The Evolution of Varicose Veins Treatment

Submitted by jchuen on 1 June 2013 - 11:40pm

Last weekend I was invited to speak at the Australian and New Zealand Society of Phlebology Conference at Westmead Hospital in Sydney. We demonstrated a number of techniques including endovenous laser ablation surgery, endovenous radiofrequency ablation surgery, ultrasound-guided injection foam sclerotherapy, and mechanicochemical sclerotherapy with the Clarivein device.

There is no question that varicose veins surgery as we used to know it has moved on from the standard ligation and stripping surgery that is available in the public hospital system. We now recognise that varicose veins return even after the best treatment, and that we can control and manage this with a wide range of techniques.

Whilst standard surgery is still an excellent and safe procedure with a rapid recovery, there are distinct advantages to replacing part of the procedure with endovenous techniques. Unfortunately the Medicare and Private Insurance rebates for a same-for-same procedure using endovenous laser or RF ablation and stab phlebectomies are far below that of standard surgery, and therefore patients are pay significant out-of-pocket or "gap" fees unless they are willing to split their treatment into multiple visits. Furthermore, unless the procedure is done by a surgeon with access to a private hospital, patients are unable to use their private health insurance, which delivers an extra sting in the tail.

The model of care for varicose veins surgery is slowly changing. Delivering the best results requires the practitioner to be prepared to use all the tools in the box. Sometimes this will be open surgery, sometimes endovenous surgery and sometimes sclerotherapy. At Eastern Vascular we are pleased to be able to offer all of these techniques where necessary.

So to round off with a brief blast from the past – a friend sent me this link to a photo of cyclist Greg Hincapie's varicose veins. Hopefully he has had something done about them before he develops superficial thrombophlebitis (painful clots in the veins) or skin damage.

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