Vascular Consultant for Nuffield Health Chester

posted in: Varicose Veins

Mr. Sameh Dimitri: Pioneering The Way In Treating Varicose Veins

Mr. Sameh Dimitri is an expert vascular consultant who is a consultant at Nuffield Health, The Grosvenor Hospital. An expert in varicose vein treatments, he is trained in vascular surgery and practices in the Mersey region (Wirral, Liverpool, and Chester). His treatments are minimally invasive, helping to limit the amount of pain that the patient feels. Mr. Dimitri runs courses to help other surgeons who are interested in vascular treatments develop their skills on the new treatment options available. Mr. Dimitri is currently the only vascular and endovascular surgeon in the United Kingdom that is approved to provide training to other surgeons that are interested in learning cyanoacrylate glue treatment.

Mr. Sameh Dimitri is a member of several hospital boards and has received numerous awards for his works in vascular surgery. Mr. Dimitri is currently posted as Consultant Vascular and Endovascular Surgeon at the Countess of Chester Hospital NHS Foundation Trust. He is also the Vascular Unit Lead Surgeon and Chair of Thrombosis Group at the Countess of Chester Hospital NHS Foundation Trust. Mr. Dimitri is also a member of Vascular Governance North West Committee and he is an Expert Adviser for NICE in Vascular Technologies. He is a member of several different boards including Vascular Society of Great Britain and Ireland, British Venous Forum, European Venous Forum, Royal College of Surgeons (Eng) (Ed), Association of Surgeons of Great Britain and Ireland, Royal Society of Medicine, British Medical Association, European Society for Vascular Surgery, and the American College of Phlebology.

Mr. Dimitri has been the pioneer vascular surgeon in varicose veins treatments. Some of the treatment options that he is skilled in performing are endovenous laser treatments (EVLT), foam sclerotherapy, and radio-frequency ablation (VNUS). These treatments are considered world renowned for their high success rates and Mr. Dimitri’s dedication in giving his patients the best treatment available.

Vascular Consultant for Nuffield Health Chester - Vein Solutions

What are Varicose Veins?

Varicose Veins occur when vein valves that are pumping blood to the heart from the legs become weak. They become weak because the distance the blood has to travel from the heart to the legs and back to the heart is a somewhat longer process than blood travelling to other extremities. Because of this, the blood flows backwards and the valves to do close properly. Pressure from the blood on the vein causes the vein itself to be enlarged in appearance, therefore causing varicose veins. Although they are usually unsightly and sometimes uncomfortable, they do not cause major health problems.

Treatment Options of Varicose Veins

There are two types of varicose veins – truncal veins, which are large bulging veins, and thread veins. Thread veins are typically called “spider veins.” These are fine, unsightly veins with red or purple discoloration. First, Mr. Dimitri will give the patient a consultation, where he will determine which type of veins that the patient has, then he discusses the treatment options for the patient. There are several different treatment options for varicose veins. These include endovenous laser treatments (EVLT), foam sclerotherapy, and radio-frequency ablation (VNUS). Each of these treatment options are proven to help with varicose veins and to help the patient cope with any pain that they may be experiencing.

Endovenous Laser Treatment

Endovenous Laser Treatment is a treatment option for patients that do not want to do conventional surgery. The treatment begins with the surgeon administering a local anaesthetic to the problem area, numbing it so the patient will not feel any pain. Next, through a small cut, he inserts a small, thin, tube which contains the laser thread, inside of the cut. The laser probe begins to heat the vein from the inside, which causes the vein to close. The procedure takes about 45 minutes to an hour on each leg. Afterwards, the patient will stay in the outpatient area for one to two hours for observational purposes. The patient will have to wear a supportive stocking for the next seven to ten days after the surgery. Patients with small recurrent veins from a previous surgery do not qualify to have endovenous laser treatments. These veins must be managed with foam sclerotherapy.

Foam Sclerotherapy

Foam Sclerotherapy is a same day treatment option, meaning patients can go home the same day of the procedure. The surgeon will place a local anaesthetic to the affected area. Next, the surgeon will take a solution and mix it with air to make a foam. Then the surgeon will injected the foam into the affected vein. Sometimes an ultrasound is needed to help the surgeon guide the injection needle through the vein if the vein is particularly deep. As the foam hits the vein, immediately the foam reacts inside of the vein wall. The foam causes an inflammation, which pushes out any blood left inside the vein. This makes the inside of the vein wall extremely sticky, causing the vein wall to close up. In time, usually a few weeks or months, the veins shrink up, and the veins disappear. Afterwards, the patient is directed to wear a pressure bandage. The pressure bandage places pressure on the foam sclerotherapy spot and that ensures that the vein does not fill up with blood once again. It is recommended that the pressure bandage be worn for 12-24 hours after the procedure and compression stockings should be worn for the next three to four weeks. Complications that are specific to foam sclerotherapy are discoloration of the skin, lumps under the skin, inflammation across, the vein site, fainting, vision problems, and injections needed to be repeated.

Radio-Frequency Ablation

Radio-Frequency Ablation is a treatment option that is minimally invasive in the treatment of varicose veins. When a patient receives this treatment, a local anaesthetic is injected to the affected area. Next, a catheter is injected into the main thigh vein. Usually, an ultrasound is needed specifically for guiding the catheter to the main vein. The tip of the catheter is then placed at the joining point of the main vein and deep vein in the groin area or in the back of the knee. Then, a probe that is generates radio frequency energy is used to heat up the vein causing the vein to collapse down. In many patients, they notice smaller veins lower down the leg usually shrink on their own following this treatment. In other cases, if there are still veins lower down in the leg that did not shrink on their own, these veins can also be treated after four to six weeks with foam sclerotherapy.

As with all surgeries, there are many complications that the patient must be watchful for after their surgery or procedure is completed. Some of this complications include a lump in the groin area, skin continuing to look discoloured (usually a brownish shade), numbness or a tingling sensation, swelling or pain in the treatment area, warmth in the treatment area, and infections of the wound area. Mr. Dimitri insists that the patient contacts his office if any of these situations occur while the patient is recovering from treatment.

Treatment Locations:

Vein Solutions provides private treatment and private consultation for at the following locations:


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