The Daily Express recently wrote about a man (Rob Crowley, 35) who had undergone a ‘MIRACLE’ treatment for his Varicose Veins after having had an unsuccessful surgical procedure with the NHS.
The headlining treatment in question was the Endovenous Laser Ablation (EVLA) Therapy available at our Birmingham clinic, and the article effectively raises three major points. First, that the EVLA treatment was far more effective at treating varicose veins than a surgical procedure. Second, the article highlights that patients aren’t aware of endovenous treatments, and finally, that the NHS has an out-dated approach to the management of Varicose Veins.
So, let’s tackle the latter two issues and start by demystifying the condition and its EVLA treatment.
What are Varicose Veins?
The vascular network serves to distribute oxygen to tissues within our bodies through blood that circulates in a specific direction. The flow is regulated thanks to valves, which stop the blood from backtracking on itself and causing congestion. When theses valves weaken, or fail to function properly and the vein’s walls stretch, blood can accumulate and cause the vein to swell.
Varicose veins can be recognised by their blue and purple colours, which draw all the more attention to the convoluted, raised patterns that they follow. The condition is often hereditary and is seen in women more often than in men. Hormonal changes such as experienced during pregnancy can cause veins to become varicose, as can putting pressure on your lower body – be it because of your occupation or your weight.
What is EVLA?
An EVLA procedure is performed under local anaesthetic and involves a slim laser-tipped fibre, being inserted through a catheter and along a vein, until it reaches the edge of a Varicose Vein. Once there, the laser’s heat collapses the vein’s walls, and keeps doing so along its length as your surgeon guides it back out.
This straightforward treatment falls short of being a miracle, but according to the National Institute of Clinical Excellence (NICE), it certainly represents the Gold standard for the treatment of Varicose Veins thanks to its 95.4% success and non-recurrence rate (after five years). Although NICE designated EVLA as the most effective Varicose Vein treatment in 2013, it is a procedure that has been around for 15 years and arguably doesn’t warrant being presented as a novelty. At The Private Clinic we also offer VenaSeal, Foam Sclerotherapy and Phlebectomy treatments meaning our expert surgeons can pick the best treatment to suit you.
Patients’ lack of awareness of its availability is partly due to the NHS, as the institution doesn’t commonly offer EVLA, with GPs rarely suggesting the private sector.
The NHS’s approach to the treatment of Varicose Veins
The most significant difference between The Private Clinic’s approach and that of the NHS, is that we treat the source of the problem first, whereas the NHS focuses on the symptoms. The problem with such a tactic is that patients suffer for longer periods of time, during which the condition can worsen and develop into something far more serious.
With the NHS, the treatment options available to you are decided by the severity of your symptoms. So, if you have big unsightly veins, but they aren’t painful or causing you too much discomfort, then your symptoms will be considered as cosmetic and you’ll be told to treat them privately.
If, on the other hand, you are experiencing pain and discomfort, then you may be eligible for treatment, but your practitioner might recommend as much as six months of self-care first. This would include regular exercise, using compression stocking, resting often while elevating the affected area. After this period, you’re most likely to be treated by surgical stripping, Sclerotherapy, or endovenous radiofrequency obliteration.
The challenge of treating Varicose Veins lies in their reoccurring nature, and research shows that chances of recurrence after treatment are higher for recurrent Varicose Veins than for primary ones. This means that it’s best to eliminate them properly the first time round.
Our ‘miracle’ patient Rob found this out the hard way. He was eligible for a surgical procedure, but those have a two-year recurrence rate of 33%, going up to 41% for five years and rising to 70% for ten years, and it’s still the most widely offered Varicose Vein treatment on the NHS (Health Technol Assess, 2013). Rob’s veins did indeed come back, and they were more painful and unsightly than ever. Furthermore, he was refused additional treatment.
When he came to us, his treatment lasted 45 minutes; he went home directly after the procedure, and was varicose vein free after wearing compression garments for a few weeks to promote healing in the area.
Possible Varicose Vein complications
While it’s true that your symptoms may not end up developing past the cosmetic stage, you should be aware of complications that may arise if you don’t treat your Varicose Veins once they start causing you pain.
The CEAP clinical score ranks the progression of venous diseases as follows:
- C0 – No palpable or visible veins
- C1 – Spider Veins, Thread Veins, broken veins
- C2 – Varicose Veins
As mentioned, the starting point for vascular treatment should be when Varicose Veins begin developing symptoms, because these may lead to:
C3: Oedema – the tissue in your affected area may start collecting excess watery fluid and cause that part of your body to become disproportionate to the rest.
C4: Eczema, Sclerosis or Pigmentation – the tissue in the affected area may start to harden (Sclerosis), become discoloured (Pigmentation), or your skin may develop Eczema and become dry, itchy, red and swollen.
C5: Healed Ulceration – An ulcer is a painful chronic sore that can take up to six weeks to heal. Once you develop an ulcer it is likely to reappear with time.
C6: Active Ulceration – Some ulcers never heal, meaning that you’ll have to manage them and the discomfort they cause, continuously.
The C3-C6 complications are very serious and can severely impede on your quality of life. Note that some of these conditions can also develop as adverse effects of vein stripping or ligation. In view of this, it may be worth considering treating your Varicose Veins with EVLA from the get-go as you run less chances of recurrence, procedural adverse effects, as well as extended periods of time spent in pain.
The Private Clinic
We are one of the leading veins clinics in the UK and our vascular team only consists of highly qualified, senior Consultant Vascular Surgeons. They are experts in their field, who are trained in EVLA as well as adjunctive treatments, enabling them to offer our patients fully personalised care.
- The least invasive method for varicose veins and thread veins removal treatment for your legs, body and face.
- Our Consultant vascular surgeons are pioneers in EVLA(Endovenous Laser Ablation) and have treated thousands of patients.
- No lengthy downtime or recovery required.
- The NICE (National Institute for Clinical Excellence) Gold Standard for treatment of Varicose Veins findings show that the success rate after five years for EVLA is 95.4%.
- A consultation with one of our Consultant Vascular Surgeons costs £150, including a free ultrasound scan of your legs (usually priced between £350 and £450 at most clinics and private hospitals).
- We focus on the underlying cause of your veins and you will only see a Consultant Vascular surgeon for varicose veins.
- We have treated thousands of patients who have regained their confidencewhilst avoiding health issues.
- Treatment takes one hour, you can go home shortly after being treated.
- Owing to our success, we have been featured on Channel 4’s Embarrassing Bodies , TLC’s My Naked Secret and featured in Harper’s Bazaar’s Cosmetic Tweakment Trends for 2019.
- We have carried out over 7,000 procedures in treating Veins.
- See our before and after photo gallery.