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1. Surgery
Conventional treatment involves stripping of the veins by surgery under general anaesthetic. This may be carried out on a day-case basis, or more commonly with an overnight stay, with the patient returning to full normal activities 3-6 weeks later.
Stripping carries the risk of numbness of the thigh due to skin nerve damage in up to 11% and a recurrence rate of up to 10% at 1 year rising to 20 % at 5 years
Bruising and discomfort commonly may persist for 3-6 weeks following surgery.
2. Sclerotherapy
Outpatient injection of sclerosant solution ( Sclerotherapy ) is commonly used after laser treatment of the main incompetent veins (or surgery where it replaces phlebectomy) to complete the treatment of the smaller varicose and spider veins.
3. Laser ablation treatment for varicose veins (ELVeS/EVLT)
With an estimated 50,000 cases of varicose veins treated every year in the UK but an estimated prevalence of 250,000 symptomatic cases, it appears that many people are not coming forward for treatment. In particular the prospect of up to 6 weeks off work following surgery is off-putting for many working people. However, Laser Treatment is now available allowing return to normal activities within 24 hrs with results as good as, and in some respects better than, surgery.
The EndoLaser Vein System (ELVeS) was FDA-approved in 2002 and is CE-marked but it is new to the UK. See the recommendations of the NICE guidelines of March 2004 www.nice.org.uk/pdf/IPG052guidance.pdf
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