This is a brief overview of the main types of vein problems and their treatments.
I hope you find this information useful and that it will help you to understand a little more about vein problems. Please feel free to arrange an appointment to see me if you would like to discuss any of these conditions or their treatment.
Varicose veins
These are large, protruding veins that are easily visible. They often cause symptoms such as aching, itching and swelling. Sometimes they cause problems with phlebitis (inflammation), bleeding, and skin changes that in the extreme case lead to leg ulceration (see below).
Not all varicose veins need to be treated. The purpose of a consultation is to determine which of the treatments might be suitable for you, and to discuss the benefits and risks of each. During a consultation you will be offered a choice of treatments, but I will also give you my opinion of the most appropriate way of dealing with your problem.
The most commonly used treatments for varicose veins are:
Compression hosiery (surgical support stockings). These are good for easing symptoms, but do not get rid of the veins.
Sclerotherapy (injection treatment) by “foam” or liquid. This is generally good for tidying up small numbers of veins and in treating veins causing leg ulceration, but there are important risks to consider.
Surgery (sometimes called “stripping” or removal of the veins)
Despite the advent of newer treatments such as those mentioned below, surgery (“phlebectomies” or “avulsions” ie. removal of veins) to remove some of the varicose veins is often necessary and is a good way of getting rid of all or almost all of the veins in one go.
Radiofrequency Ablation
This is now a well established method for closing off the main refluxing or incompetent truncal veins (such as the long or short saphenous veins) that cause varicose veins. It does this by heating the inside of the vein through a tiny wire and catheter passed into the vein at its lower end.
My experience is that this gives a less painful recovery. Many people are back to work within a few days.
The method I currently use is called VNUS or VNUS ClosureFast.
It is possible to carry out VNUS under local anaesthetic and I will discuss that option with you at consultation.
Laser ablation (EVLA or EndoVenous Laser Ablation)
I do not use this method at present. I feel it is unnecessary since the VNUS method works very well, and many would say is superior to some types of laser treatment.
None of the treatments is perfect in that there are pros and cons to all of them. None give a permanent result. No matter what some people might tell you, veins can reappear, although often this is years after successful treatment. There are risks with all of these treatments. These include bleeding, infection, wound and scar problems, skin numbness or neuralgia (nerve pain), deep vein thrombosis (DVT), foot drop, vascular injury, and anaesthetic risks. I will gladly discuss these with you at consultation.
Leg ulceration
This is when the skin on the leg breaks down and an open sore is left.
Having an ulcer on the leg can be a painful, unpleasant and debilitating condition. The causes, which are very often related to problems with the circulation, should be investigated urgently.
Treatment is determined by finding the cause of the ulcer using tests such as ultrasound scanning. Treatment can mean using bandaging or stockings, treating any underlying vein problems (see above) or artery problems, and dressing the area appropriately.