You're so vein

THEY'RE large, they're painful, and they can be extremely embarrassing.

Until recently, getting rid of varicose veins meant admission to hospital, an anaesthetic and an operation to literally strip out the veins from your legs.

Now, a new laser treatment being offered at the Nuffield Hospital in York can get rid of the problem without removing them at all.

"Varicose veins are a common condition and one-third of people will get them at some point in their lives," said consultant vascular surgeon Stephen Brooks.

"They often run in families, appear knobbly and bumpy and are blueish in colour because of the blood within them.

"The veins enlarge because the valves inside them stop working and the blood then flows at a higher pressure."

Although varicose veins do not generally threaten your health they can be a massive cosmetic concern, not to mention the common symptoms of discomfort, aching, pain and itching.

Symptoms generally worsen towards the end of the day, especially if you have spent most of it on your feet.

The condition can also cause complications. Phlebitis is an inflammation of the vein and can be very painful for a few weeks. Eczema can also be troublesome and will recur unless the veins are treated. The most serious complication is ulceration as healing can be prolonged.

All varicose veins are treatable; it is a matter of deciding which treatment is best for you.

Surgery involves a day in hospital, a general anaesthetic and a series of incisions through which the veins are removed from the leg. In contrast, laser treatment enables the veins to remain in the leg and is performed as an outpatient with no need for a general anaesthetic.

"It's not really a surgical operation and there are no incisions" said Mr. Brooks.

"We use only local anaesthetic (which numbs the skin) and there are therefore several significant advantages over conventional surgery."

"At the initial consultation the patient is examined and an ultrasound scan is performed to accurately define the anatomy of the veins. Different treatment options will be discussed. About two thirds of people who have not had previous vein treatment are suitable for the laser technique and up to one third of those who have been treated before are suitable."

During laser treatment (which is called EVLT) the surgeon inserts a fine catheter up the main vein in the thigh, beginning at knee level and as far as the groin. Local anaesthetic is injected around the vein and the catheter is then slowly withdrawn as the laser is activated. The laser heats up the lining of the vein, and this causes the vein walls to fuse together. The leg is then bandaged, the patient has a drink, walks for twenty minutes and goes home. Over the next few weeks the vein simply shrivels up.

So is it worth the money?

"The recurrence rate for laser treatment is as good as or possibly better than surgery up to three years. A longer comparison is not possible as EVLT has not been around for as long as surgery," said Mr Brooks.

"Patients can return to full activities immediately after laser treatment, although sports such as gym work should wait for one week.

"There is no need for time off work after EVLT. After a vein operation the patient is usually off work for at least two weeks."

Other novel treatments include filling bulging varicose veins with foam, a procedure being piloted at Wythenshawe Hospital, in Manchester, by vascular surgeon Professor Charles McCollum.

Researchers discovered that the microscopic foam, filled with tiny oxygen bubbles, can be injected into veins to smooth bulges and stop blood flow problems associated with the condition.

He said the foam had the consistency of shaving foam, but much smaller, and is entirely harmless. He said it pushes blood out and the bubbles dissolve, allowing the vein to heal flat.

To inquire about laser vein treatment (EVLT) ring the York Nuffield Hospital on 01904 715000

Updated: 12:21 Friday, July 01, 2005