Colchester Veins

21st century treatment for varicose veins
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Treatment
Surgery
Laser Treatment
Radiofrequency
Sclerotherapy

Radio-Frequency Ablation


In this technique a tiny catheter powered by radio-frequency energy is used to heat up the inside of the defective vein causing it to block off. Usually the defective superficial vein trunk treated is either the long saphenous or short vein which runs down the inside of the thigh and down the back of the calf respectively. The procedure is usually performed under local anaesthetic as a day case or in clinic. About 70% of varicose veins that have not been operated upon and 20% of previously treated varicose veins are suitable. Veins unsuitable for radio-frequency may be too tortuous or may be partially blocked by thrombophlebitis thereby not allowing the tiny catheter to be passed up the vein. Preoperative ultrasound scanning will identify which veins are suitable. In most cases treatment of the main vein trunk is sufficient. However, in some cases additional treatment of the lumpy veins
Results
(varicosities) is necessary either by sclerotherapy or phlebectomies.

The advantages of radiofrequency treatment over surgery are less pain, quicker recovery, less bruising and less scarring. It can be done under local anaesthetic.

The disadvantages are that the long term recurrence rate is not known and further treatment of residual lumpy veins (varicosities) may be required.

The procedure


Prior to the procedure the surgeon will obtain consent and mark the vein with a permanent marker with the aid of an ultrasound scanner. After cleaning the skin with antiseptic solution, local anaesthetic is injected to freeze the skin. A small puncture wound measuring a few mm is made and a needle is introduced into the defective vein with the aid of the ultrasound machine. A fine wire guide is passed up into the vein and a wider tube (sheath) passed over the wire. The radio-frequency catheter is inserted through the sheath. The catheter is carefully positioned a safe distance from the deep vein under ultrasound guidance. A dilute local anaesthetic solution is injected around to protect the tissues from heat. Several injections up the leg may be required and can make the leg feel swollen. The radio-frequency catheter is gradually pulled back and the defective vein treated. A Compression bandage is applied after removal of the catheter and sheath.  The procedure usually takes between 30 to 45mins.



 

After the procedure


Tightness along the path of the treated vein is common and simple painkillers should be taken to reduce symptoms. Bandages should be removed in 1-2 days and replaced by compression stockings which need to be worn for up to two weeks. The patient is advised to walk and resume normal activities within a couple of days. Heavy exercise and gym workouts should be avoided in the first week. The patient is reviewed in six weeks, by then most of the varicose veins would have shrunk and many disappeared. Over 70% of patients do not require further treatment. Remaining veins can be treated by injection sclerotherapy.

Side effects

Bruising and acheing along the path of the vein treated are common. Rarer side effects are heat damage to the skin causing redness of the overlying skin, a patch of skin numbness in the lower leg and deep vein thrombosis (DVT). In a small number of cases the treatment doesn’t work and the vein fails to block off. The treatment can be repeated or alternative treatment performed. Varicose veins can come back as with any form of treatment.