Our vein clinic specialises in all aspects of venous disease treatment, including many common conditions such as varicose veins, spider veins, venous ulcers, pelvic varicosities and varicocele.
Small varicose veins and Spider veins are treated by sclerotherapy. A tiny needle is used to administer a series of injections that contain small amounts of a sterile solution into the vein. Because the needle is so small, patients do not need any anaesthesia and usually feel little pain. The solution displaces the blood within the diseased vein and causes the vein to collapse. The treated vein is absorbed and eventually becomes nearly invisible.
Although the same vein may require multiple injections over time, this injection procedure for each session can be performed in our clinic in less than 30 minutes. The total number of veins treated during one session will depend on the size and location of the veins as well as the overall medical health of the patient. Any follow up sessions will be scheduled at least four weeks apart so that the results of the previous treatment can be accurately evaluated.
It involves a precise insertion of a very thin (less than one millimeter) laser fiber into the diseased veins under real-time ultrasound guidance, followed by an application of laser energy to heat and close the varicose veins. Over time, the treated veins are absorbed by the body. This is an outpatient procedure, done under local anaesthetic with resumption of normal activity within a few days.
A catheter is placed in the diseased vein under real-time ultrasound guidance, and radiofrequency energy heats the vein tissue. The vein is closed and is eventually sealed shut. The abnormal reflux of blood is stopped. This is an outpatient procedure, done under local anaesthetic with resumption of normal activity within a day.
Although the medium and long term results of RF ablation and laser ablation (EVLA) are identical there are some minor differences which mean that some patients are best suited to either one or the other.
The most recent innovation in the treatment of varicose veins is the use of medical glue (cyanoacrylate) known as VenaSeal to physically shut down and seal the main abnormal vein. The VenaSeal procedure involves the placement of a very small amount of Medical Glue into the vein through a small catheter. Once the affected vein is closed, blood is re-routed through other healthy veins in the leg. In contrast to heat-based procedures such as Endovenous Laser or Radiofrequency Ablation, VenaSeal does not require large volumes of local anaesthesia and there is no risk of skin burns. In addition, VenaSeal does not require uncomfortable compression stockings aftrer the procedure. However, the disadvantage is the limited evidence of long term effectiveness compared with thermal ablation. We do not know for sure yet whether this technique is as effective and durable as thermal ablation. Almost inevitably this technique is also more expensive than EVLT although our prices are still the most competitive of any in the UK.
Microphlebectomy, also referred to as Ambulatory Phlebectomy, is occasionally recommended for the treatment of varicose veins because not all veins can be treated with sclerotherapy or EVLA or RFA.
A minimally invasive surgical technique, Microphlebectomy is usually performed as an office procedure under local anesthesia. Typically performed through a pinhole puncture, the technique permits the removal of most larger varicose veins, and results in very little patient recovery time. In some cases, this procedure is performed in conjunction with Ultrasound Guided Sclerotherapy.
Advantages of RFA and EVLT over Surgery
Both RFA and EVLT also eliminate reflux and remove incompetent veins and superficial varices just like surgery but, by being performed under image guidance through tiny pinhole incisions, this is achieved as an outpatient, under local anaesthetic, without cuts or scars, with excellent success rates and patient satisfaction and earlier return to work.