Older patients may miss out on varicose vein treatments on NHS

These are turbulent times for the NHS and to add to junior doctor strikes and contract concerns, is a health rationing row between NHS chiefs and the Royal College of Surgeons (RCS).

Six Clinical Commissioning Groups (CCGs) across the Birmingham region are looking at plans to cut funding for a whole range of operations, from cataract surgery to varicose vein treatments.

The CCGs, which provide treatment for over two million patients in the Birmingham area, published a document in April entitled the ‘Policy for Procedures of Lower Clinical Value’. A host of procedures were listed that would now require GPs to give evidence of ‘exceptional clinical need’ before their use would be sanctioned. As well as varicose veins, other treatments to be hit include cosmetic surgery, treatment for back pain and groin hernia repairs.

The Royal College of Surgeons were asked to give their feedback on the report and hit back, saying that “some policies are presented as if they are supported by clinically-evidenced guidance but in fact contravene this guidance” and that this could prevent patients receiving the treatment they need.

The plan is to impose thresholds on particular procedures; for example, a weight restriction on those undergoing hip or knee surgery or only treating more advanced cases of varicose veins. As the RCS points out in their letter, though, lack of early intervention in varicose veins can result in an increased deterioration that will later require a surgical intervention.

However, these are not the first CCGs that have rationed varicose vein procedures and patients are increasingly have to opt for private treatment. At Cornwall Vein Clinic, we offer the full range of varicose vein treatments that NHS patients were previously able to access. Depending on the extent of the problem, there are a number of minimally invasive, but highly effective treatments. These include endothermal ablation, sclerotherapy and exciting new technological innovations such as ClariVein™ and cyanoacrylate glue occlusion. Surgery should be a last resort.

If you have further questions or to find out more about your treatment options, please call 01872 226 100 to arrange a consultation at the Cornwall Vein Clinic.

Men drive up demand for varicose vein treatments

Varicose veins may seem the bane of middle-aged women, but experts now believe that they are just as likely to affect men as women – the difference is that, in the past, women were more likely to seek treatment. However, that’s all set to change as men are becoming increasingly motivated to seek a solution to varicose veins.

Whether it’s because we live in a more visual world or that more of us than ever are playing sport and exercising regularly and men do not want to reveal the unsightly blue bulges marring their legs; SportEngland’s latest data noted that over 15 million adults now play sport at least once a week, an increase of almost 2 million on 2005/6. There’s even now been a term coined to describe varicose veins in men – ‘grandpa legs’.

Are varicose veins merely an aesthetic concern?

Most people do not suffer problems associated with these swollen, visible veins lying just under the skin, but symptoms include:

  • A feeling of aching or heaviness in the legs
  • The skin may itch or there is a burning sensation
  • You may experience ‘restless legs’ and even cramping in the legs particularly at night
  • The legs and ankles may swell up, particularly common at the end of the day

Although these symptoms might not necessarily affect your ability to perform normal activities or impact on your quality of life, varicose veins can be very unsightly, with lumps, swelling or noticeably blue or purple twisting veins pushing against the skin. The skin can also change colour and texture and, in some cases, result in ulcers.

What treatments are available for varicose veins?

When treatments were mainly restricted to surgery or wearing compression garments, it’s not surprising that many men choose to just put up with the problem. However, technological advances in recent years has meant that there are now minimally invasive, highly effective procedures available.

In addition to NICE-recommended endothermal ablation procedures, Cornwall Vein Clinic also offers two other innovative and exciting keyhole treatments for varicose veins that are performed as keyhole procedures; ClariVein™ and cyanoacrylate glue occlusion. They require no anaesthetic, are quick to perform and mean significantly less downtime, so are increasingly popular with male patients wanting a solution to varicose veins. For more information on the treatments we offer, call 01872 226 100.

Endothermal ablation: the varicose vein treatment you should be offered

The NHS is facing its worse financial crisis in a generation according to regulators. Estimates published towards the end of 2015 suggest that the NHS is heading towards an annual deficit of at least £2 billion . This is attributed to increased care requirements for an ageing population, restricted budgets and unexpected staffing costs. Whilst these are undeniable factors driving the current healthcare landscape there is still plenty to do to modernise the service at grass roots levels to improve the patient experience and eliminate unnecessary costs.

For some time, the casual prescription by GPs of antibiotics for viruses to mollify parents and screaming children has been a known issue. This placebo actually costs the NHS around £10m a year, despite it having no effect whatsoever on viruses. Worse that that it contributes to antibiotic resistance, threatening to make common infections untreatable.

A less well-covered topic in the media is the expenditure on varicose vein treatment. This is a common health complaint which affects up to 30 per cent of UK adults. For many people there are no symptoms but the condition can result in heaviness, aching and cramps. Over time this can develop into more serious problems such as leg ulcers which have a significant effect on the patient’s quality of life.

Traditionally, this condition has been treated with surgery and carried out under general anaesthetic. Whilst most patients can return home on the same day the procedure is invasive and can result in pain, bruising and bleeding. Recovery can take up to three weeks before returning to work and there is a small risk of nerve damage and or deep vein thrombosis.

The National Institute for Health and Care Excellence (NICE), best known for ruling which new drugs doctors can prescribe on the NHS recommends that endothermal ablation should be offered as an initial treatment for varicose veins. Carried out under a local anaesthetic the procedure relies on high frequency radio waves or lasers to seal the affected blood vessels.

According to NICE, prescribing endothermal ablation as the preferred treatment would deliver a more successful and less invasive treatment for patients as well as making an annual saving of £4.5 million across the UK.

For more information on which treatment for varicose veins is most appropriate for your needs, please call 01872 226 100 to book a consultation at the Cornwall Vein Clinic.

Help! I have varicose veins. What are my treatment options?

Varicose veins affect about a third of the UK population, mainly women. The condition results from enlarged veins in the legs, forcing the blood to flow in reverse. In some patients the symptoms are hardly noticeable but in others the level of discomfort can be severe with itchiness, cramps, continual throbbing and heaviness in the legs. Eventually the condition can deteriorate to ulcers, resulting in a significant effect on the quality of life. Most people end up wearing compression stockings at some point during treatment.

What are my treatment options for varicose veins?

The specialists at Cornwall Vein Clinic stay abreast of the latest techniques and technologies and Mr Ken Woodburn will be demonstrating his techniques for the treatment of varicose veins at the Venous Workshop held during the 38th Charing Cross Symposium, the longest running and largest symposium in Europe, dedicated to exploring vascular and endovascular challenges.

Traditionally, the preferred option was surgery although this is increasingly becoming a last resort as other, less invasive and modern techniques have been developed to deal with the condition. Surgery requires a general anaesthetic and typically results in up to three weeks away from work along with pain and bruising.

  1. Endothermal ablation should be offered as a first course of action. Unlike surgery, this can be carried out under a local anaesthetic and typically has mild side effects such as bruising and transient pins and needles. A small incision will be made just above or below the knee to insert a catheter to heat up the vein to seal it shut but patients can expect to return to work within 24 hours.
  2. Endovenous laser treatment may also be advised as an initial treatment option. The procedure is similar but may result in more tightness and bruising, with the possibility of short-term nerve damage. Both techniques may still require you to wear compression stockings.
  3. Ultrasound-guided foam sclerotherapy may be advised when endothermal ablation treatment is unsuitable. This procedure requires an injection of a foam compound into the affected veins to seal them shut. Whilst this is can be carried out under a local anaesthetic and you should expect to be back to work in less than 24 hours (with 84 out of 100 cases being successful) sclerotherapy can cause headaches, back pain, temporary vision problems and possibly blood clots in other veins.

However, as NICE, the National Institute for Health and Care Excellence, details in their guidelines on the preferred order of varicose vein treatments, the individual needs and preferences of the patient should always be taken into account. For a comprehensive assessment of your individual requirements, please call 01872 226 100 to book a consultation at the Cornwall Vein Clinic.

Does sitting down or standing for long periods of time cause varicose veins?

We are very aware that embarking on a course of private medical treatment can be an anxious time for some people, particularly if you are funding your own treatment. It can be difficult to work out in advance, how expensive the treatment will be, particularly as many vein clinics will only give you an estimate of cost once you have been seen by one of their consultants. Often a combination of different treatments are required, with each one incurring a separate charge, and costs can soon mount up.

At the Cornwall Vein Clinic our pricing is transparent and clearly displayed on our website. You are unlikely to be faced with unexpected additional costs, as we aim to treat all the veins that you are concerned about in a single visit, and even if this requires more than one treatment technique on the day it will not result in additional charges. We know that in a review of 1300 patients treated by our surgeons, almost 90 per cent of patients had their veins treated in a single endothermal treatment, and overall only 25 per cent required further minor ‘tidy up’ injections carried out in the out-patient clinic.

You can therefore be confident that the prices displayed on our website are the prices that you will pay, and your surgeon will endeavor to complete your treatment in a single visit whenever possible.

If you’re interested in having your vein condition can be assessed and an appropriate treatment advised, get in touch to book a consultation.

Two new treatments launched at Cornwall Vein Clinic

Cornwall Vein Clinic is introducing two new keyhole treatments for varicose veins, that avoid the need for multiple local anaesthetic injections during the treatment, and are potentially quicker to carry out. Both techniques are similar to existing techniques as they involve placing a catheter in the vein through a small incision in the calf or lower thigh, made under local anaesthetic.

ClariVein™ for varicose veins

In one technique, endovenous mechanochemical ablation (Clarivein™) a tube with a rotating hollow wire at its tip is inserted through the skin into the affected vein in the leg using ultrasound guidance. As the tube is pulled back out of the vein, the wire is rotated, damaging the lining of the vein. At the same time a chemical is injected through the hollow wire into the vein. The vein becomes inflamed, and then shrivels and closes.

Varicose veins treated with glue occlusion

The aim of the other technique called cyanoacrylate glue occlusion is to close a varicose vein by sticking its walls together. The cyanoacrylate glue is put into the affected vein via a special tube inserted into the vein at the knee and passed to the top of the great saphenous vein, using ultrasound to guide it. This treatment doesn’t require bandages to be worn afterwards and skin staining is very rare.

Both these techniques can only treat one leg per treatment visit and have the same potential complications as the established keyhole treatments, but there is not yet enough information available about these techniques to say if these complications are any more likely, or if the success rate of these treatments is any lower. We are excited to be bringing these techniques to Cornwall, as the will be particularly suited to individuals who don’t cope very well with injections.

For more information on all the treatments we offer for removal of varicose veins, get in touch to book a consultation.