Other Varicose Vein Treatments

Surgery

Surgical treatment of varicose veins is the oldest and most established method of treatment. Surgery involves a general anaesthetic and may require a night in hospital. Usually the surgeon will make a small incision in the groin and then a further incision just below the knee. The main varicose vein will then be stripped out between these incisions.  At the same time, the surgeon may make several smaller stab incisions around the lower leg and calf to remove the unsightly smaller vein branches - a procedure known as multiple avulsions or phlebectomies. Following surgery your leg will be heavily bandaged and you are likely to require some time away from work to recover.  The discomfort and bruising from the surgery will take several weeks to subside.

Up to 20-30% of patients will suffer from recurrent varicose veins in the years following surgery. Surgery for varicose veins is still performed in some cases and Mr Tsavellas will advise you if this is the best option for you.

Foam Sclerotherapy

Liquid sclerotherapy (injection treatment) has been used for decades to treat varicose veins with variable results.  It is still the treatment of choice for thread veins but for larger veins the results of just injecting liquids are not good.

Foam sclerotherapy is a simple and recent modification of the traditional injections which is far more effective.  The liquids are transformed into a shaving foam consistency and injected precisely into the correct place by ultrasound guidance.  These two simple modifications have revolutionised injection therapy and mean that some patients can be effectively treated by injections alone.  Some doctors even use foam as a substitute for major surgical stripping but many believe that EVLA is more effective and durable for larger veins and reserve foam injections for those varicosities that persist after these treatments. Foam sclerotherapy is virtually painless just involving one or two small needle punctures into the affected veins.  Serious complications with foam sclerotherapy are very rare but it is possible for any of the following to happen: allergic reactions, deep vein thrombosis (DVT), temporary eye sight disturbances, ulceration of skin.  The commonest problem with foam sclerotherapy is staining of the skin which can take several weeks or longer to go.  If larger veins are treated some patients experience an uncomfortable phlebitis but this can usually be relieved by aspirating through a needle. After treatment you will have to wear compression stockings for two weeks.  You may need more than one sclerotherapy session to achieve the desired result.

In summary, foam sclerotherapy is a very useful addition to our armoury for use against varicose veins - and is particularly useful in complex veins through scar tissue, in recurrent varicose veins or in hard skin around ulcers at the ankles - but it isn't as good as EVLA for large truncal veins.

Support Stockings

Compression graduated stockings can be prescribed to slow down the progression of leg varicose veins.  This is done for symptomatic relief, but they must be worn every day for the rest of your life to be effective.  Stockings may help vein symptoms so long as they are worn, but they will not cure the problem.  Pain medication may help keep you more comfortable.