is passed up the long saphenous vein (the vein commonly affected in varicose veins), usually from knee level to the groin.
Under ultrasound control obliteration of the long saphenous vein is achieved by applying radiofrequency energy to the vein wall. This causes heating which leads to vein wall thickening and contraction of the vein. Over a period of weeks to months the vein is reabsorbed by the body and disappears. The procedure can be performed under general or local anaesthetic.
Studies have shown that long term results of this treatment are similar to conventional surgery but recovery from the procedure is faster.
Laser AblationShow [+]Hide [-]
In a similar manner to radiofrequency ablation a laser catheter is passed up the long saphenous vein from knee level and this vein is treated with laser energy. This similarly causes shrinkage of the vein which is eventually reabsorbed by the body. As with RFA this procedure can be performed under either general or local anaesthetic.
SclerotherapyShow [+]Hide [-]
Sclerotherapy or injection of varicose veins is a procedure designed to improve the appearance of your varicose veins. The veins are injected with a solution called a sclerosant which damages the internal lining of the vein and causes blood clotting within the vein. In time your own body will then destroy the vein and it will disappear. The solution normally used for this procedure is called sodium tetradecyl sulphate (STD) and is available in different concentrations depending on the size of the vein being treated.
Foam SclerotherapyShow [+]Hide [-]
Normally STD is injected as a solution directly into the vein to be treated. Foam sclerotherapy involves making small volumes of the solution into a foam by rapid mixing and agitation with a small volume of air. This can then be used to treat some of the larger underlying abnormal veins which would not normally be treated with conventional sclerotherapy. This is performed under ultrasound control. The foam solution causes intense spasm of the vein and a greater volume can be injected without using too much of the STD solution.
The initial results with foam sclerotherapy are very promising and this method of treatment offers a possible alternative to surgery. However it should be emphasised that this is a new treatment and at present the long term results are not yet known and it is not possible to say how this treatment compares in terms of results with conventional surgery or sclerotherapy. This procedure is carried out in the out-patient clinic and does not require a general anaesthetic.
Compression TherapyShow [+]Hide [-]
Not all varicose veins require intervention. Some patients with varicose veins do not require any treatment and others may prefer to try elastic compression stockings. These can be very effective in relieving the symptoms of varicose veins.
Compression therapy with stockings or bandages may also be used for patients with leg ulcers related to venous disease. The assessment and treatment of both venous and arterial leg ulcers is available in the Northern Vascular Centre at the Freeman Hospital.