Varicose veins were described as early as 1550 B.C. in a rare document known as the Ebers papyrus. Considered an irreversible condition with no recommended treatment, varicose veins were referenced by Hippocrates and described by Leonardo da Vinci.
Over the centuries, the medical community has expanded its understanding of causation and come up with treatments and procedures for varicose veins that are today so minimally invasive, streamlined and safe, one can be treated and resume normal activities relatively quickly, even following vein removal.
Heredity plays a big part in the development of varicose veins in men and women, but don’t blame your family exclusively for this condition: pregnancy and obesity contribute to the development of varicose veins and can exacerbate that genetic predisposition. Further, your legs are perpetually vulnerable to the pressures of gravity, age and even inactivity.
Varicose Vein Surgery at Nuffield Health Grosvenor Hospital
There is no single method for the treatment of varicose veins, each case involves a clinical examination to identify the type of varicose veins present and guide the decision regarding the optimum treatment strategy. Surgery is the traditional technique for treating varicose veins and requires a general anaesthetic.
A 3-5cm incision is made in the groin and the connection between the main superficial vein in the thigh and the main deep vein is tied off. The superficial vein is then stripped out through an additional incision on the inside of the knee. In cases where the vein connection behind the knee is the cause of the varicose veins an incision is made here to tie this connection off. Small varicosities below the knee are removed through further incisions (less than 3mm in size) – these are called ‘phlebectomies’ or ‘avulsions’.
Most conventional varicose vein operations are now done as day-case procedures and do not routinely require an overnight hospital stay. However, patients are required to wear support stockings for a week following surgery and a convalescence period of 1 to 2 weeks is usually needed. Complications of varicose vein surgery are generally uncommon but include bleeding, wound infection, nerve damage, deep vein thrombosis and varicose vein recurrence.
Minimally Invasive Treatment at Nuffield Grosvenor Hospital
Endovenous ablation techniques have expanded the minimally invasive options for patients requiring treatment for varicose veins. As a full-service varicose vein treatment clinic, we offer patients five options that range from simple advice to less-invasive surgical approaches:
They’re neither attractive nor sexy, but if you’d like to reduce the appearance of your unsightly varicose veins, wearing support stockings will not only disguise your condition but these are engineered to temporarily reduce swelling that is the telltale sign of this condition.
Sclerotherapy Foam Treatment:
Sclerotherapy for the treatment of varicose veins involves the use of a sclerosant (a substance which seals up blood vessels when injected) and has been used for many years to treat small varicose veins. Over recent years a technique has been developed which allows sclerotherapy to be used to treat larger varicose veins (up to 1cm in diameter). This involves mixing the sclerosant with air bubbles to create a foam.
Local anaesthesia is used to numb the skin and using ultrasound scanning, a small amount of foam is injected into the vein being treated. Following the procedure a bandage and stocking are sited on the leg which need to remain in place for around 1 week. The stocking should be worn for a further week after the bandage is removed.
Endovenous Laser Treatment:
Laser treatment for varicose veins is a method of treating varicose veins without conventional surgery. The whole procedure takes less than 1 hour to perform and allows patients to return to their normal routine within 24 to 48 hours. In around 98% of cases this technique is successful in obliterating the vein by the end of the procedure.
Almost anyone with varicose veins is suitable for laser treatment. However, there are those who are not suitable. Patients with small recurrent veins after a previous surgery do not qualify for this treatment. These can be managed with foam sclerotherapy.
Radio-frequency ablation treatment is an alternative minimally-invasive technique for the treatment of varicose veins using a similar principle to laser treatment.
A catheter is introduced under local anaesthetic into the main superficial thigh vein under ultrasound scan guidance. The tip of the catheter is positioned at the junction of the superficial and deep vein in the groin or at the back of the knee and a probe generating radio-frequency energy is used to heat up the inside of the vein causing it to collapse down. Smaller calf veins lower down in the leg in a significant number of patients usually shrink on their own following the treatment or can be treated after 4-6 weeks with foam sclerotherapy treatment or through small incisions (less than 2mm).
Varicose Vein Treatment Aftercare
Regardless of your particular varicose vein treatment, you’ll spend time in recovery as staff assesses your general well-being.
Before you are discharged, you will be given instruction on changing bandages and advised of critical hygiene practices post-op patients must follow to speed up recovery time following varicose vein treatment. You will also be asked to show that you can move around enough to circumvent potential circulation problems, after care procedures and compression stockings.
Varicose Vein Consultation at Nuffield Health Grosvenor Hospital
Varicose veins can broadly be divided into 2 categories based on their size:
- Truncal veins – large, prominent veins which bulge from under the skin.
- Thread veins (or ‘spider’ veins) – fine, unsightly veins with a red or purple discoloration.
The varicose vein treatment options for thread veins are different from that for main varicosities.
Your initial consultation will involve a clinical examination in addition to an ultrasound scan to identify the type of varicose veins present and guide the decision regarding the optimum treatment strategy. Some patients with thread veins will not require ultrasound scanning.
Vein Solutions provides a comprehensive range of varicose vein treatment services encompassing both minimally-invasive techniques and conventional vascular surgical procedures at at Nuffield Health Grosvenor Hospital.
Mr. Sameh Dimitri at Nuffield Health Grosvenor Hospital
Mr Sameh Dimitri trained in vascular surgery in the Mersey region (Wirral, Liverpool and Chester). He is interested in minimally invasive treatment for venous disease and has run courses to train consultants who wish to develop their skills in the new treatments. Mr Dimitri is currently the only consultant vascular and endovascular surgeon in the UK approved to provide training to other surgeons in cyanoacrylate glue treatment.
As the only consultant vascular and endovascular surgeon approved to train surgeons in cyanoacrylate glue treatment, Mr. Dimitri’s unique approach to radio-frequency ablation (VNUS), foam sclerotherapy and laser therapy (EVLT) ensure that his treatments at Nuffield Health Grosvenor Hospital are world renowned.
A current member of professional organizations from the British Medical Association and European Society for Vascular Surgery to the American College of Phlebology and Royal Society of Medicine, Mr. Dimitri serves as University of Liverpool Honorary Lecturer and Vascular Unit Head at Countess of Chester Hospital NHS Foundation Trust, Chester Clinical Lead.
While Mr. Dimitri’s personal interests extend from tennis to scuba diving, it is his sterling reputation as practitioner, teacher, department head and surgeon that endear him to patients of all ages in addition to his formidable dedication to pursuing and pioneering groundbreaking techniques in the treatment of vascular disease.
Risks and Complications.
Monitoring post-operative and treatment signs and notifying us if you are concerned about the following:
Lump in the groin area.
You may have developed a haematoma; a skin sack filled with fluid or blood. It may disappear without intervention, but if you’re concerned, contact staff so we can determine whether or not it must be drained.
Has the skin returned to its normal colour.
Don’t be alarmed. This takes time—even if that discolouration is a pronounced shade of brown.
Numbness or tingling.
Again, this is a sign of a healthy recovery as your body adjusts to its “new normal.” It can take weeks or even months for either sensation to disappear.
Swelling, pain and/or warmth in treated area.
These symptoms could indicate Deep Vein Thrombosis (DVT), a common risk following any surgery. If you suspect a DVT, err on the side of caution and report your concern to our staff.
Common symptoms of infection include pain, redness, tenderness and warmth at the site, offensive-smelling fluid drainage and you may have a temperature. Infection can delay full recovery; contact us for assistance.
Vein Solutions provides private treatment and private consultation for at the following locations:
- Treatment of Varicose Veins without Conventional Surgery
- What is a Endovenous Laser Treatment of Varicose Veins
- Varicose Veins and the NHS’s Role in Treatment
- Recovery after Varicose Vein Treatments
- Private Endovenous Laser Treatment at Spire Cheshire Hospital