Mr Stephen Blair has been invited to speak on the subject of “Painless treatment of varicose veins with ClariVein and sclerotherapy” at this year’s meeting of the British Association of Sclerotherapists. It is an honour to be invited.
Painless treatment has been the “Holy Grail” of varicose vein surgery for over 30 years. In 1986 Stephen Blair published a trial which showed that a new method of removing varicose veins was significantly less painful than stripping varicose veins. 35% did not even need one Paracetamol after having their veins removed by sequential avulsions and consequently, the time off work and quality of life etc were better. However 65% still needed pain killers.
Endovenous treatment was then introduced and Laser treatment (EVLT) was a significant improvement and this could be done without a general anaesthetic with obvious benefits. However this could never be called painless. This requires about 250ml of local anaesthetic to be injected into the leg to reduce the chances of the laser burning other tissues. This is called tumescent analgesia. Injecting this amount of fluid is painful. If the laser burns through the vein wall a haematoma can develop which is very painful and takes weeks to go away. The skin overlying the vein can also be burnt. If the local anaesthetic doesn’t push nerves away from the vein, nerve damage can occur which is as high as 10% in veins of the calf. This still requires time off work for most people.
Radiofrequency ablation followed, which did not perforate the vein so was less painful. However it still required injecting large amounts of local anaesthetic (tumescent analgesia) which is painful and while it is being reabsorbed the pain continues.
ClariVein is equally effective as all the above treatments in getting rid of the main vein. It does not require tumescent analgesia ( large volumes of local anaesthetic). This is a mechanical method not a burning method therefore there is no nerve damage, no burning of skin and no haematomas. There is genuinely no pain during the procedure. It feels like the vibration of an electric toothbrush as the wire spins round inside the vein which it ablates with a combination of its mechanical effect and the release of a sclerosant to destroy the lining of the vein.
Foam Sclerotherapy can be used in combination with this to treat side branches, and obvious varicose veins around the leg. In common with other endovenous treatments, trials have shown that if these are not treated at the same time, recurrences are more common. This is again pain free treatment.
Bandaging is important for the treatment of these side veins. Conventionally this involves an ankle to top of thigh bandage. However from personal experience there are real problems with bandages of this type. Therefore a new bandaging technique has been developed and tested which enables both compression of side veins and a return to full normal activity including driving immediately after the procedure. Painless treatment of varicose veins with ClariVein and sclerotherapy has arrived.