Varicose Veins

The gold standard treatment option for most patients is a group of techniques referred to as “endovenous”. Traditional open surgery requires general anaesthesia, a significant skin incision as well as “stripping” of the vein; this is more painful and associated with a longer recovery and a higher rate of wound complications. Endovenous treatments are minimally invasive procedures delivered through the needles and catheters and are almost always performed under local anaesthetic. Typically, thermal energy (heat), delivered by a slim catheter, is used to seal off the affected vein, causing it to collapse and eventually be absorbed by the body. The newer Venaseal procedure avoids the use of heat, instead using a special type of glue to seal of the vein.

There are two common methods of endothelial ablation:

1. Endovenous Laser Ablation (EVLA):
   • EVLA uses laser energy delivered through a thin fiber inserted into the varicose vein. The laser heats the vein from the inside, causing it to collapse and seal shut. Blood flow is then naturally rerouted to healthier veins.
2. Radiofrequency Ablation (RFA):
   • RFA involves the use of radiofrequency energy delivered through a catheter inserted into the vein. The catheter heats the vein wall, causing it to collapse and close off.

Both EVLA and RFA have advantages over traditional vein stripping surgery, such as being less invasive, requiring minimal recovery time, and producing good outcomes. They both have very similar high success rates, although analysis of studies suggest that radiofrequency ablation has causes less pain and fewer complications and so if endovenous ablation is the best treatment option for your condition, we will perform it using radiofrequency ablation (RFA).

Learn more about RFA

There is however a newer endothelial method of sealing large varicose veins, known as the Venaseal procedure which uses glue, rather than heat, to seal off the vein. We are the first private vascular surgery service in Scotland to introduce this procedure. Because there is no ‘burning’, this procedure requires less local anaesthetic injections, causes less bruising and swelling and most patients don’t even need to wear compression stockings following the treatment. It is therefore likely to become the new gold standard method over the coming years.

Learn more about Venaseal

Foam sclerotherapy is a minor procedure that is used to treat varicose veins and spider veins. It can be done alone or in addition to RFA or Venaseal. It involves injecting a special foam solution into the affected vein, causing it to seal off and eventually be absorbed by the body. It can be used to treat larger varicose veins, although when using foam to treat large veins it is associated with a higher risk of complications, which is why we do not use it for this purpose. Its main use is in treating smaller veins after the larger vessels have first been treated with other methods.