Home
Bupa members

Support and offers for individual members and customers

Varicose vein surgery Q&As

Published by Bupa's health information team, June 2009.

Answers to questions about varicose vein surgery

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

What are my alternatives to varicose vein surgery?

There are a number of alternative treatments to varicose vein surgery. These include wearing compression stockings, endovenous laser ablation (EVLA; the use of laser to close your vein), radiofrequency ablation (RFA; the use of a high-frequency electrical current to heat the wall of your varicose vein to close it) and sclerotherapy (injection of liquid or foam into your varicose veins). Your surgeon will discuss all suitable alternatives to varicose vein surgery with you.

Explanation

Compression (also called thrombo-embolic deterrent or TED) stockings may relieve the swelling and aching of your legs but they won't prevent more varicose veins from developing. Compression stockings can help the blood in your veins to flow up towards your heart, and some people won't need any other treatment.

Endovenous laser treatment uses a fine laser which is passed inside your varicose vein. The laser heats the inside of your vein causing damage to the vein wall. This causes the vein to close. Radiofrequency ablation involves using a high-frequency electrical current to heat the wall of your varicose vein. This damages the vein causing it to close. Both these procedures get you moving around again quickly, give you less bruising and can be performed under a local anaesthetic. A local anaesthetic completely blocks feeling from the area operated on and you will stay awake during the operation.

Sclerotherapy involves injecting a chemical into your varicose veins which damages the veins, causing them to close. Liquid sclerotherapy is often used to treat smaller varicose veins. For larger veins, foam sclerotherapy is sometimes used. Studies have shown that this treatment is effective at treating varicose veins in the short term. However, the long-term benefits of this treatment aren't yet known. A US study showed that in some people, foam bubbles escaped from the leg veins and reached the heart. Sometimes the bubbles crossed into the oxygen-carrying blood that is pumped round the body, including to the brain. It's important to discuss the safety of ultrasound guided foam sclerotherapy with your doctor.

You will be given compression stockings to wear after your treatment. Your surgeon will advise you on how long you will need to wear them for.

Your surgeon will discuss all suitable alternatives to varicose vein surgery with you.

Further information

Sources

  • Hirsch SA, Dillavou E. Options in the management of varicose veins. J Cardiovasc Surg 2008; 49:19-26. www.minervamedica.it
  • Campbell B. Varicose veins and their management. BMJ 2006; 333:287-292. www.bmj.com
  • Ultrasound-guided foam sclerotherapy for varicose veins. National Institute for Health and Clinical Excellence (NICE), 2006, Interventional Procedure Guidance 217. www.nice.org.uk
  • Subramonia S, Lees TA. The treatment of varicose veins. Ann R Coll Surg Engl 2007; 89:96-100. www.rcseng.ac.uk
  • Endovenous laser treatment of the long saphenous vein. National Institute for Health and Clinical Excellence (NICE), 2004, Interventional Procedure Guidance 52. www.nice.org.uk
  • Radiofrequency ablation of varicose veins. National Institute for Health and Clinical Excellence (NICE), 2003, Interventional Procedure Guidance 8. www.nice.org.uk
back to top

Why might I need another operation for my varicose veins?

Varicose vein surgery doesn't cure varicose veins and it isn't always possible to prevent more from developing. Steps to reduce the risk of them developing again mainly involve improving your circulation and muscle tone by taking regular exercise, losing weight, and stopping smoking. Don't wear tight-fitting clothing which can restrict your circulation and don't sit or stand still for long periods of time, particularly if you're pregnant.

Explanation

Varicose vein surgery doesn't cure varicose veins. Up to one in five varicose vein operations are performed on people who have had previous surgery for this condition. Even if you have had your varicose veins completely removed, new varicose veins can still develop. If you do develop more varicose veins, your surgeon may advise you to have another operation or an alternative treatment.

There are a number of things that you can do to help you reduce your risk of developing more varicose veins, even after surgery. Taking regular exercise is a great way to improve your circulation and general health. Your GP can advise you on the best types of exercise for you. If your job involves a lot of standing, try to change position frequently and move around every 30 minutes. Gentle movement of your feet will help you to stretch your calf muscles and increase circulation. Don't wear tight-fitting clothing as this can restrict your circulation. Try to take regular breaks throughout the day and, when you do, keep your legs raised while you are resting. Ideally, you should raise your legs above the level of your heart - this can be achieved by lying down and resting your legs on something comfortable that keeps your legs raised.

As being overweight can be a cause of varicose veins, try to lose excess weight by eating healthily and taking regular exercise. This will take any unnecessary pressure off your circulatory system and your heart will find it easier to pump blood around your body. Your GP will be able to advise you on the best ways to lose weight.

Stopping smoking may reduce your risk of developing varicose veins and will also greatly improve your general health. There is no evidence that herbal remedies are effective to prevent varicose veins.

As many women develop varicose veins after pregnancy, the use of compression stockings during pregnancy may relieve any swelling and aching of the legs and prevent more varicose veins from developing. Compression stockings (also called TED or thrombo-embolic deterrent stockings) are worn to help blood flow back to the heart.

Further information

Sources

  • Campbell B. Varicose veins and their management. BMJ 2006; 333:287-292. www.bmj.com
  • Wolf B, Brittenden J. Surgical treatment of varicose veins. J R Coll Surg Edinb 2001; 46:154-158. www.rcsed.ac.uk
  • London NJM, Nash R. ABC of arterial and venous disease: Varicose veins. BMJ 2000; 320:1391-1394. www.bmj.com
  • Bamigboye AA, Smyth R. Interventions for varicose veins and leg oedema in pregnancy. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No: CD001066.pub2. www.cochrane.org
  • Longmore M, Wilkinson IB, Rajagopalan S. Oxford Handbook of Clinical Medicine. 6th ed. Oxford: Oxford University Press, 2004:528-529
back to top

I'm pregnant and I have developed varicose veins. Can I have surgery?

If you're pregnant, you have an increased chance of developing varicose veins. In most women, varicose veins improve three or four months after giving birth. Your GP therefore won't recommend any surgery for your varicose veins unless there is no improvement after this period. Rest and gentle exercise may help to improve your circulation and reduce your chances of getting varicose veins.

Explanation

If you're pregnant, you have an increased chance of developing varicose veins. If you do develop varicose veins during pregnancy, any treatment you might receive will focus on the relief of symptoms such as pain, night cramps, tingling and leg aches. As varicose veins often improve three or four months after giving birth, your GP won't recommend any surgery unless there is no improvement after this period.

There are a number of things you can do to improve the circulation in your legs when you are pregnant which may help to decrease your chance of developing varicose veins. Try not to stand for long periods and try to have regular breaks which allow you to move your legs. If you can, elevate your feet and legs when you're having a break. When you're resting for longer periods, try to rest on your left side as this decreases pressure on the veins in your legs and feet. Gentle flexing of your feet can also help as this will stretch your calf muscles and improve circulation in your legs.

Your GP may suggest that you wear compression stockings (also called TED or thrombo-embolic deterrent stockings). These help to maintain your circulation, can relieve any swelling and aching of your legs and can prevent more varicose veins from developing.

Further information

Sources

  • Bamigboye AA, Smyth R. Interventions for varicose veins and leg oedema in pregnancy. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No: CD001066.pub2. www.cochrane.org
back to top

Related topics

back to top

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: June 2009

 

Rate this page

Up to £100 off a Bupa Health assessment

Bupa health insurance

Free online health check

Bupa Care Homes

Bupa travel cover