VARICOSE VEIN


Treating varicose veins

Varicose veins don’t always need treatment. If your varicose veins are not causing you discomfort, you may not need to have treatment.

Treatment of varicose veins is usually necessary:

  • to ease symptoms – if your varicose veins are causing you pain or discomfort

  • to treat complications – such as leg ulcers, swelling or skin discolouration

  • for cosmetic reasons

If treatment is necessary, your doctor may first advise thefollowings

  • using compression stockings

  • taking regular exercise

  • avoiding standing up for long periods

  • elevating the affected area when resting

Compression stockings

Compression stockings are specially designed to steadily squeeze your legs to improve circulation. They are often tightest at the ankle and get gradually looser as they go further up your leg. This encourages blood to flow upwards towards your heart.

Compression stockings may help relieve the pain, discomfort and swelling in your legs caused by your varicose veins.

You may need to wear compression stockings for the rest of your life if you have deep venous incompetence. Deep venous incompetence is where you have problems with the valves, or blockages, in the deep veins in your legs.

In these circumstances, you will need to wear compression stockings even if you have had surgery to treat some varicose veins.

You usually need to put your compression stockings on as soon as you get up in the morning and take them off when you go to bed.

They can be uncomfortable, particularly during hot weather, but it’s important to wear your stockings correctly to get the most benefit from them.

Compression stockings usually have to be replaced every three to six months. If your stockings become damaged, speak to your GP because they may no longer be effective.

Further treatment

If your varicose veins need further treatment, or if they are causing complications, the type of treatment will depend on your general health and the size, position and severity of your veins.

Endothermal ablation

One of the first treatments offered will usually be endothermal ablation. This involves using energy either from high-frequency radio waves (radiofrequency ablation) or lasers (endovenous laser treatment) to seal the affected veins.

Radiofrequency ablation

Radiofrequency ablation involves heating the wall of your varicose vein using radiofrequency energy. The vein is accessed through a small cut made just above or below the knee.

A narrow tube called a catheter is guided into the vein using an ultrasound scan. A probe is inserted into the catheter that sends out radiofrequency energy.

This heats the vein until its walls collapse, closing it and sealing it shut. Once the vein has been sealed shut, your blood will naturally be redirected to one of your healthy veins.

Radiofrequency ablation is carried out under local anaesthetic (you are awake). The procedure may cause some short-term side effects, such as pins and needles (paraesthesia).

You may need to wear compression stockings for up to a week after having radiofrequency ablation.

Endovenous laser treatment

As with radiofrequency ablation, endovenous laser treatment involves having a catheter inserted into your vein and using an ultrasound scan to guide it into the correct position. A tiny laser is passed through the catheter and positioned at the top of your varicose vein.

The laser delivers short bursts of energy that heat up the vein and seal it closed. The laser is slowly pulled along the vein using the ultrasound scan to guide it, allowing the entire length of the vein to be closed.

Endovenous laser treatment is carried out under local anaesthetic. After the procedure you may feel some tightness in your legs, and the affected areas may be bruised and painful. Nerve injury is also possible, but it’s usually only temporary.

Ultrasound-guided foam sclerotherapy


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