CLARIVEIN | SAPHEON | STEAM
For the majority of patients thermal ablation (Laser or RF) is the best treatment. It can be used on almost all cases of varicose veins and there is extensive literature from scientific studies demonstrating excellent clinical results, an almost perfect safety record and durability of the results over many years. It is for this reason that NICE recommends that all varicose veins are treated this way. NICE GUIDELINES
Laser or EVLA does however have one drawback. Local anaesthetic must be administered to ensure no pain is felt during the heating process. This anaesthetic is delivered through needles and although these are tiny and in our hands most patients tolerate the procedure very well, there are some patients who are seriously needle phobic. Over recent years two new techniques have been developed which can painlessly ablate veins and hence do not require the local anaesthetic. These are Clarivein and Sapheon (Superglue) both of which are available at Veincentre.
Clarivein works by a combination of a rotating wire which scratches the vein wall and at the same time a chemical sclerosant is injected. This combination works better than sclerosants alone. All this is carried out through just one tiny skin puncture and is painless. Clarivein Website.
Watch a video of the Clarivein procedure below.
Sapheon (Superglue) relies on sticking the walls of the vein together using a medical grade Superglue. This too is carried out through just one tiny skin puncture and the procedure is painless. Sapheon Website.
Watch a video animation of the Sapheon procedure here:
A recent study has demonstrated good results. (Twelve-Month Follow-up of the European Multicenter Study on Cyanoacrylate Embolization of Incompetent Great Saphenous Veins; Journal of Vascular Surgery: Venous and Lymphatic Disorders 2014; 2(1):1 p105–106)
So what’s the snag? Why not use these techniques routinely?
Well all techniques have advantages and downsides. Each patient must be carefully assessed and decide on the basis of the evidence in their case which technique is best for them. All patients and all veins are not equal. Not all veins are suitable for these treatments. Although these two new methods avoid the discomfort of the local anaesthetic needles there can be some pain after the procedure, particularly with Superglue, from phlebitis. Perhaps the biggest downside however is the limited evidence of long term effectiveness and safety compared with thermal ablation. We do not know for sure yet whether these techniques are as effective, as durable or as safe as EVLA.
Almost inevitably these techniques are also more expensive than EVLA although our prices are still the most competitive of any in the UK.
Read about these techniques, watch the videos, discuss with us by phone or at consultation and decide with our guidance which technique you would prefer. Whichever you decide you are in good hands!
Steam (Cermavein) is yet another novel technique is the use of Steam passed down the catheter instead of a laser fibre. At first sight this may sound promising but the technique still requires the local anaesthetic injections so offers no advantage over laser EVLA. There are several disadvantages. Firstly the results of early studies are not nearly as impressive as EVLA, no long term results have been published and although steam may appear cheap in fact the devices used are far more expensive than EVLA devices.
For these reasons we do not recommend Steam as a sensible option for varicose vein treatment and do not offer it in any of our clinics.