Types of Treatment for Varicose Veins
Surgery for varicose veins:
The surgical treatment for varicose veins is changing all the time. A few years ago the only treatment was open surgery (the so called ‘high tie and strip’). Over the last 10 years a lot of newer treatments for varicose veins have been developed which are generally more minimally invasive (less damaging to the patient) and result in faster recovery.
These newer techniques include:
Reliable information about these new operations is sometimes difficult to come by for a number of reasons:
- The technology is developing rapidly so some of the new techniques haven’t been around long enough for the relevant comparative trials to be done and published.
- There is a ‘trade war’ going on between the manufacturers of the various new devices – as a result the competition for market share leads some companies to produce promotional literature which can be biased and may not give the whole story – for the individual patient it can be very confusing and difficult to know where the best option for them lies.
- There are a lot of articles written in the press about new treatments and some of these articles can give a biased impression or fail to explain the whole story to the reader.
- At the moment there are not very many surgeons skilled and experienced in the new techniques – some surgeons who haven’t learned the newer techniques may have a one-sided view and tend to put patients off.
- Surgeons are constantly assessing and comparing one treatment against another treatment by means of a variety of ‘clinical trials’. Often times these trials lead to plenty of differences of opinion – and surgeons love arguing with each other about the significance of particular results.
Choosing your varicose veins treatment:
Choosing between these possible varicose vein treatments can be difficult. Not all surgeons offer all of the newer veins treatments and making sense of the choices on offer can be problematic. Our website aims to help with that choice. We have laid out in the following paragraphs our views of the various options available.
Please note that these opinions are those of the authors of the website (both consultant vascular surgeons with a lot of vein surgery experience) – other vein surgeons (and some of the veins surgeons listed on this website) will have their own views which may differ from ours.
At the end of the day the surgeon you see will have his or her professional opinion about what type of varicose vein operation is the best. As long as the procedure is carried out to a good standard a good outcome can be obtained from any of these varicose vein operations. We think it is important that a veins surgeon should be able to use open surgical methods as well as the minimally invasive techniques and select the right procedure for each individual patient.
Whichever technique your surgeon recommends you should have a duplex ultrasound scan done before a decision is made as to how to treat your veins. Vein scanning is very important in deciding which operation is the best choice as no-one can tell for sure where the underlying problem is in the leg just by looking at the external appearance. The vast majority of good veins surgeons will insist on doing a scan before deciding what surgery is needed. The scan may be done by the surgeon or by a trained ultrasound technician.
Ultrasound scanning is painless and non – invasive (that means there are no needles or dangerous X-Rays) and it takes only a few minutes to do.
DUPLEX ULTRASOUND SCANNING FOR VARICOSE VEINS
By clicking on the links listed below you will be taken to the relevant page with information about a particular minimally invasive technique for veins surgery:
Open vein surgery – also called ‘high tie and strip’
This operation for varicose veins was first done about a hundred years ago. It consists of a cut in the top of the leg where there is frequently a faulty valve. The damaged varicose vein is then divided and ‘stripped’ out of the leg using a plastic rod which is pushed down the vein from the groin to the knee.
The operation has been around for a long time and a lot of studies have been done about the various ways of doing it and the results and risks that such surgery entails. Lots of surgeons have been trained in the past to do vein surgery this way, but it is slowly being replaced by the ‘minimally invasive’ ways of vein surgery described on the previous pages.
How long does it take to get better from surgery?
The operation does work well in good hands but it takes quite a while to get over the bruising and discomfort from the stripping and the cut in the leg. Recovery from surgery can take up to six weeks.
What are the risks of having surgery?
Complications include wound infections from the cut in the groin, deep vein thrombosis and nerve injuries from damaging a nerve in the thigh when the vein is stripped out. Recurrence of the veins is also quite common and a lot of patients need to have repeat surgery at some point in the future.
What patients might be suitable for open veins surgery?
Out of choice we personally offer all suitable patients operations using the minimally invasive techniques such as EVLT. However there are some patients who are not suitable for EVLT (approx 5 – 10 % of veins patients) and these patients can be offered open vein surgery and get good results.