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:
|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.
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)
|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 and Microsclerotherapy but some patients are best treated with Phlebectomies/ Avulsions.
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 Sclerotherapy and Microsclerotherapy Injections.
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 necessary for around 10% of our patients, where further sessions of injections are required. This does not indicate that the first session of injections have not worked; it is just that some patients require more than one treatment. If you do need more than one session there will be an additional fee for these. There is a safety limit as to how much of the foam chemical can be injected in one session, once the limit has been reached the clinician must stop injecting.