Varicose Vein Treatment at Countess of Chester Hospital

The Countess of Chester Hospital has played an important role in developing vascular services in Chester, including newer approaches to treating varicose veins. This history is closely connected with Mr Sameh Dimitri, Consultant Vascular and Endovascular Surgeon and founder of Vein Solutions.

One particularly significant development was the hospital’s participation in early European research into cyanoacrylate closure for varicose veins. The Countess of Chester Hospital was one of the UK centres involved in the European Sapheon Closure System Observational ProspectivE study, known as eSCOPE, which assessed cyanoacrylate treatment for reflux affecting the great saphenous vein.

Mr Dimitri was one of the investigators involved in the European multicentre study. The research included seven centres across four European countries and contributed to the clinical evidence surrounding a treatment that offered a different approach to conventional surgery and thermal ablation.

Today, Vein Solutions provides private varicose vein treatment in Chester, Cheshire and North Wales, with care continuing to reflect Mr Dimitri’s longstanding involvement in minimally invasive vascular treatment.

Cyanoacrylate Treatment And The eSCOPE Study

Cyanoacrylate treatment represented an important development in endovenous treatment because it allowed an incompetent vein to be closed using a specially formulated medical adhesive rather than heat.

The prospective European multicentre study included patients with reflux affecting the great saphenous vein. The Countess of Chester Hospital was one of the UK study sites, and Mr Dimitri was named among the investigators in the subsequently published European research.

This early clinical work was particularly relevant because cyanoacrylate treatment offered another minimally invasive approach to managing venous reflux.

Unlike endovenous laser treatment and radiofrequency ablation, cyanoacrylate closure does not depend upon thermal energy to close the vein. Under ultrasound guidance, a catheter is positioned within the affected vein, and small amounts of medical adhesive are delivered at specific points. The vein closes, and blood continues to return through healthy veins.

The technique has since become an established treatment option for selected patients. VenaSeal treatment in Chester uses this principle to close an incompetent superficial vein without applying thermal energy.

At the time of the early cyanoacrylate work, Mr Dimitri was the only consultant vascular and endovascular surgeon in the UK approved by Sapheon to train other surgeons in cyanoacrylate glue treatment. The company originally developed the system before Medtronic acquired it.

Mr Sameh Dimitri

Mr Sameh K Dimitri, MB BCh, MSc, FRCS (Eng), FRCS (Edin), Endovascular Diploma, is a Consultant Surgeon and Endovascular Surgeon at the Countess of Chester Hospital.

He trained in vascular surgery within the Mersey region, including Wirral, Liverpool and Chester, and has developed a particular clinical interest in minimally invasive treatments for venous disease.

His work has included participation in national and international varicose vein studies as well as training other consultants in newer treatment techniques.

This experience is reflected in the treatment approach at Vein Solutions, where patients can be assessed for several forms of varicose vein treatment rather than being offered the same procedure regardless of their vein anatomy.

Varicose Vein Assessment

Varicose veins are more than enlarged vessels visible beneath the skin. They commonly develop because valves within the superficial venous system no longer prevent blood from flowing backwards effectively.

This backward flow, known as venous reflux, increases pressure within the affected veins and can cause them to enlarge. Symptoms can include aching, heaviness, swelling, itching and discomfort after prolonged standing. More advanced venous disease may contribute to skin pigmentation, inflammation, bleeding or venous ulceration.

For this reason, a varicose vein consultation in Chester includes clinical examination and, where appropriate, duplex ultrasound scanning. The scan maps the superficial and deep venous systems and identifies the source and extent of reflux.

This is particularly important because the most visible varicose vein is not necessarily the source of the problem. A bulging vein on the calf, thigh or behind the knee may be connected to a larger refluxing vein beneath the skin.

Ultrasound findings form the basis of an individual treatment plan, rather than selecting a procedure based solely on the appearance of the veins.

Varicose Vein Treatment

Varicose vein treatment has changed substantially from the conventional vein-stripping procedures widely performed in previous decades.

Current NICE guidance for confirmed varicose veins with truncal reflux recommends endothermal ablation where suitable. Ultrasound-guided foam sclerotherapy is recommended where endothermal treatment is unsuitable, with surgery considered where foam treatment is also unsuitable.

At Vein Solutions, access to several minimally invasive varicose vein treatments in Chester means the procedure can be selected according to ultrasound findings, symptoms, vein anatomy, previous treatment and the patient’s clinical circumstances.

Endovenous Laser Treatment

Endovenous laser treatment, commonly referred to as EVLT or EVLA, closes an incompetent superficial vein using laser energy.

A fine laser fibre is positioned inside the affected vein using ultrasound guidance. Local anaesthetic is placed around the vein before controlled laser energy is delivered.

The treated vein closes, and blood is redirected through functioning veins. Treatment therefore addresses the refluxing vessel rather than simply removing the surface veins produced by increased venous pressure.

EVLT is normally performed under local anaesthetic as an outpatient procedure, with patients encouraged to walk afterwards.

Radiofrequency Ablation

Radiofrequency ablation is another form of endothermal treatment. Instead of laser energy, controlled radiofrequency energy heats the vein’s inner wall and causes it to close.

Under ultrasound guidance, a catheter is positioned within the affected vein, and the vein is treated in sections. Blood subsequently travels through healthy veins.

Both radiofrequency ablation and EVLT avoid the larger surgical incisions associated with traditional vein stripping and suit many patients with truncal venous reflux.

Cyanoacrylate Glue Treatment

Cyanoacrylate treatment uses a specially formulated medical adhesive to close the affected vein without thermal energy.

The treatment has particular historical relevance to Mr Dimitri and the Countess of Chester because of their involvement in the early European clinical research into the technique.

Modern VenaSeal cyanoacrylate treatment is performed through a catheter positioned inside the affected vein under ultrasound guidance. Small quantities of adhesive are placed at controlled points, closing the vessel so blood is redirected through functioning veins.

Because the treatment does not use heat, it does not require the same tumescent local anaesthetic used along the length of the vein during laser or radiofrequency treatment. Suitability is established following clinical examination and duplex ultrasound.

Foam Sclerotherapy

Foam sclerotherapy involves injecting a sclerosant in foam form into an affected vein. Ultrasound guidance can help position the foam within larger veins that require treatment.

The sclerosant acts on the vein lining, causing it to close. The treated vessel then reduces over time as blood is carried through other veins.

Foam sclerotherapy can be particularly useful for selected vein patterns, recurrent varicose veins and tributaries associated with a larger refluxing vein. Some patients require more than one treatment session depending on the extent and distribution of their varicose veins.

Conventional Vein Treatment

Although minimally invasive procedures have changed varicose vein management, conventional vascular surgery still has a place for selected patients.

Vein anatomy, previous treatment, the extent of venous disease, and other clinical factors can affect the recommended procedure. Access to several treatment methods lets you base the decision on examination and ultrasound findings rather than the availability of a single technique.

Private Varicose Vein Treatment In Chester

Vein Solutions currently provides private consultations and treatment at four locations serving Chester, Cheshire and North Wales.

Our Chester Wellness Centre clinic provides private consultation and treatment for varicose veins and a wider range of venous conditions. The clinic uses clinical assessment and ultrasound findings to plan treatment based on each person’s vein disease pattern.

Private care is also available through Grosvenor Nuffield Hospital Chester, providing a hospital setting for patients requiring private vascular care within Chester.

For patients travelling from across Cheshire and surrounding areas, Spire Cheshire Hospital provides another location for private consultation and treatment.

Patients travelling from North Wales can also access Vein Solutions through Spire Healthcare Abergele.

The same consultant-led approach applies across our treatment locations, with the treatment plan based on the patient’s symptoms, clinical findings, and venous anatomy.

Vein Solutions And Vascular Care In Chester

The Countess of Chester Hospital remains an important part of Mr Sameh Dimitri’s vascular career and his involvement in developing minimally invasive vein treatment. Its participation in early European cyanoacrylate research is also an important part of the history behind a treatment technique now available to selected patients with venous reflux.

Private treatment through Vein Solutions is currently provided at Chester Wellness Centre, Grosvenor Nuffield Hospital Chester, Spire Cheshire Hospital and Spire Healthcare Abergele.

Patients considering treatment can arrange a varicose vein consultation in Chester, with duplex ultrasound scanning used where appropriate to establish the source and extent of venous reflux.

Depending on those findings, treatment may include EVLT, radiofrequency ablation, cyanoacrylate glue treatment, foam sclerotherapy or conventional vascular procedures. Patients comparing their options can also find further information about private varicose vein treatment options in Chester before arranging an assessment.

This provides continuity from the initial examination and ultrasound diagnosis through treatment and aftercare, with the procedure selected based on the individual vein problem.

Countess Of Chester Hospital

Countess of Chester Hospital

The Countess Of Chester Health Park
Liverpool Road
Chester
CH2 1UL

If you are attending the hospital for a procedure and have been advised not to drive afterwards, arrange for a friend or relative to collect you or organise Chester Taxi Services to take you home.

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