Treatment Options:
To get an idea of some of the current common modalities available click on the link "overview" below. This is a great site with videos and advice on "what are varicose veins", how are they investigated and what are the the common treatment options available. Alternatively for a simple description see my patient information page. CVG may well be the only clinic in Christchurch currently offering open surgery, laser therapy, radiofrequency ablation and foam sclerotherapy. Check out this link for a brief overview of "treating varicose veins".
You'll notice the section on compression therapy and stockings discusses that whilst stockings can help to alleviate some of the symptoms of varicose veins there's really no good evidence to support they prevent progression of venous disease, new varicose veins from developing or that they are in fact cost effective. There are two recommendations from NICE (National Institute of Clinical Excellence) advocating the use of stockings in patients that are either pregnant or in which none of the above treatments are suitable.
You'll notice the section on compression therapy and stockings discusses that whilst stockings can help to alleviate some of the symptoms of varicose veins there's really no good evidence to support they prevent progression of venous disease, new varicose veins from developing or that they are in fact cost effective. There are two recommendations from NICE (National Institute of Clinical Excellence) advocating the use of stockings in patients that are either pregnant or in which none of the above treatments are suitable.
Common Treatment options:
Open Surgery:
Saphenofemoral or saphenopopliteal junction ligation with stripping of the great or small saphenous vein in conjunction with perforator ligation and multiple phlebectomies are well established procedures that still compare well with other newer endovenous techniques as described below. The recurrence rates and long term quality of life improvements are certainly equivalent.
Endovenous Thermoablation:
Venacure (Endovenous Laser therapy)
The link above will take you to the Venacure website and a list of current providers of laser therapy using the venacure laser catheter. This is a well established technique with excellent results in the right hands and compares favorably with open surgery.
Radiofrequency (VNUS Closure / Venefit Closure procedure)
The link above will take you to the Venefit Closure procedure website. This is the new name for what was the VNUS Closure procedure. At the bottom of the page is a short animation of the procedure itself demonstrating treatment of the great saphenous vein. Venefit has excellent result with at least four randomized trials demonstrating its superiority when compared to other techniques. See the evidence page for more information.
The link above will take you to the Venacure website and a list of current providers of laser therapy using the venacure laser catheter. This is a well established technique with excellent results in the right hands and compares favorably with open surgery.
Radiofrequency (VNUS Closure / Venefit Closure procedure)
The link above will take you to the Venefit Closure procedure website. This is the new name for what was the VNUS Closure procedure. At the bottom of the page is a short animation of the procedure itself demonstrating treatment of the great saphenous vein. Venefit has excellent result with at least four randomized trials demonstrating its superiority when compared to other techniques. See the evidence page for more information.
Endovenous Sclerosants:
UGFS: The link will take you to the most recent guidance and evidence regarding ultrasound guided foam sclerotherapy of varicose veins.
Clarivein: Clarivein is a relatively new technique using foam sclerotherpay delivered via a disposable catheter that irritates the vein wall (Endothelium). I'll be adding information to the evidence page in due course.
Sahenon: A very new technique similar to foam sclerotherapy that uses a "specially formulated medical adhesive" to seal the vein shut. This is currently only available in Canada, Europe and Hong Kong. Although currently limited to investigatory use in the United states, there are over 2,000 patients that have been treated with the system so far. Sapheon have successfully completed enrollment and follow up of its Veclose randomized clinical trial. The result of which will soon be available. Check the evidence page for updates.
Clarivein: Clarivein is a relatively new technique using foam sclerotherpay delivered via a disposable catheter that irritates the vein wall (Endothelium). I'll be adding information to the evidence page in due course.
Sahenon: A very new technique similar to foam sclerotherapy that uses a "specially formulated medical adhesive" to seal the vein shut. This is currently only available in Canada, Europe and Hong Kong. Although currently limited to investigatory use in the United states, there are over 2,000 patients that have been treated with the system so far. Sapheon have successfully completed enrollment and follow up of its Veclose randomized clinical trial. The result of which will soon be available. Check the evidence page for updates.
Mr Laws runs regular dedicated venous ulcer and varicose vein clinics in Christchurch and across Canterbury including specialist multidisciplinary clinics at Nurse Maude. Soon it will be possible to treat patients in the community without the need for admission to secondary care. In the animation below it's possible to see the VNUS Closure (Venefit Procedure) performed via a small puncture in the skin. The catheter uses radio frequency ablation to thermocoagulate (heat & seal) the vein from the inside. This can be performed without a general anesthetic and is almost always performed as a walk in and walk out procedure. See the links page for more information.