Endovenous treatments such as EVLA involving thermal energy applied to varicose veins are considered to be the optimal type of treatment for virtually all types of varicose veins. Published research continues to consistently demonstrate excellent treatment outcomes with minimal risk of complications and long-lasting results when assessed at both five years and 10 years post-treatment. The National Institute for Health and Care Excellence (NICE) recommends EVLA as a first-line treatment for varicose veins.
Despite the many advantages of endovenous laser ablation, patients must first have a local anaesthetic injected before application of the laser to remove varicose veins. The injection of local anaesthetic can be a source of anxiety for some patients despite the very fine needles used. In our experience, the vast majority of patients find EVLA with a local anaesthetic to be a very well-tolerated procedure with no adverse outcomes reported from the use of local anaesthetic. A very small percentage of patients may have a needle phobia and this has led many medical device manufacturers to explore the development of techniques for treating varicose veins which do not require the injection of a local anaesthetic. The two most well-known techniques include ClariVein and VenaSeal. These two treatments are relatively new in the UK and are only available at a handful of varicose vein clinics in London and further afield.
What is ClariVein?
ClariVein involves the use of a specialised wire which undergoes a rotational movement to impart fine scratches to the inside of the vein wall while simultaneously involving the injection of a chemical sclerosant solution. It is thought that the combination of the wire rotation combined with the injection of sclerosant thought to lead to better treatment results compared with either technique alone. The treatment is performed through one percutaneous skin entry point and does not involve any pain or discomfort.
What is VenaSeal?
VenaSeal is a technique for treating varicose veins involving the application of medical-grade superglue inside the vein to increase the stickiness of the vein walls and eventually cause them to fuse together. This technique is similarly performed through one very small skin entry point and does not involve any pain or discomfort. Published research studies on VenaSeal have shown satisfactory results at the one year mark for patients who have had the treatment.
Why are ClariVein and VenaSeal not used at Centre for Surgery?
All endovenous techniques used for the removal of varicose veins have their own specific set of pros and cons and with certain risks associated with them. As with all varicose vein treatments, patient selection is vital and it is important to carry out a thorough clinical assessment including a duplex ultrasound assessment.
Patient preferences are always taken into account when deciding on the most appropriate treatment for treating varicose veins at our London clinic. As with EVLA, not all patients will be suitable for these types of treatments and some patients may have veins that do not allow proper use of these vein treatment techniques. The benefit of both these techniques involves the elimination of the injection of local anaesthetic although they can still be post-operative discomfort from the development of vein inflammation and this is particularly true with the VenaSeal method.
The major disadvantage associated with both techniques is the significant lack of research studies which demonstrate the long-term success of these techniques compared with the gold standard EVLA technique for varicose vein treatment. There is simply not enough data to show whether these methods are as effective or indeed as safe as endovenous laser ablation.
Both ClariVein and VenaSeal are significantly more expensive due to the complex equipment used compared with EVLA and we have always prided ourselves on providing the most competitive pricing for EVLA varicose vein treatment in the UK. If you would like to find out more about the benefits of endovenous laser ablation compared with these newer treatment methods, please speak to one of our friendly and knowledgeable patient coordinators today who will be more than happy to book a face-to-face consultation with an expert vascular specialist at ou varicose vein clinic in London.
What is Cermavein?
Cermavein is one of the latest techniques claimed to be effective in the treatment of varicose veins. The procedure involves the use of steam as opposed to laser energy for destroying the veins. Compared with laser ablation, steam ablation using Cermavein shares similarities in that it also requires the injection of a local anaesthetic around the vein prior to passing steam through the catheter. We can therefore see no particular advantages of Cermavein over EVLA in this respect. In addition, there are a number of recognised downsides to the use of Cermavein as a treatment for varicose veins which include:
- Early studies into the effectiveness of Cermavein have failed to match the treatment results from the use of EVLA
- Although the treatment appears to be similar in cost to the VLA, the equipment used to perform the procedure is very expensive and may not be as reliable as the tried and tested laser device is used for EVLA treatment
- As of 2022, there are no published studies which demonstrate the long-term effectiveness of the Cermavein technique compared with endovenous laser ablation
Centre for Surgery therefore do not offer the CermaVein treatment at our specialist varicose vein clinics in London.