Researchers have developed many new treatments for varicose veins over the last 10 – 15 years, and at Radiance Health, we’ve been at the forefront of these advances. In the past, surgeons used to treat veins by stripping the main vein out of the leg with the patients under general anesthesia.
These days we try to fix the faulty vein by minimally invasive means without ripping it out of the leg and without causing any pain or injury to the patient in the process.
Glue – The Future of Vein Repair and More
The latest idea under consideration is ‘glueing’ the leaky vein in the leg to prevent blood flow down the vein. The use of ‘tissue glues’ is not particularly new – surgeons have used cyanoacrylate glues (like superglue) for many years. In accident and emergency units, doctors use glues to treat accidental cuts on the scalp or face as glues provide an easier and less painful solution than inserting stitches into the wound.
Glues can also help in body areas where it is difficult to insert sutures (like the liver or kidney). Physicians can spray the glue onto raw bleeding surfaces during major surgery to prevent serious blood loss.
Varicose Vein Surgery Procedures
In vein surgery, we currently seal the leaky veins using heat-based systems, such as Endovenous Laser treatment or Venous Closure procedures. These techniques work very well, but they have a disadvantage:
Because they both use heat to close the vein down, the physician must inject a local anaesthetic and saline solution around the vein to prevent the patient from feeling pain during the operation. This requires quite a few injections into the leg and can cause considerable discomfort for the patient, especially so for patients who have a strong aversion to needles.
No Injection Necessary – New Techniques
Techniques that don’t use injections could represent a great step forward if they work as well as lasers or VNUS closure. The current two techniques that don’t use injections include Clarivein and foam sclerotherapy.
These operations can work quite well, but foam sclerotherapy has a high recurrence rate (meaning the varicose vein returns) and doctors are still evaluation the long-term effectiveness of Clarivein. Frequently in medicine, a new idea may look fantastic at the start, but as time goes on, unanticipated problems begin to emerge. In vein surgery in particular, those problems usually relate to the varicose veins returning after a year or two. For that reason alone we won’t the true efficacy of glue-based systems in treating varicose veins for several more years.
It Always Comes Down to Cost
Finally if glue does work then cost represents the other stumbling block. Currently, the delivery system (the way in which the physician inserts the glue into the vein) costs a whopping £1200 ($1,881) per kit compared to about £200 ($313) for a laser fibre.
This cost might decrease a bit over time if lots of physicians begin to use the kits, but it is likely that the technique will remain more expensive than the heat based systems. So on balance patients might need to prepare to put up with a few injections in the leg to save themselves several hundred pounds (or dollars for those of you across the pond).
About the Author: Eddie Chaloner, MD is a consultant vascular surgeon at Radiance Health, a clinic in London, which specialises in the treatment of Varicose Veins, Thread Veins, and DVT. Eddie is one of the leading authorities on vein treatment, having been the first surgeon in London to use the EVLT method, and the first surgeon in the UK to use the new Clarivein technique.
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