Treatment Options

Conservative treatment
Patients experiencing mild symptoms such as ache or swelling, are advised to avoid prolonged standing and to use  compression stockings.

Ambulatory Phlebectomy
Ambulatory phlebectomy involves the removal of varicose veins through small incisions in the skin. It is a minor surgical procedure performed using local anaesthetic. The patient can return to normal activities within 24-48 hours.

The Procedure

The procedure involves marking out the varicose veins on the patient’s legs. Local anaesthetic is given and a series of small incisions (2-5 mm) are made along the course of the varicosities using a small scalpel. Phlebectomy vein hooks are used to “pluck” the veins through the incisions. Steri-strips and a compression dressing are applied to cover the incisions sites. The compression bandage stays on for 24 hours.

Success Rate

The long term success rate is high with less than 90% patients reporting no recurrence of their varicose veins.

Potential Complications

As with all medical services there is risk involved, however Endovascular WA works with you to minimise these. Complications may include:

  • Infection (< 5%) – reduced by intravenous antibiotics at the time of the procedure and for one week after the procedure
  • Bruising – usually settles within 2 to 3 weeks
  • Scarring – settles over 6 to 12 weeks. Depending on your skin type there is a small chance of keloid scarring (Silicon Scar Gels are helpful to minimize this).
  • Pain – during and after treatment can last up to 1 week
  • Superficial thrombophlebitis – settles over 4-6 weeks with anti-inflamatories and stockings
  • Numbness – may occur in the treated area and in the distribution of the nerve affected. This may take some weeks to months to improve, and in very rare instances may be permanent (rare – < 1%)
  • Recurrence of veins – 5-20% at 5 years, varies with patients
  • Deep Vein Thrombosis with potential Pulmonary Embolism – < 1%
  • Swelling of treated legs – could be permanent in up to 5% of people. The cause of this is sometimes unknown.

Endovenous Laser Therapy Ablation (EVLT or EVLA)

EVLT is usually performed under local anaesthesia and utilises a laser fibre to close the varicose vein from the inside. A laser fibre is passed through a small cut in the skin around the ankle or knee into the varicose vein. Once guided into place by ultrasound, local anaesthetic is placed around the vein so the procedure is not painful. The laser is then fired, delivering laser energy to the wall of the vein. This causes inflammation of the vein walls, which over a period of weeks/months fibrosis occurs and the vein closes off.

Success Rate

EVLT has a high success rate, with >95% patients experiencing an improvement in their symptoms. The recurrence rate of varicose veins in 5-20% after 5 years (compared with 20-80% with surgery). It is not unusual to have a top up (sclerotherapy) procedure in the months/years after treatment.

Potential Complications

As with all medical services there is risk involved, however Endovascular WA works with you to minimise these. Complications may include:

  • Bruising – this can be quite colourful (black and blue) for up to 2 weeks along the inner thigh
  • Numbness over the treated area – usually temporary, can sometimes last for a few weeks or months
  • Infections (<5%)
  • Skin burns (rare < 1%)
  • Inflammation of the veins, which is intentional – may cause localised swelling, tender lumpy areas and tightness along the inner thigh. The associated pain is often described as a “pulled muscle”.

All of the above are normal and part of the healing process. These symptoms can often last 3-6 weeks post procedure. Infrequent complications include:

  • Rarely Deep Vein Thrombosis (< 1%)
  • Recurrence of varicose veins (5-20% at 5 years)
  • Swelling of treated legs – could be permanent in up to 5% of people. The cause of this is sometimes unknown.

Foam Sclerotherapy

Sclerotherapy involves injecting a chemical agent (a sclerosant) to induce blood vessel scarring and closure. Sclerotherapy has a long history and has been used to treat varicose veins for over 150 years. The advent of duplex ultrasound and foam sclerosants has marked its return as a simple but effective treatment for varicose veins. In foam sclerotherapy, air is mixed with the liquid sclerosant to create a foam. When this is injected into the varicose vein (under ultrasound guidance), it displaces the blood within the vein and fills the vein. This causes the vein to spasm and scar. The vein can be checked with the ultrasound to see if the injection has been successful.

Success Rate

Foam sclerotherapy has a good success rate, with 80-90% of veins remaining closed after 3 years. To improve the success rate, veins may need to be re-injected. Regular ultrasound surveillance is used to monitor early recurrence.

Potential Complications

As with all medical services there is risk involved, however Endovascular WA works with you to minimise these. Complications may include:

  • Bruising – almost always after your procedure, however this will improve with time. Wearing medical compression stockings, anti inflammatory gels and bruising creams will aid in your recovery.
  • Skin Staining – (up to 40 – 50%) usually wears off within 6-12 months however this can sometimes be longer
  • Skin Ulceration – (less than 1%) which in the worst instance may require skin grafting
  • Mild pain – may persist for several days. This in an indicator that the injections are working.
  • Superficial Thrombophlebitis – (always) usually settles within 10-12 weeks and is treated with anti-inflammatories and stockings
  • Numbness in the treated area and in the distribution of the affected nerve. This may take some weeks to months to improve, and in rare instances may be permanent (rare – < 1%).
  • Infection – less than 1%
  • Recurrence of veins – 5-20% at 5 years, it varies with patients. There is an increased chance of surface veins developing.
  • Deep Vein Thrombosis with potential of Pulmonary Embolism – less than 1%
  • Discolouration and tender lumps will improve over 4-6 weeks. Inflammation of the vein caused by trapped blood inside, may cause new lumps to develop at a later stage.
  • Stroke – rare < 1%
  • Swelling of treated legs – could be permanent in up to 5% of people. The cause of this is sometimes unknown.

Micro Sclerotherapy

Micro Sclerotherapy is used to treat the surface veins visible on the skin referred to as reticular veins and telangiectasias. Sclerotherapy involves injecting a chemical agent (a sclerosant) to induce blood vessel scarring and closure. Sclerotherapy has a long history and has been used to treat varicose veins for over 150 years. This causes the vein to spasm and scar. The vein can be checked with the ultrasound to see if the injection has been successful.

Success Rate

Liquid micro sclerotherapy has a good success rate, with 60-70% of veins remaining closed after 1 year. To improve the success rate, veins may need to be re-injected.

Potential Complications

As with all medical services there is risk involved, however Endovascular WA works with you to minimise these. Complications may include:

  • Bruising – almost always after your procedure, however this will improve with time. Wearing medical compression stockings, anti inflammatory gels and bruising creams will aid in your recovery.
  • Skin Staining – up to 60-70%, usually wears off in 6 to 12 months, sometimes longer.
  • Skin Ulceration – (less than 1%) which in the worst instance may require skin grafting
  • Mild pain – may persist for several days. This in an indicator that the injections are working.
  • Superficial Thrombophlebitis (always, usually settles within 10-12 weeks and is treated with anti-inflammatories and stockings)
  • Numbness in the treated area and in the distribution of the affected nerve. This may take some weeks to months to improve, and in rare instances may be permanent (rare – < 1%).
  • Infection – less than 1%
  • Recurrence of veins (up to 80 % at 5 years, it varies with patients.)
  • Deep Vein Thrombosis with potential of Pulmonary Embolism – less than 1%
  • Discolouration and tender lumps will improve over 4-6 weeks. Inflammation of the vein caused by trapped blood inside, may cause new lumps to develop at a later stage.
  • Stroke – rare < 1%
  • Swelling of treated legs – could be permanent in up to 5% of people. The cause of this is sometimes unknown.