What are varicose veins?

Varicose veins are defined as swollen and tortuous leg veins that tend to bulge and protrude from the surface of the skin. They are very common and affect women more frequently than men. In many patients they produce no symptoms but in others they may give rise to pain, itch, swelling, irritability, heaviness and damage to the skin of the leg.

Many sufferers also find that they are embarrassed by the appearance of their varicose veins and often avoid exposing their legs. Varicose veins will tend to worsen slowly but more serious problems only occur in about one in ten of those affected.

Veins collect blood from the tissues and return it to the heart. The leg contains deep veins embedded within the muscles and superficial veins which lie in the fat plane beneath the skin. There are two main superficial veins – the long saphenous vein which runs up the inner part of the calf and thigh and the short saphenous vein which is located at the back of the calf. The saphenous veins contain valves throughout their length. Failure of the valves will allow blood to reflux ie run back down towards the foot. This abnormal downflow increases the pressure within the saphenous vein and this in turn causes the side branches to become engorged, swollen and tortuous - varicose veins.

A duplex scan identifies the location of the leaking or “incompetent” valves and allows the surgeon to plan the most effective treatment. This is designed to obliterate the incompetent section of saphenous vein, usually by the application of heat energy - radiofrequency closure. This is normally done under local anaesthetic, does not need a surgical incision or stitches and allows a return to work next day, with a minimum of pain. The procedure takes about one hour including recovery time. There can be no doubt that this is a great improvement compared to traditional surgical stripping and is now our standard method.

Varicose Veins Jersey will provide a solution for your problem usually by combining radio frequency closure, which treats the root cause, with actual removal of the varicose veins under local anaesthetic. This means pain killing injections using a very fine needle - you will not be “put to sleep” or sedated. We are always very happy to answer all your questions about what treatment entails, including the very small possibility of an adverse event.

The relief of symptoms and a good cosmetic outcome are always paramount.

Radiofrequency Closure

Radiofrequency closure uses heat generated by a thin catheter to obliterate the incompetent saphenous veins. This eliminates the root cause of your varicose veins. The catheter is passed painlessly up the vein from below the knee to groin level. Successful obliteration of the saphenous vein is achieved in 99% of our operations. We almost always recommend that we also remove the varicose veins themselves by the technique of “phlebectomy”. This will ensure the best possible outcome.

A pre treatment ultrasound scan is always required to determine suitability for Radiofrequency closure.

This treatment can be done easily under a local anaesthetic and, after a cup of tea, the patient is able to go home with a minimum of discomfort. The procedure usually takes about forty minutes for one leg and about one hour for two. After this walk in/walk out treatment most patients may return to work the following day. We carry out follow up after 2-3 weeks. This includes postoperative ultrasound scan to confirm successful closure of the saphenous vein(s). Audit of our results confirms a very high level of satisfaction in patients who have had treatment for varicose veins.

Removal of Varicose Veins (‘Phlebectomies’)

It is usually advisable to combine radiofrequency closure with the removal of varicose veins through tiny skin incisions – phlebectomies. 

This can easily be done under local anaesthetic and is often followed by microsclerotherapy for thread veins. Occasionally, avulsion of varicose veins or "phlebectomies" without radiofrequency closure may be a good option in purely cosmetic cases (usually small, unsightly varicose veins), but only if there is no evidence of leaking valves in the major saphenous veins. We never use stitches but close the skin with sticky paper strips “steristrips”.

Foam Sclerotherapy

Foam sclerotherapy is a treatment which involves the injection of chemical foam into one or more varicose veins. An elastic compression stocking is then fitted and worn for four weeks.

Complications include phlebitis (inflammation and soreness of the treated vein) and pigmentation (brown staining of the skin) which may either resolve over a few months or sometimes persist. Very occasionally the brown pigmentation may be marked and unsightly which, to many, is the main disadvantage of this method. Overall I am not keen on the use of foam injections in view of the potential risks and the uncertainty of the outcome compared with removal of varicose veins by “phlebectomy”.

At Varicose Veins Jersey we will discuss the advantages and possible drawbacks of each form of treatment to help you make the best decision.