To achieve the best results some patients will require a combination of the above treatment methods.
Non-Surgical Treatment Methods
Injection Microsclerotherapy and Sclerotherapy is a method where the doctor uses an extremely fine needle to inject a special solution called sclerosant directly into unwanted abnormal veins. This creates a change in the vein lining that causes the vein wall to collapse, which then disappears gradually as the body absorbs it.
Ultrasound Guided Sclerotherapy (UGS) for the treatment of larger varicose veins requires the assistance of ultrasound technology to guide the precise placement of the injections into the abnormal veins, which are hidden below the skin. The sclerosant again causes a change in the vein lining that leads to the gradual absorption of the vein. The absorption process usually occurs over several months rather than weeks.
Endovenous Laser Treatment (EVLTTM) involves the passing of a laser fibre into the abnormal vein via a tiny incision using ultrasound guidance. Local anaesthetic is then placed around the vein to be treated. The laser fibre is then fired as the fibre is withdrawn. The laser light creates a change in the vein lining and wall, which then leads to the absorption of the vein.
Most of the above treatments are followed by the application of a compression stocking on the treated leg, which must be worn for between 1-3 weeks depending on the treatment provided. All patients are advised to walk regularly, which with the wearing of the compression stocking assists with the success of the treatment.
Minor Surgical Treatment Method
Ambulatory Phlebectomy is a minor surgical procedure that involves the removal of varicose veins close to the skin surface through many tiny stab incisions. This is performed under local anaesthetic, and the cuts are often so small that they do not require stitches, although some may require stitches.
Advantages Of These Types Of Treatments
In trained hands, non-surgical and minor surgical varicose vein treatments have become a brief office procedure providing another option to the hospitalisation required for surgical stripping.
At the Vein & Laser Centre, all treatments are performed by either Dr Jacqui Chirgwin MBBS (Hons) FACP (Fellow of the Australasian College of Phlebology) or Dr Alister Lilleyman MBBS (Member of the Australasian College of Phlebology).
Are There Alternative Treatment Methods?
Laser light (not EVLTTM) applied to the legs for surface veins is not yet at a stage where it is more effective than sclerotherapy. Lasers are best used for treating small veins and capillaries on the face.
Surgery is an option for some patients with large varicose veins. Surgical treatment involves hospitalisation and is performed under general or local anaesthesia. The risks associated with surgical stripping when compared to non-surgical treatments include an increased incidence of infection, scarring, deep vein thrombosis, varicose vein recurrence, lymphatic damage and permanent nerve damage.
For example, the incidence of deep vein thrombosis after surgery is between 1:50 and 1:200. The risk of DVT with Ultrasound Guided Sclerotherapy is approximately 1:5000 - up to 100 times safer!
General anaesthesia is very safe in Australia, but there can still be a remote possibility of serious side effects.