The case for surgery vs. minimally invasive varicose vein treatment

A look at the different choices patients can opt for when it comes to how they wish to undergo treatment.

July 07, 2019 Inga Louisa Stevens

Varicose veins affect one in every two people aged 50 and older, and 15 to 25 per cent of all adults in the UAE. Tired legs, bulging veins, ulcers and a burning sensation are just some of the symptoms associated with varicose veins.  

Chronic disease

According to Dr Ashkan Haghshenas, who is a Specialist Vascular Surgeon at Burjeel Hospital for Advanced Surgery, Dubai, many people wrongly see it solely an aesthetic issue when, in reality, it is a chronic disease that affects a growing number of people in the UAE each year.

“While the majority of patients treated for varicose veins are women, men also suffer from venous diseases, even if they're less likely to seek treatment,” says Dr Ashkan. “However, factors such as heredity, pregnancy, hormone replacement therapy, contraceptives, and obesity can also contribute. In hot countries such as the UAE, the veins swell and open up in order to help cool the body and prevent overheating. This swelling makes veins larger and allows more blood to pool in one place.”

Factors such as heredity, pregnancy, hormone replacement therapy, contraceptives, and obesity can also contribute

Complications

If left untreated, varicose veins can lead to potentially dangerous complications. Although not everyone with varicose veins requires treatment, patients have choices when it comes to how they wish to undergo treatment for varicose veins: surgery or a minimally invasive varicose vein treatment.

“For many years, surgery was the only option for people suffering from varicose veins. Surgery involves an incision to find the varicose veins so they can be tied off (ligated) and removed (stripped). There is a 50 per cent chance of varicose veins coming back within five years after surgery. It is also important to be aware that vein surgery is associated with the risk of pain after operation, bleeding, scarring, infection, deep vein thrombosis, full anesthesia hospitalisation and long recovery period,” Dr Ashkan explains.

The invasive nature of surgery, along with the risk of pain and other complications, has encouraged the development of less intrusive minimally invasive varicose vein techniques. “These procedures can be performed in an outpatient setting, and if any anesthesia is needed at all, may only require an injection of a local anesthetic to numb the skin,’ says Dr Ashkan.

Treatment options

Sclerotherapy
This involves injecting a sclerosing, or scarring, agent into the vein. While sclerotherapy is very effective for cosmetic treatment of spider veins, a smaller version of varicose veins, you should note that it’s less effective for varicose veins than endovenous ablation.

Endovenous ablation
A catheter, or a thin tube, is placed inside the varicose vein, and heat, generated from a laser fiber or radiofrequency waves, is applied to the inside of the vein, causing it to close off. The success rate for endovenous therapies is above 98 per cent.

Microphlebectomy
A small prick in the skin is made over the surface of the varicose veins. Using a specialised tool, the vein is removed. This is commonly used along with endovenous ablation.