In my view, ambulatory phlebectomy is the best and most effective method to deal with superficial visible varicose veins. This comprises the removal of superficial veins through tiny 1mm diameter punch incisions made under local anaesthesia. Whilst there may be temporary bruising, there will be no skin discoloration as a result. It is my preferred method to deal with varicose veins whether truncal treatment is being performed or not, as it is likely to result in a better, quicker and a more permanent result over a single session. The leg will require bandaging, which will be removed the following day, when the leg is checked, any treated vein trunks inspected by ultrasound, and compression stocking placed on the leg.
This is the result obtained following ambulatory phlebectomy only with no truncal procedure for a large aberrant lateral thigh varicosity.
These are procedures for superficial veins, involving injection of plain or foamed sclerosant solutions, usually STS of differing strengths, into superficial varicose veins either under ultrasound control or not. Compression is mandatory after the procedures. Liquid sclerotherapy may be less effective than foam sclerotherapy, however it is less likely to result in staining of the skin and irritation. It may be one of the safer methods to deal with incompetent perforating veins in the region of the calf if sclerotherapy is the chosen treatment.
This is the result of ultrasound-guided foam sclerotherapy of residual calf varices as a staged procedure following truncal ablation
I treat tiny visible blue veins (known as spider or thread veins or telangiectasiae) by microsclerotherapy. I use two different sclerosant solutions depnding on the cirumstances, either dilute STS or Aethoxysklerol (polidocanol), and I use magnifying loupes to visualise the veins better to ensure a proper intra-procedural result. The majority of clients derive a positive result from this procedure, however, there is a high chance of developing more tiny blue veins in time. Compression hosiery is required following microsclerotherapy.