What are the treatment options for varicose veins?

For varicose veins of the legs, the traditional treatment was surgery, which is still carried out in more than 50% of the cases in Britain. The problem with surgery, however, is that it’s quite an extensive operation, there are side effects and risks associated with it, and the biggest problem is that it’s an operation that doesn’t really work very well (i.e. there’s a high chance that these veins will come back again).

Newer techniques have been developed over the last decade or so. The most common of these is endovenous laser ablation (EVLA/EVLT). Instead of stripping the veins physically out of the body (which is what happens in surgery), EVLA destroys the veins where they actually are. It is a much more gentle technique and does not involve any general anaesthetic; it is carried out in most cases as an outpatient, “walk in, walk out” procedure. We use a little bit of local anaesthetic. The treatment entails putting a needle into the vein that we want to destroy, and then passing a laser fibre through that needle into and along the vein. In order to stop the laser heat and light from hurting you, we inject a lot of very dilute local anaesthetic solution around the vein; once that local anaesthetic is in place, we gently pull the laser fibre out, heating the vein up all the way along, which destroys it.

This technique is now probably the most common non-surgical technique for dealing with varicose veins, because it is the most simple, most effective, safest and cheapest way of dealing with the problem.