Since Laser came into the local medical scene in Singapore, as an alternative to traditional surgery in the 2000s, the treatment of Varicose veins has been revolutionized leading to more patient comfort and lesser need for hospitalization.
Over the past 6- 7 years, newer treatment methods like “Glue” (Venaseal) and “Chemical” (Clarivein) have been made available.
The different treatment choices can often be bewildering for patients and so here is simple write up on the pros and cons of each treatment method.
Which one gives the best rates of long term success(less chance of new veins coming back)?
So far based on 2-3 years data and local experience, Venaseal gives superior seal rates compared with the other modalities.
Which method gives the least bruising and pain during the recovery phase?
Both Venaseal and Clarivein are superior to traditional laser and radiofrequency in terms of bruising and pain.
What are the side effects of the newer methods?
Venaseal can have a delayed allergic reaction about 1month after the procedure in 10% of the time. This is a very minor side effect with just redness. It easily subsides with anti-inflammatory medications
The chemical used in Clarivein can cause mild skin pigmentation in 10-20% of patients. Again this can be reversed with time and topical medications.
When should Laser or Radiofrequency be used?
Laser or Radiofrequency should be used if the veins to be treated are too big for Venaseal and Clarivein to give a good seal.
What is this nerve injury I hear associated with Laser and Radiofrequency?
As both Laser and Radiofrequency are heat based treatment, the vein is essentially “cooked” at a temperature >120 Celsius to seal it. Around the knee, there is a nerve that lies closely related to the Vein to be treated. If treatment is done at this spot there is a 10% chance of nerve injury. Fortunately, this DOES NOT LEAD TO PARALYSIS. Patient just experiences a permanent numbness around a patch of skin in the inner part of the knee. Most patients don’t find this a major problem.
Which treatment is best for me?
The various methods can often seem confusing. The best way forward is to consult a Vascular Surgeon who is experienced in all these forms of treatment so he or she can best advise the best treatment for the patient, based on the anatomy and distribution of the diseased veins.