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Chronic Venous Disease Varicose Vein Conservative Management Sclerotherapy Endovenous Laser Therapy (EVLT) Endovenous RFA Surgery
Early treatment prevents advance complications such as eczema and non-healing ulcer. The extent and distribution of the disease are crucial in choosing the treatment options. Feel free to discuss the benefits and side effects with a vascular surgeon.
1) Sclerotherapy
Sclerotherapy: Veins are injected with sclerosant that irritates the inner lining, causes mild inflammation, obliteration, and subsequent reabsorption of the unwanted veins
Foam sclerotherapy: Sclerosant in the form of microfoam is more effective for large varicosity
Trans-illuminated sclerotherapy: Side-illuminate with a bright ring of light to show up the deeper veins for injection
2) Endovenous Laser Therapy (EVLT)
The skin is numbed, under ultrasound guidance, a catheter is inserted through a needle stick into the abnormal vein.
Catheter is directed to site of reflux.
Laser energy is delivered causing the vein to collapse and seal shut.
3) Endovenous RFA: Similar to EVLT but radiofrequency energy is used
Surgery
Performed under local or general anaesthesia
1) High tie: A small groin crease incision is made to cut and tie off the origin of reflux at the junction between the superficial and deep vein.
2) Invagination stripping: A “PIN stripper” is inserted through the cut end and advanced down the vein. The end of the PIN stripperis sewn to the end of the vein. The tip of the stripper is perforated through the skin at knee level and the stripper is removed. The vein is pulled in on itself and is “stripped” out through a 2mm incision.
3) Hook Phlebectomy: through multiple small stab incisions a hook is inserted to fish out and remove the vein.
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