Julia Bradbury's Vein Treatment at Veincentre
TV Presenter Julia Bradbury underwent treatment for her varicose and thread veins with us at our London clinic in 2015. She very kindly discussed the results of her vein treatment in a Daily Mail article and we often have patients enquring as to exactly what treatment she underwent.
In line with our Standard Treatment Pathway, found here, please see below a description of Julia's patient journey.
In summary, we first treated the underlying cause of her varicose vein problems with EVLA and, once we fixed the underlying cause, we started treating the varicosities on the outside of her legs using a combination of foam and micro-sclerotherapy (i.e. both the lumpy veins and thread veins). This treatment plan followed the NICE (National Institute of Health and Care Excellence) guidelines on how to manage varicose veins. These guidelines can be found here.
JULIA, WHY DID YOU SEEK TREATMENT?
Julia: “I’ve been plagued by thread veins since I was in my 20s, but four months into my pregnancy with my twin girls Xanthe and Zena, who are now 15 months old, varicose veins started to emerge behind my knee and down my calves, and my legs looked like stilton. They were awful. I feared I’d never be able to wear a dress or skirt again. I’ve always consciously avoided short skirts and shorts and I became the mistress of disguise, wearing leggings and the right shirt, even on holiday. Having been through five gruelling rounds of IVF, I was keen to avoid anything that was particularly invasive or involved a general anaesthetic, which is why laser treatment offered by Dr West’s clinic appealed."
Stage 1: CONSULTATION
Julia presented with large varicosities on her right leg and smaller ones on her left, especially low down. She had multiple thread veins on both legs.
A clinical examination and colour duplex ultrasound scan was performed on both of her legs to accurately determine the underlying sources causing her vein problems. Without this full and detailed scan it is impossible to expertly assess the veins in order to determine the exact treatment required.
Julia’s scan revealed that the varicosities were being caused by gross reflux (faulty valves) in the Great Saphenous Vein (GSV) in both her right and left leg. The Small Saphenous Veins in both her legs were normal. (The Great Saphenous Vein is the big vein which runs from the groin to the ankle).
Stage 2: DESTRUCTION OF THE VARICOSE VEIN SOURCES
In order to fix the underlying cause of Julia’s veins, Endovenous Laser Ablation (EVLA) was required. The EVLA procedure involves first numbing the area to be treated with local anaesthetic, inserting a thin laser fibre into the vein through a needle puncture which then heats up the vein wall and destroys it. A general anaesthetic is not required.
Julia commented “It wasn’t painful, more like a tickling sensation. The worst part was the burning smell as the laser does its job. The initial session took about an hour and you get used to it."
Following the treatment, Julia was placed into a pair of class II compression stockings which she had to wear for a week. The stockings help reduce any post procedure swelling and pain.
Stage 3: FOLLOW-UP
Julia attended for her follow-up 6 weeks post EVLA. She had no problems post-treatment. At this stage her veins hadn’t started to look any different however this is quite normal at this point (especially as the majority of her veins were thread veins). Sometimes the veins may disappear, or get smaller, but our experience is that the vast majority require direct treatment.
A repeat duplex ultrasound scan was performed which confirmed that the EVLA treatment had successfully destroyed the veins causing her problems (i.e the two GSVs).
At this point, Julia underwent her first session of Foam Sclerotherapy and Micro Sclerotherapy injections to the visible veins. Foam sclerotherapy is a chemical mixed into a foam which is then injected into the veins. The foam mixes with the blood in the veins and caused the blood to go hard. Once the blood has gone hard, your body will gradually break down this blood and reabsorb it into the bloodstream. Foam Sclerotherapy is used for larger veins, whereas for smaller thread veins micro-sclerotherapy is used.
Following this treatment, Julia had to wear her compression stockings for another week!
Around 6 weeks following this treatment, Julia commented: ‘I can’t boast that I’ve got flawless legs but the improvement is astonishing. I feel more confident about going bare-legged, which is brilliant now the summer is here. I don’t have to think about how best to disguise my legs and can wear dresses and skirts that are a bit shorter without feeling self-conscious. My legs feel smooth to the touch and I feel sure that this is a permanent solution to the problem that has plagued me for most of my adult life.’
Stage 4: FURTHER SESSIONS OF FOAM/ MICROSCLEROTHERAPY INJECTIONS
Although Julia responded well to the first session of injections, as she had quite extensive varicose and thread veins they were unable to be all be treated in one session. As such, Julia has attended for several more sessions of injections to 'tidy-up' all the visible thread veins.
Due to the chemical within the sclerotherapy, there is a limit to how much we can safely inject in one go. We would love to be able to keep going until we've injected all the visible veins however regrettably, once we have reached the safety limit we must stop injecting. If we haven’t managed to inject all the veins, then it is likely you will need to return again. Sometimes veins can also be particularly pesky and require two injection sessions to get the desired result.
Around 10% of our patients will be like Julia and require additional sessions of injections after their follow-up. At initial consultation, we encourage the consultant to inform you as best they can how many session you are likely to need however it is impossible to be accurate as it is also dependant on how your own body reacts to the treatment.
At Julia’s most recent visit to us she videoed Dr West performing a session of the microsclerotherapy injections. This short video can be found on Instagram, here.
The original Daily Mail article can be found here, Farewell stilton legs!
Julia's legs before treatment
vs Julia's progress after Stage 3. At this point, there were still thread veins that required treatment and some post treatment bruising was still visible.
Although Julia required EVLA, other methods which may be required to fix the underlying cause include: Ultrasound Guided Foam Sclerotherapy, Perforator Ablation (TRLOP), Embolisation, Avulsions (Phlebectomies), MOCA (Clarivein™®), Superglue (Venaseal™)