Varicose Vein Treatment Pathway

Our 4 stage treatment pathway aims to effectively treat both varicose and thread veins and any symptoms associated with them.

We developed this pathway back in 2003, and it is firmly established and recognised by the National Institute of Health and Care Excellence (NICE) as the gold standard.

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Stage 1: Consultation

During your initial consultation, a detailed clinical examination and a Colour Duplex Ultrasound Scan of your legs is performed. The scan will accurately determine any underlying cause of your vein problems (i.e. whether any veins contain faulty valves; causing the blood to flow down the leg instead of up towards your heart).

The duplex ultrasound scan is undertaken by a consultant vascular specialist. Without this full and detailed scan, it is not possible to expertly assess your veins and determine the exact treatment required.

Stage 2: Primary Treatment – Fixing the Root Cause

In order to treat the source of your vein problems, and restore healthy blood flood to the legs, the most common primary treatment required is Endovenous Laser Ablation (EVLA).

For patients with minor varicose or thread veins, EVLA treatment may not needed and the primary treatment is likely to be Foam Sclerotherapy. Depending on the scan results, alternative treatments to EVLA may be available.

 

Stages 1 and 2 can be done in the same visit. This service is called See & Treat, if you are interested please read more about it here or ask our patient advisers for more information.

Stage 3: Follow-up – Cosmetic Treatment

Once the source of the problems has been fixed, the visible varicose veins (which branch off this source) may reduce in size. However, in order to achieve the desired cosmetic results, it is normal for further direct treatment to be needed. The vast majority of patients (over 99%) require treatment at follow-up.

The most common follow-up treatment required is Foam Sclerotherapy and Microsclerotherapy, but some patients with larger varicosities are best treated with Avulsions/ Phlebectomies.

The follow-up is usually around 6-8 weeks post EVLA.

Treatment at Stage 3 is often performed alongside EVLA treatment at Stage 2.

Stage 4: Cosmetic Finishing Touches

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 Foam Sclerotherapy and Microsclerotherapy but some patients are best treated with Phlebectomies/ Avulsions.

Around 10% of patients need to attend for further treatment after their initial follow-up. This does not indicate that the first session of injections has 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.

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