Varicose veins

Varicose veins are engorged, twisted veins that usually appear blue or dark purple in colour. They typically occur in the legs and feet and are caused by leaking valves in the veins. Normally, in combination with the calf muscles, the venous valves direct blood flow upward from the legs toward the heart. If they become weak or damaged, they allow blood to reflux down toward the leg and pool in the veins. This causes high pressure in the veins, causing them to stretch and become swollen.

Aside from the unpleasant appearance, varicose veins are often uncomfortable, causing symptoms such as aching, heaviness, itching, or swelling in the legs. Left untreated, they can eventually lead to inflammation, scarring and ulceration of the skin. They are equally common in women and men and can be influenced by factors such as genetics, age, inactivity, pregnancy, cigarette smoking, being overweight and taking the contraceptive pill or hormone replacement therapy.

The gold standard treatment option for most patients is a group of techniques referred to as “endovenous”. Traditional open surgery requires general anaesthesia, a significant skin incision as well as “stripping” of the vein; this is more painful and associated with a longer recovery and a higher rate of wound complications. Endovenous treatments are minimally invasive procedures delivered through the needles and catheters and are almost always performed under local anaesthetic. Typically, thermal energy (heat), delivered by a slim catheter, is used to seal off the affected vein, causing it to collapse and eventually be absorbed by the body. The newer VenaSeal™ procedure avoids the use of heat, instead using a special type of glue to seal of the vein.

There is however a newer endothelial method of sealing large varicose veins, known as the VenaSeal™ procedure, which uses glue – rather than heat – to seal off the vein. We are the first private vascular surgery service in Scotland to introduce this procedure. Because there is no ‘burning’, this procedure requires less local anaesthetic injections, causes less bruising and swelling and most patients don’t even need to wear compression stockings following the treatment. It is therefore likely to become the new gold standard method over the coming years.

Foam sclerotherapy is a minor procedure that is used to treat varicose veins and spider veins. It can be done alone or in addition to RFA or VenaSeal™. It involves injecting a special foam solution into the affected vein, causing it to seal off and eventually be absorbed by the body. It can be used to treat larger varicose veins, although when using foam to treat large veins it is associated with a higher risk of complications, which is why we do not use it for this purpose. Its main use is in treating smaller veins after the larger vessels have first been treated with other methods.