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TRADITIONAL SURGERY.

Most varicose veins of the legs are never treated. The mainstay of treatment for those that are still remains surgery; most commonly tying and stripping. Such surgery is very effective in most cases and most patients are pleased with the results but it is far from perfect. It is expensive, time consuming, uncomfortable at best and usually requires a general anaesthetic. Patients need significant time off work and play whilst they convalesce. Scars are inevitable and recurrence of symptoms and varicose veins occurs in at least 10% of patients after surgery.

MINIMALLY INVASIVE TECHNIQUES.

Over the last 15 years several new interventional radiological (minimally invasive ultrasound guided) techniques have been developed to replace surgery for this common problem and provide an effective treatment for all veins; even those which are apparently minor and causing cosmetic problems only for which many patients are unwilling to have an operation. There are two main techniques (RF ablation (VNUS Closure®) and Laser Ablation (EVLA or EVLT)) both of which have been extensively studied and been shown to be both safe and effective and to produce very encouraging results even for difficult recurrent varicose veins.

Although the latest minimal invasive procedures can be offered to most patients there will still be the occasional one who, given the choices, will opt for traditional treatment. Although we strongly advise against this, it can be arranged following consultation. We always accept that the final decision is the patient's. It is very important however to be presented with all the options with their risks and benefits. Sadly many patients are still only offered surgical stripping and not told about minimally invasive methods to remove their varicose veins.

Before looking at the different types of traditional treatment there are a number of simple, generally sensible, steps that you can take that may ease your symptoms or prevent them from getting worse. These include:

Try to maintain a healthy weight.

Take regular exercise.

Eat a balanced diet, including plenty of fibre to prevent constipation.

Avoid long periods of sitting or standing.

When resting, keep your feet up.

Avoid very tight clothing around the waist and thighs.

None of these however will make existing varicose veins disappear. The traditional treatments which have been used for the treatment of varicose veins include:

Support stockings

Injections

Surgery

'Alternative treatments'

Support Stockings.

Support stockings are elastic stockings designed to be worn all the waking day. They apply compression to the leg in a graduated way, i.e. greater at the ankle than the thigh, thus helping blood pass back up the leg. They must be fitted correctly to have any chance of helping. Although support stockings cannot make varicose veins disappear some patients do get relief from their symptoms whilst wearing them and are happy with this solution. Most patients however do not like the way they look or feel. Your legs can get hot and sweaty and can blister. Some patients are allergic to the latex. They can be difficult to put on especially for the elderly or infirm. There is little research about support stockings for varicose veins but that which does exist does not show much benefit, although in one study 1 in 4 people who tried support stockings before surgery decided to do without the surgery so presumably they must be doing some good!