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Varicose Veins

Varicose Vein RemovalVaricose veins are swollen, gnarled veins occurring most frequently in the lower limbs and more commonly in the superficial veins of the legs, which are under high pressure when standing. They are produced by a condition called Venous Insufficiency, in which the blood circulating around the lower limbs is not able to return to the heart due to the valves in the veins being damaged. The blood then pools in the distended veins which become varicose.

Not only are varicose veins an unsightly cosmetic concern, they can also cause the patient pain especially when walking or standing. They can often feel itchy and scratching them can cause ulcers. Swollen ankles or calves are also possible. However, serious complications are rare. Varicose Veins never go away without treatment. They frequently progress and worsen over time.

Who gets Varicose Veins?

Varicose veins can occur in people of any age and gender, however, women are much more prone (especially those who have had children), along with those who have a family history of varicose veins or people who spend a great deal of time standing.

Investigation of Varicose Veins

A full and thorough clinical history which includes details about pregnancies, medications, exercise and diet habits will enable your surgeon to determine possible underlying causes for your varicose veins and thus to determine possible treatment options. In particular you will be asked about any history of deep vein thrombosis (DVT) as this can sometimes be a contraindication for varicose vein treatment.

At Specialist Medical Clinic we offer a Varicose Veins package where a preliminary analysis of your varicose veins is made, an accurate assessment of the full anatomy of the venous system of the leg and in particular, identify where the damaged venous valves are located. By doing this, corrective treatment can be tailor-made to each individual’s requirements. To fully assess the venous anatomy of your legs, a Duplex Venous Doppler scan will be required.

Treatment options for Varicose Veins

There are several treatment options available for varicose veins. The most suitable option is dependent on the severity of the venous insufficiency. With great advances in medical technology, all pre-conceived ideas of varicose vein treatment being severe and painful, with a lengthy recovery period and marked bruising are fading. These days treatment is simple, easy and almost entirely pain-free with walk-in, walk-out procedures.

VNUS® ClosureFASTTM (Minimally Invasive Technique)

This is the latest technology in varicose vein treatment and along with Endovenous Laser Treatment (EVLT), has made vein stripping in the USA virtually obsolete.

Physicians using the VNUS® ClosureFAST™ catheter, the only radiofrequency device on the market today for the treatment of venous reflux, report that most patients return to normal activity almost immediately following the procedure, with little or no post-operative pain.

Under local anaesthesia and ultrasound guidance, a device is inserted into the diseased vein and advanced to the site of vein damage. The catheter then delivers radiofrequency (RF) power to heat and seal the vessel. The technique is extremely successful and far less painful and traumatic to the patient than vein stripping. Radiofrequency devices operate at far lower temperatures than Laser to heat and shrink the vein walls, therefore limiting the impact on surrounding tissues and, according to a clinical study, causing significantly less pain and bruising than EVLT.

The Specialist Medical Clinic is proud to be the only clinic in Gibraltar and on the Costa del Sol to offer this technique to our patients!

Conservative Treatment (Injection Sclerotherapy)

This treatment is used mainly for the elimination of small isolated varicose veins or spider veins when there is no obvious evidence of underlying problems with the main veins. The treatment is performed by injecting an irritant solution, either concentrated saline or a specialised sclerosant solution, directly into the veins themselves.

The irritant damages the vein walls, causing them to swell, adhere and seal shut. The vein then slowly turns into scar tissue and gradually disappears over a period of weeks. Sclerotherapy is generally performed in the doctor’s office in less than 30 minutes and is considered highly effective when properly done, although the same vein may require multiple injections and repeat treatments over time. The treatment can be painful, with a burning or stinging sensation common, but the discomfort usually passes in a few minutes. Side effects are generally mild and temporary, and can include skin sores, superficial phlebitis (inflammation of the vein), bruises and discoloration around the treatment site.

Vein Stripping

This is the traditional surgical approach to varicose veins which can still have its place as part of a treatment package. In this technique the varicose vein is physically removed.
Our surgeon does not use this to treat large veins in the thigh as it requires general anesthesia and produces significant post-operative pain and bruising with an associated lengthy and uncomfortable recovery period.

The technique is however highly effective to remove small veins in the lower leg under local anaesthetic.

EndoVenous Laser Treatment (EVLT)

Endovenous Laser Treatment is a similar technique to VNUS ClosureFast. It uses an optical fibre to deliver extremely high heat – over 700 degrees centigrade – which boils the blood in the vein to create a clotting effect which seals the vein as the device is withdrawn. The increased heat generated by this technique seems to result in more pain than our preferred VNUS method. Patients can not only suffer from more pain and bruising, there is also a significant chance of some vein staining to appear on the treated leg, which is difficult to eliminate.
(This procedure is not currently available at the Specialist Medical Clinic)