Do I need these veins and how will blood circulate without them?

Most of the blood flow back to the heart is through the deep veins which are usually normal. Blood flow in varicose veins is in the wrong direction so that getting rid of them improves the circulation. When veins stop functioning normally, the body finds alternative pathways through healthy veins to take the blood back to the heart. This will have occurred by the time you present for treatment.

What if I do not treat my varicose veins?

The only thing that can be guaranteed is that the veins will get bigger with time. However, the risk of developing future complications is small and there is usually adequate warning.

Should I wait until I have completed my family?

This may have been the case when surgery was the only option but not now. If veins recur after pregnancy then they can usually be easily treated by ultrasound-guided sclerotherapy or endovenous laser ablation. We rarely treat veins by intervention during pregnancy or lactation.

Can venous disease be prevented and will treated veins recur?

There is no known way to prevent varicose or spider veins from developing. Class 1 venous support stockings, maintaining a normal weight and regular exercise may slow down the process. Avoid creams promoted to make veins disappear. Even with the best treatment by any technique, some patients will develop recurrence either in the treated veins or in new veins within 3-5 years. This may be delayed by wearing graduated class 1 support stockings and by walking, but cannot be prevented. Further treatment is usually by ultrasound-guided sclerotherapy. We consider that any patient treated for varicose veins requires on-going surveillance at six months and then yearly until all treated veins disappear.

What is diagnostic ultrasound and is it safe?

Sound is used at frequencies above the audible range (20,000 Hertz), usually 2-10Million Hertz. Ultrasound can diagnose vascular disease in two ways - reflections of the sound waves by the vessel wall or contents, and change in the sound wave frequency by blood flow. Ultrasound cannot pass through all structures in the body and is markedly reflected by air or any gases, or by bone. Ultrasound is totally painless. No harmful effects from diagnostic ultrasound have ever been reported. There is no special preparation unless an examination of vessels in the abdomen is to be performed when you will need to fast for all but clear fluids for 12 hours before.

Does the treatment hurt?

EVLA is performed under local anaesthetic. Neither form of sclerotherapy requires any anaesthetic. Non-surgical out-patient techniques are not distressing and are well tolerated. Most patients agree that "it was not nearly as bad as I thought it would be". The needles used are extremely fine and many are hardly felt at all. Injected solutions sting and aching develops for a short time until the bandages or stockings are applied. The procedures tend to cause some pain by about the third day as inflammation within the vein develops and this can persist until about day 7 on average. The pain is appreciably less than with surgery.

Does the treatment interfere with day to day activities?

These are walk-in, walk-out procedures. You can then immediately return to normal activities including driving the following day.