Varicose veins explained

Mr Simon David Hobbs Mr Simon David Hobbs Consultant Vascular Surgeon at Nuffield Health Wolverhampton Hospital
Unsightly and uncomfortable varicose veins can diminish your confidence and get in the way of the life you love. But Mr Simon Hobbs, Consultant Vascular Surgeon at Nuffield Health Wolverhampton hospital, says getting rid of them is not as scary as it once was.

The way we remove varicose veins has changed a lot in the last 5 to 10 years. In the past, invasive open surgery was the only way to eradicate the bulging, tortuous, and sometimes painful veins in your legs. These days we have the technology and the skills to treat varicose veins without the need for a major surgical procedure.

The old way of dealing with varicose veins

Varicose veins occur near the surface of the skin but the problem often begins in the large ‘feeder’ veins buried deep within the leg – usually the Great Saphenous vein. One way valves in the vein are designed to prevent the backflow of blood but when they become faulty - blood is allowed to reflux and pool in the lower leg, stretching and dilating smaller veins under the skin’s surface.

The most effective way to treat the problem was to physically remove the large vein feeding the varicosities. The most common way to do this was to make two cuts - one in the groin and another lower down the thigh before tying off the vein in the groin and stripping it out of the thigh. Patients usually required a general anaesthetic and their recovery could be slow and painful.

Moving on

Today, I perform over 95% of my procedures under local anaesthetic with minimally invasive techniques that allow people the freedom of a ‘walk-in walk-out’ procedure with a swift recovery.  With no need for a general anaesthetic, we can take things out of the operating theatre and into the more comfortable environment of a treatment room, making the process a lot less daunting for the patient.

The new way

There are several new techniques, the most common of which is endothermal ablation. Rather than cutting and removing the offending vein, we insert a very fine tube into the vein and heat it from the inside using a laser fibre or a radiofrequency catheter. This causes the lining of the vein to shrink down and to block off, stopping the reflux of blood back down the vein. The dilated veins closer to the skin are then removed using very fine incisions - a technique called microphlebectomy.

Foam sclerotherapy is another technique growing in popularity. Instead of using heat, a foam solution is injected into the vein, blocking the flow of blood. The vein shrinks and disappears within several months.

Some people have put up with varicose veins for years because of a fear surrounding the procedure. Access to these treatments means reclaiming your legs and your confidence could be easier and a lot less scary than you thought.

Last updated Wednesday 27 November 2019