Varicose vein treatment

Varicose veins can vary in size from 0.5cms to sometimes what looks like a bunch of grapes many centimetres across.

Veins in the legs have valves which allow blood to flow back to the heart against gravity. When veins become varicose the valves no longer work effectively, which allows blood to pool and flow in the wrong direction. This build-up of pressure causes the vein structure to distort and become twisted and stretched, thus giving it a bulging, rope-like appearance.

Varicose vein surgery is usually performed under a general anaesthetic as a day case, although an overnight stay may be required for surgery on both legs. The operation usually takes about 60 minutes.

To fully remove the entire vein, it may be necessary to make several small cuts along the length of the leg. Afterwards, the cuts are stitched (sutured) and covered with a dressing. The smaller cuts may be closed with adhesive paper strips or stitches. Your leg is then wrapped in a bandage – this applies pressure to reduce bleeding and bruising. 

After the operation, it’s usual to go home the same day. However, if your consultant feels it’s necessary, you may be asked to stay overnight. You should be able to get back to work the next day depending on the severity of your veins. Most people can go back to work within two to three days but some may take a little longer. You will need to wear support stockings for one to two weeks.

Varicose veins are dilated tortuous veins, which usually occur in the legs and may not cause pain.

Signs you may have with varicose veins include:

  • Veins that are dark purple or blue in colour
  • Veins that appear twisted and bulging; often like cords on your legs
  • An achy or heavy feeling in your legs
  • Burning, throbbing, muscle cramping and swelling in your lower legs
  • Worsened pain after sitting or standing for a long time
  • Itching around one or more of your veins
  • Bleeding from varicose veins
  • A painful cord in the vein with red discoloration of the skin
  • Colour changes, hardening of the vein, inflammation of the skin or skin ulcers near your ankle, which can mean you have a serious form of vascular disease that requires medical attention

Once vein have developed they do not go away without treatment. However, in a large number the veins may not cause you any symptoms and hence can be left alone. They however do tend to get more prominent with time.

Studies suggest that 1 in 10 patients develop worsening symptoms such as swelling and skin changes. Once you develop swelling there is an increased risk of skin changes and once you develop skin changes there is a further risk of ulceration.

Skin changes are usually permanent and cannot be reversed, and hence it is worth considering treating varicose veins before this happens.

Unfortunately the NHS rations the treatment of varicose veins.

At Circle, the consultant surgeon you meet at the consultation will be the surgeon who treats you. As part of the consultation you will have an ultrasound test which will help determine the best treatment for you.

This is a minimally invasive treatment of varicose veins. It involves placing a wire with a heated probe in the varicose vein under ultrasound guidance. This probe is attached to a generator which heats it. The heat obliterates the varicose vein. This takes just a few seconds. Once the vein has been sealed, the probe is removed and a bandage applied to the leg. This treatment has been approved by the National Institute for Clinical Excellence which assesses the safety and effectiveness of all new treatments

Two different sources of heat are commonly used:

Radiofrequency Ablation of Varicose Veins

The source in this is radiofrequency energy.  These are high-frequency waves.


In this the source of heat is laser energy.

All cases are done as an ambulatory day case procedure. Compared to open surgery, EVA is associated with much less bruising, scarring and potential for complications such as wound infection, or discomfort following surgery. In most cases the treatment is performed under local anaesthesia, however, if you have a lot of veins or it involves both legs then a general anaesthesia is needed. EVA causes minimal discomfort and facilitates quick return to work (average 2-3 days)

This is a more recent technique which involves destroying the inner lining of the vein using a combination of a tiny rotation burr along with a sclerosing agent. (these used to be used for injections of veins) these are gaining in popularity as they do not need any anaesthesia and is painless. Currently they are recommended for smaller veins

Traditional surgical interventions include vein stripping, which involves making small incisions (cuts) near the top and bottom of the damaged veins and in your groin. The surgeon will ‘tie off’ (a technique called ligation) the affected veins through the groin incision, preventing blood flow.

A special wire instrument is then inserted through the groin incision and guided down each vein, before being pulled out through the lower incision, taking the damaged vein with it. Vein Stripping is normally performed under a general anaesthetic on a day case basis.

This involves injection of a sclerosing agent with the vein, but it is delivered as a foam for better contact with the vein lining. It also works on the principle of destroying the inner lining of the vein.

Multiple Avulsions are usually performed in conjunction with Endovenous Ablation (EVA).

Occasionally they can be done on their own if there some veins left behind after the initial treatment.

Local anaesthetic is applied to the affected area and small skin incisions are made and used to extract the veins, using a special vascular hooked instrument. The incisions are so small they do not normally require sutures. Multiple Avulsions can be performed as an outpatient under local anesthetic. Normal activity can be resumed straight away, and you should be able to return to work on the following day.

All surgery is carried out using our state-of-the-art diagnostic and surgical equipment, allowing you to benefit the latest techniques.

This is a self-funded service. You do not need a GP referral.
Simply complete the 'Fast-track your treatment' form and one of the team will get back to you.

The guide price for varicose vein removal (ablation) with radiofrequency is £3,200 for one leg, or £4,200 for both legs. Price excludes initial consultation with a specialist but includes pre-assessment, surgery and aftercare.

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Circle Health Group, 1st Floor, 30 Cannon Street, London, EC4M 6XH