Laser or VNUS vein treatment
There are a number of different devices available for treating varicose veins without conventional surgery. These all work on similar principles but do have some subtle variations.
The basic technique involves the use of an ultrasound scan to identify the veins underlying the problem in the leg. The leaking vein often originates in the groin, although sometimes it is behind the knee and it usually runs down onto the calf to form the visible veins. Through a tiny incision (3-4mm long) a guidewire is passed into the vein and all the way up to its origin. The device for treating the vein is then guided into position using the wire and the ultrasound.
Fluid is then injected all around the vein which helps keep the vein wall in contact with the treatment device and also protects surrounding structures. The device is then “fired” and the energy it releases is transmitted into the wall of the vein, thus destroying the vein and preventing any further leakage through it. The device is then removed and any remaining veins are removed through tiny nicks in the skin. Bandages are worn for 5 days after the procedure, followed by a period in compression stockings.
The picture on the right shows the endovenous catheter being used to treat the main vein responsible for varicose veins - the long saphenous vein. The treatment is halfway through. Above shows veins before and after treatment.
The 2 main techniques in use in the UK are Endovenous Laser treatment and VNUS®. The first of these obviously uses laser energy to treat the vein, whilst the latter uses radio-frequency energy to achieve the same result. The differences between the outcomes for these 2 types of device are relatively small but the big difference is the improvement in patient outcomes relative to conventional surgery. Patient satisfaction is around 80% after conventional surgery but this rises to well over 90% with the improved endovascular techniques. Your specialist will discuss with you whether he feels that either the laser treatment or the VNUS® closure is better suited to you.
Pros and Cons of Vein Occlusion Techniques
Pros: The main advantages relate to the fact that these newer techniques cause less pain and bruising than conventional surgery. Patients require painkillers for a much shorter period of time following the newer treatments. The average number of days off work needed following ordinary surgery is around 2 weeks but after the new endovenous treatment this is reduced to around 4 days. Many patients can be treated under local anaesthetic but some patients with extensive veins may be advised to have a short general anaesthetic.
Cons: When this technology was first introduced some experts were concerned that in the years after treatment some of the veins would begin to open up again. As experience has grown with this treatment this doesn’t appear to be the case but it still doesn’t have the very long follow (10 years+) that some conventional surgery patients have had.
If you wish to look at websites for the two different techniques please follow the links below, but bear in mind that these are commercial websites that understandably promote their products in as favourable light as possible:
VNUS® www.vnus.co.uk/
Laser www.diomeduk.com
