Open surgery was a very effective treatment for primary i.e. first time treatment for varicose veins but did involve a general anaesthetic and recovery time away from normal activities and work.
Open surgery for recurrent varicose veins was technically much more challenging and carried not inconsiderable risk due to scarring around the major leg arteries and nerves.
Minimally invasive treatments:
Minimally-invasive techniques are now the mainstay of varicose vein treatments. They treat the veins from the inside (‘Endo-venous’) and seek to destroy the lining of the vein (the endothelium). Without the endothelium the vein can no longer function so it ceases to transmit blood and shrinks down to become a fibrous cord of scar tissue. Various techniques involve different modalities to achieve this endothelium destruction (known as ablation).
Endo-venous techniques can be broadly divided into catheter-based and non-catheter-based.
Catheter based techniques:
These achieve destruction of the endothelium by the use of an energy source delivered via a catheter (specialised tube) passed into the vein.
The energy can be thermal i.e. the use of heat energy to effectively cook the inside of the vein, laser energy, steam, or radio-frequency energy.
Non-Catheter based techniques:
These involve injection of a chemical irritant (‘sclerosant’) directly into the vein system being treated.
Sclerosants can be used in varying strengths employing varying sizes of needles depending on the diameter of the vessel to be treated. Weak sclerosant solutions (0.2% or 0.5%) are injected in liquid form have long been known to be effective in very small veins and thread or spider veins and is the technique I use for Microsclerotherapy.
A stronger solution (1% or 3%) of sclerosant is mixed under pressure, the Tessari technique, with air or carbon dioxide (CO2) to form foam. The foam displaces blood within the larger varicose veins allowing this to be an effective treatment for varicose veins. The foam is visible on ultrasound which ensures deployment of the foam into veins requiring treatment hence ultrasound guided foam sclerotherapy (or ‘USGFS’……..we are addicted to pseudonyms in the medical field!).
At Southwest Veins we offer the minimally invasive Foam Sclerotherapy treatment.
Book your FREE initial consultation to discuss your varicose or thread vein removal via video. This enables us to meet, virtually, face to face and for us to diagnose your condition and answer any specific questions.