TREATMENT OPTIONS
There are a number of options, the merits of which we are happy to discuss at TVC
Do nothing
if you have minor varicose veins that do not bother you cosmetically and are not causing any symptoms, then this approach may be reasonable. Certainly, you do not have to make an urgent decision and can afford to ‘wait and see’. Varicose veins are usually progressive, however, and waiting too long might result in a bigger operation eventually!
Conservative treatment
If you have developed varicose veins, staying slim and active might help to slow down their progression. Walking is good for venous function, as are most forms of exercise. Elevate your legs when resting. Graduated compression stockings may help some people but there is no evidence of their efficacy, most people hate wearing them and they are their use is not recommended by NICE.
If your veins are causing trouble – you have developed symptoms - then referral to a specialist for consideration of definitive treatment to get rid of them is recommended by NICE. (www.nice.org.uk/guidance/cg168). Unfortunately, although NICE has declared that treatment of varicose veins is cost-effective (treatment improves quality of life at reasonable cost), most Clinical Commissioning Groups in the UK will not fund treatment on the NHS unless varicose veins are associated with significant complications such as skin damage or ulceration (treatment may be cost-effective but it is not affordable).
At TVC we offer a modern, bespoke service for people with varicose veins. We will listen to want you want from treatment, assess your veins clinically and with duplex ultrasound scanning and together we will plan the most effective solution for you.
Interventional Treatments for Varicose Veins
NICE guidance CG168 Varicose Veins: Diagnosis and Management was published in July 2013. This guideline recommended that people with symptomatic varicose veins should be referred to a specialist for treatment. It recommends that they should then undergo a Duplex Ultrasound Scan to determine the cause of the varicose veins. It also recommended that people with the most common cause of varicose veins (GSV incompetence) should be treated with endothermal ablation. If this was not possible, then NICE recommended Ultrasound-Guided Foam Sclerotherapy and only if this was not possible should conventional varicose vein surgery be considered.
This had been our approach at TVC for many years. We have been personally performing Duplex Ultrasound scanning for all of our patients with varicose veins for over 25 years and Endothermal Ablation has been our treatment of choice for over 20 years. Everyone is different, however. People present with varicose veins due to incompetent valves in other veins. Some have huge veins, others smaller veins but maybe lots of them. Many people have small thread veins in addition. You may be mainly concerned with relief of symptoms or prevention of complications, or you may be seeking treatment to improve the appearance of your legs.
The TVC Varicose Vein Treatment Pathway ensures that your requirements are met