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THE SURGEON
Dr JOCELYN BROOKES is a radiologist at University College Hospital, London, and The London Clinic.
He says: Varicose veins are caused by faulty valves. These are supposed to prevent the blood from flowing the way gravity wants - downwards - but if they don't work properly blood will escape down and put pressure on the vein, causing pain and bulging.
The condition is often genetic, although it can also be caused by pregnancy or a job where you stand all day because you are effectively constantly calling on the valves to fight against gravity; if you have a genetic predisposition to weak valves, this can be the tipping point.
Despite the preconception of varicose veins being a middle-aged woman's condition, men are just as likely to have them. Laser ablation has been available as a treatment for nearly a decade and is a really good alternative to other options, such as surgery.
With lasering, you literally cook the vein so that it shrinks and blood can no longer flow through it.
To destroy veins, the laser's beam must heat them up to a certain temperature. Until now, the type of beam we used would heat the blood inside the vein to kill it. Our new laser is less powerful and heats only the water in the blood - this is enough to kill the vein.
Because water isn't as thick as blood, much less energy is required to heat it. This means there is much less damage to the tissue and nerves surrounding the vein, as well as less pain and a quicker recovery time.
A further advantage of this new technique is that with traditional lasering, we have to inject an anaesthetic substance called tumescence into the lasered veins. This puts the vein into a spasm so it tightens and grips the laser, making the procedure more effective. It can also cause painful bruising. With the new laser, you need little, if any, tumescence.
When I saw Mark, he had prominent veins running down the inside of his left thigh, the inside of his knee and down to his calf. They were quite ugly. We agreed Mark would be a good candidate for the new laser surgery as he was keen not to have any time off work. He also liked the idea of a very quick recovery rate.
First, I outlined the position of Mark's varicose veins with a pen. Then, using ultrasound guidance, I put a needle directly into the vein to be treated just below the knee.
Through that I passed a wire, and over the wire a catheter (or tube) into the vein; the laser goes through this catheter.
Using the wire as a guide, we moved the catheter along the vein up to the top of it near the groin. I then pushed the laser just proud of the catheter. Before I started lasering, I injected a very small amount of tumescence anaesthetic through the skin - a far smaller amount than with the old laser system.
For each vein, I slowly moved the tip of the laser through it, to shrink and then kill it. Then, using a scalpel, I put pinprick-sized holes into each vein and pulled it out using a tiny hook.
When all the veins were out, I bandaged up the leg. An hour or so later, I checked that the puncture wounds had clotted, and then the patient can leave when they feel ready.
As Mark has shown by his pain-free and rapid recovery, this new development in lasering is a terrific advance, and just about everyone with varicose veins is suitable for this treatment.'
READ the Article at the Daily Mail website
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