Varicose veins occur because blood flows down leg veins towards the feet, rather than away from the feet towards the heart. Normal veins have valves in them, which are structures that act as one-way doors permitting blood flow in 1 direction- that is towards the heart. When these valves malfunction, they permit blood to flow in both directions. This means there is more blood flowing to the feet than there should be. This then leads to the complications of varicose veins and Chronic Venous Insufficiency.
It therefore follows that the treatment should be to close off these abnormal routes that blood takes. Blood then flows through normal healthy veins which appropriately direct the blood back to the heart.
Traditionally, the malfunctioning veins used to be stripped off, a rather traumatic way of removing them from the venous system. This procedure requires general or regional anaesthetic, hospital stay and prolonged recovery.
Endovenous ablation is the technique of choice now. What we do is seal off the malfunctioning vein but leave it in-situ. There is no need to remove it so avoiding the trauma of stripping. Endovenous ablation is accomplished using either heat to denature proteins in the wall of the veins causing the veins to shrink and seal shut, or by using chemicals that damage the cells in the veins walls, also causing the vein to seal shut.
A needle is inserted into the malfunctioning vein and through this the ablation device is inserted. The device is activated along the length of the vein causing it to occlude. Because it is minimally-invasive, local anaesthesia is all that is usually necessary. Patients can get up off the operating table and walk soon after the procedure. Overnight stay is not necessary. Time away from work is minimal, and in fact is frequently not even necessary.
Endovenous Radio-Frequency Ablation/ Endovenous Laser Therapy
Endovenous Radio-Frequency Ablation (RFA) and Endovenous Laser Therapy (EVLT) both use thermal energy to effect vein closure. RFA has been shown to cause less pain and bruising than EVLT and is the treatment of choice at The Vascular & General Surgery Centre.Clarivein
Chemical ablation has been available for some time, but is gaining more interest with the introduction of Clarivein. Clarivein is a device that irritates the inner lining of the vein with a rotating metal tip and injects a chemical at the same. The combination of these two irritative mechanisms results in very effective vein closure with minimal discomfort. Clarivein is offered at The Vascular & General Surgery Centre.
Complications are minor. Bruising is common but will always resolve within 2-3 weeks. Small areas of numbness occurs in about 7% of patients but most resolve with time.