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STANDARD PATIENT DIAGNOSIS & TREATMENT PRINCIPLES

The principles of how to manage all types of leg veins, which we adopted when we started in 2003, are now firmly established and recognised by NICE.

There are 4 stages to effective management of Varicose Veins:

STAGE 1
CONSULTATION
Clinical examination and a Colour Duplex Ultrasound Scan is performed to accurately determine the underlying sources causing your problems.

Without this full and detailed scan by a vascular specialist it is impossible to expertly assess your veins or determine the exact treatment you require.
STAGE 2
DESTRUCTION OF THE VARICOSE VEIN SOURCES
This is most commonly by
Endovenous Laser Ablation (EVLA)

however, depending on your examination, some patients need or request: 
Ultrasound Guided Foam Sclerotherapy 
Perforator Ablation (TRLOP)
Embolisation
Avulsions (Phlebectomies)
MOCA (Clarivein™®)
Superglue (Venaseal™)
STAGE 3
FOLLOW-UP
After the destruction of the source, the varicose veins visible on the outside of your legs (which branch off this source) may disappear, or get smaller, but it is normal for further direct treatment to these to be required.

This is normally undertaken using Ultrasound Guided Foam Sclerotherapy, but some patients are best treated with avulsions.
STAGE 4
COSMETIC FINISHING TOUCHES
Once the underlying source and larger varicose veins have been dealt with then symptoms should resolve but there may be some persistent cosmetically unattractive smaller veins and thread or spider veins remaining.

These are best dealt with using a combination of Foam and Microsclerotherapy.

Additional Notes:
Stages 1 and 2 can be done in the same visit.
Treatment at Stage 3 may also be given at the same time as Stage 2. 
Stage 3 is usually about 6 weeks later. All patients must attend for this follow-up.
Stage 4 is neccessary for around 10% of our patients, where further sessions of injections are required.