Surgical Treatment

The Consultant surgeons at the British Vein Institute now consider that surgical treatment where the veins are tied off and stripped out is no longer an appropriate treatment for varicose veins.

There are other treatment modalities using heated probes but these are also invasive, can require a general anaesthetic and incur a longer recovery period than foam sclerotherapy.

The information below is provided for completeness.

Radiofrequency Ablation & Laser Ablation

These techniques use a similar methodology but heat to different temperatures (RFA 200°C and laser 2000°C). They involve insertion of a wire under ultrasound guidance, which is passed inside the vein from the calf up to the groin. The vein is surrounded with fluid (tumescence) which insulates the surrounding tissues and squishes the vein to aid heat delivery. These techniques are used to treat large varicose veins in the thigh (long saphenous vein) or behind the calf (short saphenous vein). The probe at the end of the wire is then heated and pulled along the vein until it has been treated along its whole length.

Advantages:

Effective in all operators

Can be done under local anaesthetic or general anaesthetic depending on patients wishes

Disadvantages:

Heat can result in injury to adjacent structures including the skin and nerves resulting in skin discolouration, burns and numbness.

More expensive equipment involved

This method can only be used to treat the major superficial veins. Prominent varicose veins in the calf either need surgical removal or treatment with foam sclerotherapy

These techniques are not usually suitable for recurrent veins due to tortuosity of the veins