TREATMENTS

Treatment options

At Glasgow Vein Clinic, we offer evidence-based treatments for varicose veins based on NICE Guidelines (CG 168).

In summary, the NICE guidelines recommend that if you are suitable for minimally invasive treatment with endothermal ablation treatment, this should be offered.

If you are not suitable for endothermal ablation, then ultrasound guided foam sclerotherapy should be offered. 

If neither of these is suitable, then traditional varicose veins surgery should be offered. 

At Glasgow Vein Clinic, we have extensive experience and the necessary facilities to offer all these treatment options.  

 

The optimum treatment strategy will be based on the clinical and ultrasound assessment at your initial consultation.  It will also take into account your individual clinical circumstances, and your personal preferences.

Our out-patient, and in-patient treatment facilities are fully staffed and are provided in a safe and reputable hospital setting.

EndoThermal Ablation  (RadioFrequency Ablation / RFA)

We offer RadioFrequency Ablation as the first line treatment option in patients whose veins are anatomically suitable (as determined by ultrasound). 

The treatment is carried out in theatre, and can be done either under local or general anaesthetic. 

A small incision is made in the leg, through which a fine catheter is passed, which is then guided up the vein with ultrasound. Some cold fluid is injected around the vein and the catheter is activated. This causes heating to the lining of the vein which makes it seal. Once closed, blood stops flowing in the vein and it gradually shrivels up and disappears.

You may require some foam sclerotherapy or phlebectomies (avulsions) which can be done at the same time, or at a later date.

 

The most appropriate strategy for you will be discussed at your initial consultation. For further information on foam and phlebectomies (avulsions), see the relevant sections below.

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Ultrasound Guided Foam Sclerotherapy  (UGFS)

Foam sclerotherapy can be used to treat varicose veins of varying sizes, and is particularly well suited for patients with recurrent varicose veins.

The procedure is carried out in the out-patient clinic, or in theatre if done along with RadioFrequency Ablation treatment.

It is done under local anaesthetic.

You will be lying on the couch. Using ultrasound and local anaesthetic, a number of small cannulas are carefully inserted into the veins. Foam is prepared and injected into the veins through the cannulas. The foam injection does not normally cause pain but you may feel a bubbling sensation as it moves about.

You may need more than one treatment session to close all the veins. The number of treatment sessions will therefore depend on how many veins you have. Normally only one leg is treated at each visit.

Surgery - including ligation / stripping and avulsions (phlebectomies)

Ligation and stripping surgery used to be the main treatment for varicose veins, but in modern vascular practice most surgeons will recommend minimally invasive treatments such as RadioFrequency Ablation and foam sclerotherapy instead.

However, for some patients surgery still remains a useful option for treatment – and in accordance with NICE Guidelines, should be offered if the veins are not suitable for RadioFrequency Ablation or Foam (*there are some reasons why this may be the case which would be discussed with you at your initial consultation if applicable).

Either way, at Glasgow Vein Clinic, we have all the out-patient, in-patient and theatre treatment facilities required, to offer you the full range of options, including surgery if it is the most suitable for you. 

Surgical treatments are usually done under general anaesthetic.

Microinjection Sclerotherapy

This is used to treat small veins including spider (thread) and reticular veins.

The procedure is carried out in the out-patient clinic.

You will be lying on the examination couch. A tiny needle is inserted into
the veins and a liquid sclerosant drug is injected. 

It causes the veins to shrivel up and disappear gradually.

You may need several treatment sessions, and normally only one leg is treated at each visit.