New ways you can treat varicose veins.
Byline: DR MIRIAM STOPPARD
During the summer, the hot weather brought out a rash of middle-aged men and women baring their legs and their varicose veins. And to be honest, it wasn't always a pretty sight.
A fair proportion of over-50s have varicose veins, those lumpy, blue bulges that appear on the fronts and backs of legs due to faulty valves in the veins.
Without competent valves, the column of blood in the legs ( from foot to groin) exerts considerable pressure on the veins below which give way and balloon out.
If only those sufferers knew about the new treatments, championed by Professor Nick Cheshire, of London's Royal Brompton and Harefield hospitals, that promise a solution.
It's a revolution. Vein stripping was standard therapy in the 1960s when a burr was threaded down a vein then pulled out, taking the vein with it.
Ouch! No longer. Now excision of varicose veins is performed via tiny incisions in the skin to remove clusters of varicose veins.
Then there's the crochet-hook technique where a varicosity is hooked through a small incision in the skin, cut out and the healthy ends of the vein are joined up. Much less traumatic than the old methods.
Around four out of five patients will have incompetent valves in the groin, filling the long vein in the thigh. Of the rest, over half will have the same problem behind the knees. The excess down pressure makes side branches of veins balloon out.
Veins can be treated from the inside. - endovenously. Most methods use a heat source bored inside the vein to cause clotting, then closure and ultimately scar formation.
Energy sources include laser, diathermy and sclerotherapy, where a solution is directed into the vein, sometimes under local anaesthetic.
Recurrence, however, may follow treatment. Patients should be told that with vein treatment, whichever method is used, there's no guarantee.
Most patients who have the treatment will also need to be followed up and may need further intervention.
You may even go for a one-step option that combines endovenous techniques with a hook excision of local varicosities, but this will require monitoring by your doctor. Post-op discomfort from phlebitis, inflammation of the vein's walls, can be helped by non-steroidal anti-inflammatory tablets and cream.
For thread veins and spider veins, there's microsclerotherapy using fine needles to inject an irritant and induce scarring. A 20-minute session will improve appearance significantly.
For patients with both varicose veins and thread/spider veins, the best surgeons will combine endovenous treatment and microsclerotherapy, over two to four weeks. You can choose from a menu of treatments to achieve the desired results.
Methods are less traumatic than before