In 2015, television presenter Julia Bradbury visited Veincentre’s London clinic to undergo treatment for her thread and varicose veins. Patients are often keen to know about the specifics of the treatment and learn out more about the intricacies of the procedure. Ms. Bradbury kindly discusses the process and results of her treatment.
Veincentre began by treating the underlying cause of Julia’s varicose vein problems with EVLA. Once the underlying cause of the varicose veins was dealt with, the team began treating the external varicosities on her legs with a combination of microsclerotherapy and foam (this tackles both the lumpy veins and thread veins).
All Veincentre's treatment follow the NICE guidelines (National Institute of Health and Care Excellence).
Julia explained her reason for seeking varicose veins treatment.
She said: “I've been plagued by thread veins since I was in my 20s, but four months into my pregnancy with my twin girls Xanthe and Zena, who are now 15 months old, varicose veins started to emerge behind my knee and down my calves, and my legs looked like stilton. They were awful. I feared I'd never be able to wear a dress or skirt again. I've always consciously avoided short skirts and shorts and I became the mistress of disguise, wearing leggings and the right shirt, even on holiday. Having been through five gruelling rounds of IVF, I was keen to avoid anything that was particularly invasive or involved a general anaesthetic, which is why laser treatment offered by Dr. West's clinic appealed."
Consultation: Stage 1
On initial examination, Julia presented with large varicosities on her right leg and smaller varicosities on her left, particularly on the lower leg. On both legs, Julia had multiple thread veins.
In order to accurately determine the underlying sources behind Julia's vein problems, a colour duplex ultrasound scan and clinical examination were performed on both of Julia's legs. It is impossible to assess the veins to determine the treatment needed without this full and detailed scan.
In Julia's case, this ultrasound scan revealed that the underlying condition of the varicosities in both legs was gross reflux (faulty valves) in the Great Saphenous Vein (GSV) - the large vein that runs from the groin to the ankle. In both of her legs, the Small Saphenous Vein was normal.
Destruction of the varicose vein sources: Stage 2
In this case, endovenous laser ablation (EVLA) was required to fix the underlying cause of Julia's varicose veins.
This procedure has a number of stages, beginning with numbing the target area with local anaesthetic before a thin laser fibre is inserted into the vein through the use of a needle puncture. This thin laser fibre then heats up the vein wall and destroys it. In this procedure, a general anaesthetic is not required.
Julia said, of the procedure: "It wasn't painful, more like a tickling sensation. The worst part was the burning smell as the laser does its job. The initial session took about an hour and you get used to it."
For a week after the treatment, Julia wore a pair of class II compression stockings, which helped reduce any post-procedure swelling and pain.
Follow-up: Stage 3
Julia's first follow-up appointment was 6 weeks post-EVLA. Julia had no problems following on from her treatment. As is often normal at this stage, Julia's veins had not yet begun to show signs of shrinkage – which is all the more common as the majority of her veins were thread veins. Typically, the vast majority of veins require direct treatment – though some veins may disappear.
It was confirmed that the EVLA treatment had successfully destroyed the veins that were causing Julia's problems, i.e. (the two GSVs) with the repeat duplex ultrasound scan.
Julia underwent her first session of foam sclerotherapy injections and microsclerotherapy injections to the visible veins at this stage in the treatments. The process of foam sclerotherapy involves a chemical that is mixed into a foam and subsequently injected into the veins.
Once it has mixed with the blood in the veins, the foam should harden the blood. Once this occurs, the patient's body gradually breaks down the blood and reabsorbs it into the bloodstream. Microsclerotherapy is used for smaller thread veins, while foam sclerotherapy is used for larger veins.
Julia wore her compression socks for another week after this treatment, in line with best practice.
Six weeks later, Julia shared: "I can't boast that I've got flawless legs but the improvement is astonishing. I feel more confident about going bare-legged, which is brilliant now the summer is here. I don't have to think about how best to disguise my legs and can wear dresses and skirts that are a bit shorter without feeling self-conscious. My legs feel smooth to the touch and I feel sure that this is a permanent solution to the problem that has plagued me for most of my adult life."
Further sessions of sclerotherapy injections: Stage 4
Despite responding well to the first session of injections, Julia’s varicose and thread veins were relatively extensive, so they required a further session of treatment for best results. These sessions can be considered 'tidy-up' sessions to attend to any visible thread veins remaining.
As a result of the chemicals required in sclerotherapy, there is a legal limit to how much of the chemicals can be safely injected in one session. Though patients are often keen to continue with the duration of the session until they are content with the end result, patient safety is of the utmost importance.
If all the veins have not managed to be injected before reaching the safety limit, it is likely that patients will need to return again. It is also important to note that some veins can also be particularly difficult and require two injection sessions to get the desired result.
Much like Julia, approximately 10% of patients may require additional sessions of injections after follow-up. The consultant is encouraged to accurately inform the patient about how many sessions they are likely to need based on their initial consultation.
However, it is important to bear in mind that everybody responds differently to the treatment, so a definite answer is too difficult to give.
Julia's most recent visit to Veincentre included her video of Dr. West performing a session of her microsclerotherapy injections. Watch Julia's short Instagram video of Dr. West’s treatment here.
Image Credit: Veincentre
About Veincentre
Veincentre are the UK’s leading varicose veins specialists using Gold Standard, minimally invasive techniques, with 15 clinics nationwide.
At Veincentre, we provide the most effective, proven treatment and the highest quality of care that is accessible to everyone. We treat the cause, not just the symptoms! All our treatments are minimally invasive – walk-in, walk-out, require no general anaesthetic, no surgery and no time off work.
The most important aspect of care for any condition is the ability and attitude of the team of doctors and nurses looking after you. We have headhunted some of the most experienced and respected vein specialists in the UK. By choosing Veincentre, you can be assured that discomfort will be minimised, outcomes will be optimised, and you will be looked after by a team who really care for you
From your initial point of contact you will be communicating with our patient advisers, who only deal with patients who suffer from varicose veins so are all highly experienced and can confidently answer all of your queries or provide any advice.
Start your journey to healthy veins and happy legs…
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