Treating Varicose Veins

The treatments are performed in our clinic rooms.  Patients lie comfortably on the examination couch.  Relaxing music is played and chat with you while we work.

Ultrasound imaging allows our Consultants to demonstrate the exact position of the veins to enure that all varicose veins are destroyed during the treatment.  The varicose veins treatment begins by placing cannulae (small plastic tubes) into the offending veins  using ultrasound guided placement and local anaesthetic.  The cannulas sit inside the veins and allow us to administer the foamed sclerotherapy agent with precision.  The active agent in the foam is STS (sodium tetradecyl sulfate) which is a detergent  sclerosant and is licensed for use in the treatment of varicose veins.  The liquid is mixed with a gas (carbon dioxide) to create a mousse or foam, consisting of very small bubbles.  This  damages the inner surface membrane of the veins causing them to spasm and for a clot.  An inflammatory reaction is generated as part of the body's healing process, and initially the vein becomes a bit lumpy and tender but over the subsequent days to weeks, the inflammation settles and the vein is completely obliterated.

STS is a safe medication to use, it acts on the vein surface it touches after insertion but is deactivated by blood, so disperses safely without acting elsewhere and is excreted via the kidneys within a few hours.

What are the risks involved with foam sclerotherapy for my varicose veins?

All operations involve some risk but this is not a big procedure and so the risks are small.  Nonetheless we will ask you to sign a consent form to say that you understand what the treatment involves and you would like to proceed.  The risks of this treatment include:

• Bleeding (minimal)
• Infection (minimal)
• Tender and red veins (this can be managed by wearing the compression stockings and taking painkillers and anti-inflammatory medications
• Skin discolouration (we will use the lowest effective strengths of the solution to minimise this risk and, if it happens, will fade in 3 - 12 months)
• Lumpiness and bruising (common)
• Deep vein thrombosis (1 in 400 people)
• Recurrence (new veins, reticular veins and thread veins can grow)

Aftercare

At the end of the procedure, the Consultant will wrap your legs in bandages which you wear for one week.  You are able to walk normally and conduct your usual daily activities.  You may not need to take time off work.  You may wish to avoid running or doing sweaty gym sessions because your bandages need to be worn for one week.  You can obtain a Limbo from chemist or online, to allow you to shower and keep your bandages dry.  The leg may ache slightly for a few days. This is normal and will resolve slowly. The treated veins can be a little tender and lumpy.  Pain killers and anti-inflammatory medications, such as paracetamol and ibuprofen are not always needed but will help if your legs are uncomfortable.

After one week, you can take the bandages off and you will see a marked improvement. To remove the bandage, first peel off the stocking and then cut the bandage down the front from top to bottom using scissors. Taking care not to injure your leg. Soaking the sticky tape in the bath or shower will help to release this. Nail varnish remover can be used to remove the adhesive and blue pen marks.

We advise wearing a stocking during the day for the second week and then we ask that you come and see us again at 14 days. At this visit we will check all the veins have responded to treatment, close any that are still active and decompress any large ones. We will often perform sclerotherapy for the superficial thread veins at this point to improve the cosmetic outcomes.

It is often impossible to achieve a perfect cosmetic appearance without further sclerotherapy sessions. Once the big superficial trunks have been closed, it can take 3-8 sessions of sclerotherapy to eradicate the thread veins. The varicose veins usually disappear completely, but this may take a few weeks.

Foam Sclerotherapy for varicose veins - a patient's view