Clare Park Vein Care specialises in "walk in, walk out" day case varicose vein treatments. We offer a number of minimally invasive options for the treatment of varicose veins with our experienced consultant vascular surgeon.
Clare Park Vein Care offers the latest minimally invasive options for varicose vein care
Treatments are delivered quickly, safely and comfortably under a local anaesthetic allowing our patients a quick return to normal daily activities. We offer all our new patients a "one-stop" clinic for diagnosis with an ultrasound vein scan performed by our consultant vascular surgeon to allow accurate planning for treatment. Let us make your varicose vein treatment with us a first class experience.
What are varicose veins?
Varicose veins occur in up to 40% of adults in the UK. Our veins return blood from the legs to the heart and their normal function depend on precision "one-way" valves within the veins. Varicose veins are caused by incompetent or "lazy" valves within the leg veins. Given time, venous incompetence gives rise to a constant column of refluxing blood and high venous pressures affecting the most dependent part of the legs (venous hypertension). This causes the common clinical features of bulging veins, flare veins, spider veins, ankle swelling, skin pigmentation and venous eczema.
What are the long term consequences of untreated varicose veins?
Venous hypertension will eventually give rise to ankle skin pigmentation and itchy venous eczema. If varicose veins remain untreated at this stage, then progressive damage from venous hypertension will cause venous ankle ulcers. These can be difficult to heal and scars remain despite ulcer healing.
What are minimally invasive treatments for varicose veins?
The traditional approach to varicose vein treatment involves open surgery under a general anaesthetic to make an incision at the groin crease or behind the knee to tie and strip out the faulty veins. Recovery from open surgery can be slow due to pain and bruising. There is also the risk of surgical wound infection in the groin. Recurrence rates can be seen in 10-30% of patients at five years following open surgery. Currently about 70% of patients in the UK with varicose veins undergo open surgery for treatment of their condition.
The majority of patients at Clare Park Vein Care are treated with the latest minimally invasive techniques. These are performed under a local anaesthetic usually in 45 minutes (single leg) to 90 minutes (both legs). There is no surgical incision and our patients return to normal function at home the next day with many returning to work after 48 hours. Our main options for minimally invasive varicose vein treatment are endovenous laser (EVLA or EVLT) or radio frequency ablation (RFA).
Both these techniques rely on heat energy to seal incompetent varicose veins. The laser or RFA fibre is placed accurately under ultrasound guidance within the affected vein with a local anaesthetic injection. More local anaesthetic solution is delivered via a series of small injections (tumescent analgesia) into the leg to protect the patient from the heat generated by the laser or RFA fibre. Varicose veins unsuitable for laser or RFA in the legs can also be treated at the same session with micro-incisions for vein avulsions (phlebectomies). At the end of the quick procedure, no stitches are required for wound closure and the leg is dressed with compression bandaging.
Are all patients suitable for minimally invasive varicose vein treatments?
In our experience about 5% of patients are unsuitable for laser or RFA due to the small size (less than 3mm), extreme tortuosity or pre-existing blood clot formation within the affected vein. Hence it is very important to obtain expert assessment of your varicose veins with a vein scan before proceeding with any form of varicose vein treatment.
What is the difference between laser or RFA?
Both these minimally invasive techniques are applied using the same principles of intra-operative ultrasound guidance, injections for tumescent analgesia and closure of the varicose vein with heat from an energy source (laser or RFA). They have equally good outcomes with regards to closure of the affected vein following treatment. RFA produces less post-operative pain and discomfort in studies comparing laser versus RFA.
However laser has the best evidence for long term durability of treatment beyond five years. At Clare Park Vein Care, our consultant vascular surgeon will assess each patient individually to determine the best technique for successful treatment. All potential treatment options will be discussed with you so that you can be assured that the best method of treatment is chosen to achieve the most durable treatment and the least risk of treatment side effects. In our experience, patients with veins that are more superficially sited will do better with RFA. Both Laser and RFA are recognised by all the major health insurers.
Are there any minimally invasive options for varicose vein care that do not require the injections for tumescent analgesia?
Non-tumescent analgesia techniques are at the cutting edge of varicose vein care. These techniques are feasible but require more long term follow-up data before they have more universal appeal among varicose vein patients and health insurers. Currently these techniques are called ClariVein or Sapheon.
ClariVein therapy for varicose veins is an almost needle free and thus more comfortable technique that for varicose vein patients who are not keen on the multiple injections required for laser or RFA. ClariVein makes use of a mini rotating catheter which introduces a sclerosant solution (Fibrovein) into the affected vein under ultrasound guidance. It is a 15 minute day case procedure and patients return to normal function immediately. The two year success rate for ClariVein is reported to be 96% at two years following treatment. Currently ClariVein is only available to self-funding patients.
Our staff will be undergoing training for Sapheon this autumn in Germany. Sapheon is the latest non-tumescent technique for varicose vein treatment that uses a special tissue glue to seal the affected vein. It is quick, safe and comfortable but as it is still an emerging technology, the long term durability of Sapheon is still being studied. Sapheon will only be available to self-funding patients.
What can I expect after minimally invasive varicose vein treatment?
Most of our patients go home on the same day following their procedure. Older patients and some patients who undergo a general anaesthetic or those who have both legs treated at the same sitting may request an overnight stay. Your leg will be bandaged with compression stockings. Some minor bleeding with oozing through the bandaging is commonly encountered. It is advisable to keep your legs elevated in the first 48 hours following treatment to minimise oozing, swelling and discomfort.
Patients are advised to change into compression stockings after the first 24 hours which should be worn during the day time and removed at night before bedtime. These stockings should be worn for the first two weeks and patients are advised to walk normally at home and elevate their legs at rest. Driving should be avoided for 48 hours or until it is comfortable performing a simulated emergency brake test. Most patients go back to work after two to three days. Any minor bruising should spontaneously resolve within four to six weeks.
Who will be performing my procedure at Clare Park Vein Care?
Mr. Patrick Chong is a consultant vascular surgeon based at Frimley Park Hospital NHS Foundation Trust. He trained in London and the south east. He first started performing minimally invasive vein treatment in 2005. He is currently co-director of the London Postgraduate School of Surgery Endovenous Workshop which trains the next generation of UK surgeons to deliver expert care in minimally invasive varicose vein surgery. His private clinics are located in Farnham, Guildford, Camberley and Reading with patients coming from Surrey, Hampshire, Berkshire and London.