Varicose Vein Clinic

Welcome to The Vein Clinic at Gosforth Private Clinic, state of the art facilities dedicated to the treatment of venous insufficiency causing varicose veins.  Our cardiovascular doctors specialize exclusively in problems with circulation providing a comprehensive evaluation and treatment plan utilizing the most modern equipment and individual approach to each of our patients.

 

At The Vein Clinic patients benefit by getting a fully bespoke treatment plan tailored to their individual needs, using the very latest techniques. This leads to not only our high patient satisfaction, but also excellent results with the lowest chance of recurrence.

 

We use the latest the duplex ultrasound evaluation as the standard diagnostic test for varicose veins using the most modern equipment. The ultrasound test helps our specialists identify the most appropriate treatment options for each patient. Treatment is individualized and is based on the severity of the varicose veins and the patient's physical condition. The Vein Clinic offers minimally invasive state of the art treatment such as Endovenous Thermal Ablation ClosureFast™ Procedure and new revolutionary treatment with VenaSeal™


At The Vein Clinic at Gosforth Private clinic, we are able to offer the full range of tailored treatments to each individual. We have close working relationships with leading vascular surgeons and the full vascular ultrasound assessment is performed by our highly experienced Sonographers or Consultant Vascular Surgeons. We will produce a bespoke report as part of your consultation so we can clearly understand your condition and decide the best treatment option that will suit you.

 

Our aim is to provide the best possible treatment to our patients, by offering a range of modern techniques and coupled with evidence based medicine, we are able to support patients in making the right choices for them.

The circulatory system consists of veins and arteries. Arteries are blood vessels that bring the fresh oxygenated blood full of nutrients from the heart to the rest of the body. Veins are vessels that transport blood without oxygen and nutrients back to the heart against gravity. In healthy leg veins, one-way valves allow blood to move only in one direction: upstream towards the heart. In order to do this, when you walk, your leg muscles squeeze the deep veins of your legs and feet pushing the non-oxygenated blood back to the heart. In your veins there are one-way valves that are placed about one inch apart that keep blood flowing in the right direction. When your leg muscles relax, the valves inside your veins close preventing the backward flow of blood back down the legs.

 

There are three types of veins in your legs: superficial veins, which lie close to the skin, deep veins, which lie in or beneath the muscles, and perforating veins, which connect the superficial to the deep veins. Deep veins bring the blood back to the major vein in your abdomen called the vena cava, which brings the blood straight to the heart.

 

Despite the common belief that people with vein problems always have varicosities, majority of patients do not have visible signs of the disease at all. Instead, they suffer from tiredness, heaviness, swelling, aching pains, burning, itching, cramps, restless leg syndrome, and even non-healing ulcers. While some people develop varicose veins, the others have so-called “spider” veins, yet other ones have swollen legs as a single sign of vein disease. Eventually and regardless of the type of venous disorder, the condition can lead to serious complications, including trophic ulcers, bleeding, infection and even blood clot formation.

 

 

All of the above-described problems, as well as many others, can be caused by abnormal circulation in the veins of the lower extremities, a condition called “venous insufficiency”. In our Vein Clinic, you will receive a comprehensive consultation, appropriate diagnostic procedures and individually selected treatment provided by caring members of our staff specializing in management and treatment of vein diseases.

 

Since venous insufficiency is a serious medical condition, it is important to know that the diagnosis and treatment of venous disease are covered by most insurance plans. The Vein Clinic at Gosforth Private Clinic is approved with most insurance companies. 

Varicose veins may not cause any pain. Signs you may have with varicose veins include:

 

  • Veins that are dark purple or blue in colour
  • Veins that appear twisted and bulging; often like cords on your legs

 

When painful signs and symptoms occur, they may include:

 

  • An achy or heavy feeling in your legs
  • Burning, throbbing, muscle cramping and swelling in your lower legs
  • Worsened pain after sitting or standing for a long time
  • Itching around one or more of your veins
  • Bleeding from varicose veins
  • A painful cord in the vein with red discoloration of the skin
  • Colour changes, hardening of the vein, inflammation of the skin or skin ulcers near your ankle, which can mean you have a serious form of vascular disease that requires medical attention

 

Varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet. That's because standing and walking upright increases the pressure in the veins of your lower body.

 

For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems.

 

Varicose veins may also signal a higher risk of other circulatory problems. Treatment may involve self-care measures or procedures by your doctor to close or remove veins.

 

Spider veins are similar to varicose veins, but they're smaller. Spider veins are found closer to the skin's surface and are often red or blue.

 

They occur on the legs, but can also be found on the face. Spider veins vary in size and often look like a spider's web.

Arteries carry blood from your heart to the rest of your tissues. Veins return blood from the rest of your body to your heart, so the blood can be recirculated. To return blood to your heart, the veins in your legs must work against gravity.

 

Muscle contractions in your lower legs act as pumps, and elastic vein walls help blood return to your heart. Tiny valves in your veins open as blood flows toward your heart then close to stop blood from flowing backward.

 

Causes of varicose veins can include:

 

  • Age. As you get older, your veins can lose elasticity, causing them to stretch. The valves in your veins may become weak, allowing blood that should be moving toward your heart to flow backward.

 

Blood pools in your veins, and your veins enlarge and become varicose. The veins appear blue because they contain deoxygenated blood, which is in the process of being recirculated through the lungs.

 

  • Pregnancy. Some pregnant women develop varicose veins. Pregnancy increases the volume of blood in your body, but decreases the flow of blood from your legs to your pelvis. This circulatory change is designed to support the growing fetus, but it can produce an unfortunate side effect — enlarged veins in your legs.

 

Varicose veins may surface for the first time or may worsen during late pregnancy, when your uterus exerts greater pressure on the veins in your legs. Changes in your hormones during pregnancy also may play a role. Varicose veins that develop during pregnancy generally improve without medical treatment within three to 12 months after delivery.

These factors increase your risk of developing varicose veins:

 

  • Age. The risk of varicose veins increases with age. Aging causes wear and tear on the valves in your veins that help regulate blood flow. Eventually, that wear causes the valves to allow some blood to flow back into your veins where it collects instead of flowing up to your heart.
  • Sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor because female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.
  • Family history. If other family members had varicose veins, there's a greater chance you will too.
  • Obesity. Being overweight puts added pressure on your veins.
  • Standing or sitting for long periods of time. Your blood doesn't flow as well if you're in the same position for long periods.

  • To diagnose varicose veins, your doctor will do a physical exam, including looking at your legs while you're standing to check for swelling. Your doctor may also ask you to describe any pain and aching in your legs.
 
  • You also may need an ultrasound test to see if the valves in your veins are functioning normally or if there's any evidence of a blood clot. In this noninvasive test, a technician runs a small hand-held device (transducer), about the size of a bar of soap, against your skin over the area of your body being examined. The transducer transmits images of the veins in your legs to a monitor, so a technician and your doctor can see them.

Fortunately, treatment usually doesn't mean a hospital stay or a long, uncomfortable recovery. Thanks to less invasive procedures, varicose veins can generally be treated on an outpatient basis.

 

Ask your doctor if insurance will cover any of the cost of your treatment. If done for purely cosmetic reasons, you'll likely have to pay for the treatment of varicose veins yourself.

 

Self-care

Self-care — such as exercising, losing weight, not wearing tight clothes, elevating your legs, and avoiding long periods of standing or sitting — can ease pain and prevent varicose veins from getting worse.

 

Compression stockings

Wearing compression stockings all day is often the first approach to try before moving on to other treatments. They steadily squeeze your legs, helping veins and leg muscles move blood more efficiently. The amount of compression varies by type and brand.

 

You can buy compression stockings at most pharmacies and medical supply stores. Prices vary. Prescription-strength stockings also are available.

 

Additional treatments for more-severe varicose veins

If you don't respond to self-care or compression stockings, or if your condition is more severe, your doctor may suggest one of these varicose vein treatments:

 

Sclerotherapy. 

 

  • In this procedure, your doctor injects small- and medium-sized varicose veins with a solution that scars and closes those veins. In a few weeks, treated varicose veins should fade.

 

Although the same vein may need to be injected more than once, sclerotherapy is effective if done correctly. Sclerotherapy doesn't require anesthesia and can be done in your doctor's office.

 

Foam sclerotherapy of large veins. 

 

  • Injection of a large vein with a foam solution is also a possible treatment to close a vein and seal it. This is a newer technique.
 

Laser surgeries. 

 

  • Doctors are using new technology in laser treatments to close off smaller varicose veins and spider veins. Laser surgery works by sending strong bursts of light onto the vein, which makes the vein slowly fade and disappear. No incisions or needles are used.


Catheter-assisted procedures using radiofrequency or laser energy. 

 

  • In one of these treatments, your doctor inserts a thin tube (catheter) into an enlarged vein and heats the tip of the catheter using either radiofrequency or laser energy. As the catheter is pulled out, the heat destroys the vein by causing it to collapse and seal shut. This procedure is the preferred treatment for larger varicose veins.

 

High ligation and vein stripping.


  • This procedure involves tying off a vein before it joins a deep vein and removing the vein through small incisions. This is an outpatient procedure for most people. Removing the vein won't adversely affect circulation in your leg because veins deeper in the leg take care of the larger volumes of blood.
 

Ambulatory phlebectomy 

 

  • (fluh-BEK-tuh-me). Your doctor removes smaller varicose veins through a series of tiny skin punctures. Only the parts of your leg that are being pricked are numbed in this outpatient procedure. Scarring is generally minimal.


Endoscopic vein surgery. 

 

  • You might need this operation only in an advanced case involving leg ulcers if other techniques fail. Your surgeon uses a thin video camera inserted in your leg to visualize and close varicose veins and then removes the veins through small incisions. This procedure is performed on an outpatient basis.

 

VenaSeal™


The VenaSeal™ closure system is the only non-tumescent, non-thermal, non-sclerosant procedure that uses a proprietary medical adhesive delivered endovenously to close the vein. This unique approach eliminates the risk of nerve injury when treating the small saphenous vein, which is a risk sometimes associated with certain thermal-based procedures. Clinical studies have demonstrated that the procedure is safe and effective.  The procedure is administered without the use of tumescent anesthesia, avoiding patient discomfort associated with multiple needle sticks.


WHAT TO EXPECT

 

Before the VenaSeal™ Closure Procedure:

 

You will have an ultrasound imaging exam of the leg that is to be treated.  This exam is important for assessing the diseased superficial vein and planning the procedure.

 

During the Procedure:

Your doctor can discuss the procedure with you.  A brief summary of what to expect is below:


•You may feel some minor pain or stinging with a needle stick to numb the site where the doctor will access your vein.


•Once the area is numb, your doctor will insert the catheter (i.e., a small hollow tube) into your leg. You may feel some pressure from the placement of the catheter.


•The catheter will be placed in specific areas along the diseased vein to deliver small amounts of the medical adhesive. You may feel some mild sensation of pulling or tugging. Ultrasound will be used during the procedure to guide and position the catheter.


•After treatment, the catheter is removed and a bandage placed over the puncture site.


After the Procedure:


You will be taken to the recovery area to rest.


Your doctor will discuss with you what observations will be performed following treatment.


VenaSeal™ is usually performed on an outpatient basis meaning you will be able to go home the day of your procedure.

 

Many patients notice immediate relief but you should allow 1-2 weeks before you see the full benefit. Your surgeon may encourage you to walk frequently and avoid standing or sitting for long periods immediately after your procedure. You can usually return to normal activities the day after your VenaSeal™procedure

 

Most patients are very pleased with the results of their radiofrequency ablation for varicose veins. As with any procedure there can be complications:


Potential Risks:

 

The VenaSeal™ procedure is minimally invasive and catheter-based. As such, it may involve the following risks. Your doctor can help you understand these risks.

 

  • Allergic reaction to the VenaSeal adhesive
  • Arteriovenous fistula (i.e., an abnormal connection between an artery and a vein)
  • Bleeding from the access site
  • Deep vein thrombosis (i.e., blood clot in the deep vein system)
  • Edema (i.e., swelling) in the treated leg
  • Hematoma (i.e., the collection of blood outside of a vessel)
  • Hyperpigmentation (i.e., darkening of the skin)
  • Infection at the access site
  • Neurological deficits including stroke and death
  • Non-specific mild inflammation of the cutaneous and subcutaneous tissue
  • Pain
  • Paresthesia (i.e., a feeling of tingling, pricking, numbness or burning)
  • Phlebitis (i.e., inflammation of a vein)
  • Pulmonary embolism (i.e., blockage of an artery in the lungs)
  • Urticaria (i.e., hives) or ulceration may occur at the site of injection
  • Vascular rupture and perforation
  • Visible scarring
 
VenaSeal™ Closure System FAQ’s
  • When will my symptoms improve?
 Symptoms are caused by the diseased superficial vein. Thus, symptoms may improve as soon as the diseased vein is closed. 
 
  • When can I return to normal activity?
The VenaSeal™ closure system procedure is designed to reduce recovery time. Many patients return to normal activity immediately after the procedure. Your doctor can help you determine
when you can return to normal activity. 
 
  • Is the VenaSeal™ Closure System procedure painful?
 Most patients feel little, if any, pain during the outpatient procedure.
 
  • Is there bruising after the VenaSeal™ Closure System procedure?
Most patients report little-to-no bruising after the VenaSeal™ closure system procedure.
 
  • What happens to the VenaSeal™ Closure System procedure adhesive?
Only a very small amount of VenaSeal™ closure system procedure adhesive is used to close the vein. Your body will naturally absorb the adhesive over time. 
 
  • How does the VenaSeal™ Closure System procedure differ from thermal energy procedures?
The VenaSeal™ closure system procedure uses an adhesive to close the superficial vein. Thermal energy procedures use heat to close the vein. The intense heat requires a large volume of numbing medicine, which is injected through many needle sticks. The injections may cause pain and bruising after the procedure. 


ENDOVENOUS RADIOFREQUENCY ABLATION PROCEDURE


ClosureFast™ Procedure


The ClosureFast™ procedure uses radiofrequency energy to precisely and effectively treat patients suffering from Chronic Venous Insufficiency (CVI).

 

·         The ClosureFast™ catheter precisely heats a 7 cm vein segment (or 3 cm for shorter, refluxing vein lengths) in one 20-second interval.

·         The system’s controlled feedback mechanism monitors intravascular heat parameters in real time to automatically regulate therapeutic power

·         The heat provided by the catheter shrinks and collapses the target vein, creating a fibrotic seal and occluding the vessel.

 

Minimally INVASIVE


The ClosureFast™ procedure eliminates the need for groin surgery and general anesthesia, and is generally performed using local anesthesia in a vein specialist’s office or an outpatient surgical facility. The procedure takes approximately 45-60 minutes and most patients typically spend two to three hours at the medical facility due to normal pre- and post-treatment procedures.

 

LESS PAIN, LESS BRUISING, FASTER RECOVERY


Studies show that the ClosureFast™ procedure is associated with lower rates of pain, bruising and complications and a faster improvement in patients’ quality of life when compared to 980 nm laser ablation.1  The average patient typically resumes normal activities within a few days following treatment, and most patients report a noticeable improvement in their symptoms within 1-2 weeks after the ClosureFast™ procedure.

 

CLINICAL OUTCOMES


A prospective, international, multi-center study showed that 91.9% of treated veins were closed 5 years following treatment with the ClosureFast™ procedure.  The study used the Kaplan Meier analysis, a common statistic used for a variety of endpoints, including effectiveness of a treatment over defined period of time.

 

What happens during radiofrequency ablation for varicose veins?


Radio frequency ablation is a minimally invasive procedure to eliminate your varicose veins. It is usually done under local anaesthetic and takes 45 - 60 minutes. You surgeon will insert a tiny catheter through a small puncture in your lower leg. They will heat the enlarged vein causing it to shrink and close. Don’t worry, once the vein is closed blood will naturally reroute to other healthy veins. The puncture site will be bandaged and compression may be applied.

 

Going home after radiofrequency ablation


Radiofrequency ablation is usually performed on an outpatient basis meaning you will be able to go home the day of your procedure.

 

Many patients notice immediate relief but you should allow 1-2 weeks before you see the full benefit. Your surgeon may encourage you to walk frequently and avoid standing or sitting for long periods immediately after your procedure. You can usually return to normal activities the day after your radiofrequency ablation. 

 

Most patients are very pleased with the results of their radiofrequency ablation for varicose veins. As with any procedure there can be complications:

 

  • Vein puncture
  • Blood clots
  • Pulmonary embolism
  • Phlebitis (leg inflammation)
  • Hematoma (collection of blood)
  • Infection
  • Burning of the skin

 

This procedure may not be appropriate for patients with cardiovascular problems. Be sure and discuss radiofrequency ablation with your Consultant Cardiovascular Surgeon before investigating this procedure.

 

Therapy COMPARISON – WHY COMPROMISE?


Radiofrequency Ablation vs. Laser Ablation


In recent years, treatment options for CVI have advanced far beyond invasive procedures like vein stripping and ligation. Minimally invasive and highly effective endovenous ablation procedures are now the go-to for many physicians.

 

Easily performed in an office or hospital setting, radiofrequency (RF) ablation is a clinically proven treatment option. Radiofrequency energy is delivered at 120°C, in contrast to the more than 700°C of some laser technologies. Animal studies have shown that laser can potentially lead to vessel perforation and obliteration of the vein walls. Unlike RF, the primary method of action for laser ablation is to boil the blood or water inside the vessel, which can lead to both bruising and post-procedure pain for the patient.


FAQs


What are varicose Veins?

Varicose veins happen when small valves in veins break and cause the blood to flow in the wrong direction. This causes the veins to swell and backfill with stagnant blood. Varicose veins can appear as either bulging and ropelike, or small and threadlike. However, they can also develop deep under your skin where you are not able to see them. Varicose veins can cause aching, tired and swollen legs; create a burning, throbbing, or itching sensation; and cause muscle cramps and a general restlessness in your legs. Varicose veins require medical treatment.

 

What causes varicose Veins?

More than 80 percent of vein disease is genetic. Although pregnancy can aggravate vein disease, it doesn't actually cause it. Since varicose veins are mainly hereditary, this means they aren't caused by long periods of standing or crossing your legs when you sit down. Even so, long periods of standing, as well as obesity, can make the disease worse.

 

What are Spider Veins?

Spider veins are very small varicose veins. Although they don't usually cause discomfort, the deeper veins that often accompany them do. Many vein disease sufferers have a combination of both varicose and spider veins. While they may seek treatment for cosmetic improvement, many of our patients are looking for relief from pain.

 

Does Vein disease effect women and men equally?

More than half of all women will develop varicose vein disease over the course of their lifetime. However, 40 to 45 percent of all men will develop vein disease as well. The unique hormonal conditions that women face, such as pregnancy and menopause, often cause their veins to become worse. This is likely why more women than men seek treatment for their condition.

 

Do I need treatment for all my veins?

Varicose veins are a burden on your circulation. Because the blood inside them is travelling in the wrong direction, correcting the flow by eliminating venous congestion can only improve your circulation. In treating varicose veins, we focus only on the diseased veins and safeguard the healthy veins for normal circulation. Ultrasound guidance ensures that treatment is highly selective.

 

What happens to my veins after it have been treated?

The treated vein is closed off from the rest of the veins in your leg, allowing the body to naturally redirect the blood flow to healthy veins. The treated vein is then absorbed by your body over time.

 

Are there any complications of the treatments?

Side effects and complications are possible but not likely. Complications resulting from endovenous ablation treatment, VenaSeal and sclerotherapy are rare. You may experience some mild discomfort and bruising.  

 

Is it ok to postpone treatment?

As you probably know, postponing any type of treatment can have drawbacks. Varicose vein disease is a progressive disease that will only get worse if left untreated. When making a decision about your varicose veins, keep in mind that the sooner you get your veins treated, the easier they are to treat and control. Our patients often remark, "I wish I had done this years ago."

 

How effective is surgery as treatment option?

The failure rate for vein surgery is 25 to 43 percent in one to five years. Stripping a varicose vein surgically is not the same as removing an appendix – a one-time-only procedure – because new varicose veins can develop in other places in the leg. Repeated surgery is not an acceptable solution for a recurrent problem.

 

Will I be hospitalised or take time off work after treatment?

Treatment is on an outpatient basis during convenient office visits. You can usually resume most of your day-to-day activities shortly after each session.


Complications of varicose veins, although rare, can include:

 

  • Ulcers. Extremely painful ulcers may form on the skin near varicose veins, particularly near the ankles. Ulcers are caused by long-term fluid buildup in these tissues, caused by increased pressure of blood within affected veins.

 

A discoloured spot on the skin usually begins before an ulcer forms. See your doctor immediately if you suspect you've developed an ulcer.

 

  • Blood clots. Occasionally, veins deep within the legs become enlarged. In such cases, the affected leg may swell considerably. Any sudden leg swelling warrants urgent medical attention because it may indicate a blood clot — a condition known medically as thrombophlebitis.
  • Bleeding. Occasionally, veins very close to the skin may burst. This usually causes only minor bleeding. But, any bleeding warrants medical attention because there's a high risk it can happen again.

You can book an Initial Consultation with one of our Consultant Vascular Specialists and it may or may not includes a Colour Duplex Ultrasound Scan of your legs depending on the clinical condition.


During your consultation:

  • The consultant will explain to you about your condition and will provide you with a proposed treatment plan.
  • May or may not perform a colour duplex ultrasound scan of both legs. 
    This will help to examine all the veins in your legs to identify possible underlying problems causing your varicose veins (i.e. whether you have any faulty valves in your legs).
  • Discuss with you the results of your scan and the treatment options appropriate for you.


Insured Patients
Important note for patients with private health insurance.  Our clinic is registered with all major insurance companies.  You will have to obtain an authorisation number from your insurance company prior to attending for treatment. You can by all means book the appointment before you obtain the authorisation no. but we will require it in advance of the appointment otherwise you will have to pay yourself on the day and it may not be possible that you will be able to get a refund from the insurer.


Self- pay patients

You will be provided a proposed treatment plan and discuss the costs involved with your consultation, any ultrasound scan and cost of the procedure. You call us to get the exact cost of the procedure on 0191 284 1355.


Consultation and Treatment on the Same Day
For those patients travelling long distances it is usually possible to arrange treatment on the same day as the consultation. If you are insured you will normally need to get a letter of referral from your GP in advance of the consultation but it is your right to have treatment by us without informing your GP. Please discuss any such requirements by phone.


GP Referral
Before undergoing any treatment, it is preferable to have a formal letter of referral from your own doctor. However, you can attend consultation without having obtained a referral letter.


Our Specialists
All our consultants are experienced vascular surgeons who are consultants in the NHS and have undertaken large numbers of minimally invasive venous treatments.

 

 

TO BOOK AN APPOINTMENT
PLEASE CALL US ON: 0191 284 1355
or email to us on info@gosforthprivateclinic.co.uk


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