Blog

Many patients ask us if we radiofrequency on top of the laser for varicose veins. The answer is – we used to try RFA in the past and decided that the laser (EVLA) is better tolerated by our patients! Both laser (EVLA) and radiofrequency (RFA) methods are commonly used in treatment of varicose veins. RFA is an older technology, especially when compared with the newest 1940nm lasers accompanied by the radial fibre-optics. Although both methods use high temperatures to close the treated vein with a similar outcome, the Laser treatment is “less invasive” than radiofrequency due to the equipment used. The laser fibre has about 3 times smaller diameter than RFA electrode, so we use much smaller needle to introduce it to the vein. Also the radial fibre, which we currently use in The Vein Centre makes the procedure much more comfortable with the success rate close to 100%. For more details, please feel free to ask our staff.

After 3 months of testing (and more than 120 veins treated) we decided to replace our excellent NeoV 1470nm laser with its even better, younger,  1940nm sibling. We are the first varicose veins clinic in New Zealand to use this new technology which is still evolving to deliver even better, less uncomfortable treatment. Endovenous laser ablation remains a gold standard in varicose veins procedures, with close to 100% ablation rate. At present, 1470nm lasers are the most commonly used machines. Together with radial fibres they are characterised by low discomfort level after the procedure. 1940nm laser are the new devises, which has the same success rate, at the same time needing less energy to achieve that. It means that the laser creates even less damage to the tissue surrounding treated veins. Additionally, in theory, it might result in even lower risk of damaging the skin nerves running close to SSV or GSV.

We are thrilled to announce, that today, as the first in New Zealand, we performed successful mechano-chemical ablation (MOCA) of both great saphenous veins using Flebogrif closure system. The idea of MOCA is based on irritation of the inner surface of the vein with the mechanical device – rotating catheter in ClariVein system or 4 micro-blades in Flebogrif. It enhances the effect of injected sclerotherapy agent increasing the closure rate of the treated vein. The method is fast and seems to be less painful than ClariVein which used to be offered in The Vein Centre in the past.
The Vein Centre has been always a leader in the vein treatment in New Zealand being among the first clinics to introduce new methods of treatment. Although Flebogrif is not currently offered as a routine procedure, we will monitor results of the treatment closely to see its potential in phlebology.
For more information about the Flebogrif please follow the link below (producer’s website):

https://balton.pl/en/products/flebogrif-set-for-varicose-veins-treatment

On the 3rd of January, The Vein Centre organised a training in Lodz, Poland. It was attended by Dr Z. Klimczak and Dr J Bartosiewicz, Polish vein specialists. The training was about the application of Venaseal (glue) in saphenous incompetence causing varicose veins. As a part of the training, Dr Nowacki performed  a demonstration  procedure on a 76 year old patient with bilateral disease. It was a great opportunity to share our experience with Polish colleagues. We hope to continue this new tradition in future.

On the photo from left Dr Klimczak, Dr Bartosiewicz and Dr Nowacki (Clinical Director of The Vein Centre)

Venaseal (glue) has been successfully used for a treatment of saphenous trunks in legs with venous incompetence as the procedure accompanied by ultrasound guided sclerotherapy. Sometimes we use the glue to close the reflux in short segments of incompetent veins increasing the efficiency of the treatment, even in combination with the laser treatment.

On the photo – 2 proximal “feeding’ trunks closed with laser and glue in the same patient.

For many years varicose veins have been seen as a cosmetic problem only. This and other common misconceptions are outlined in the article below. In simple words they are:

1. Varicose veins are a cosmetic problem only – NO
2. Varicose veins are a sign of ageing – NO
3. Varicose veins are strictly problem for women – NO
4. Running can cause varicose veins – NO
5. Varicose veins are always visible – NO
6. Standing on the job causes varicose veins – NO
7. Making lifestyle changes won’t help – NO
8. Surgery is your only treatment option – definitely NO
9. Recovery after Varicose Vein Treatments is difficult – NOT at all
10. Varicose veins can be cured.

In our Centre we usually discuss all these issues in details.

For the whole article please click on the link below:

https://www.everydayhealth.com/heart-health/myths-and-misconceptions-about-varicose-veins/

An interesting article from the last issue of “Phlebology” summing up current knowledge about compression therapy – probably the most “uncomfortable” part of the venous treatment.

The key points are as follows:

• Robust evidence was found for prevention and treatment of venous leg ulcers.
• Recommendations for stocking-use after great saphenous vein interventions were limited to the first post interventional week.
• No randomised clinical trials are available that document a prophylactic effect of medical compression stockings on the progression of chronic venous disease (CVD) – in another words interventional treatment like laser ablation or glue occlusion are more effective.
• In acute deep vein thrombosis, immediate compression is recommended to reduce pain and swelling.
• Despite conflicting results from a recent study to prevent post-thrombotic syndrome, medical compression stockings are still recommended.
• In thromboprophylaxis, the role of stockings in addition to anticoagulation is limited.
• For the maintenance phase of lymphoedema management, compression stockings are the most important intervention.

The whole article can be read here: http://journals.sagepub.com/doi/full/10.1177/0268355516689631#articleShareContainer