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TVC - Outpatient Appointments


Your outpatient consultation will last around 30 minutes, during which time we will make a historical enquiry of your condition, including questions such as:

  • How long have you had varicose veins ?

  • How much trouble do they cause - aching, pain, itching, ankle swelling?

  • Have you ever suffered from thrombophlebitis, ulceration, thrombosis?

  • Have you had previous treatment for varicose veins ?

  • How is your general health apart from your varicose veins ?

We will then perform a vascular physical examination in order to assess:

  • The extent and severity of your veins

  • Whether your arteries are functioning normally

  • Whether you have complications of varicose veins such as scarring of the skin and thickening of the ankle (‘lipodermatosclerosis’), ankle oedema, eczema or ulceration

  • The likely cause of your varicose veins. We will use a Doppler ultrasound machine to listen to the blood flow and to estimate where the valves are incompetent.

All patients with varicose veins require a more accurate assessment of the cause of their varicose veins with a Colour Duplex Ultrasound Scan. This scan may require a separate visit to the x-ray department. Duplex combines ultrasound with Doppler blood flow measurement and computer software to produce a very accurate ‘roadmap’ of your veins. This enables us to establish the proper workings of your deep veins, and also to plan your surgery more accurately

Once all the results are available the treatment options we recommend will be fully discussed, together with any alternative treatments. Treatments may involve:

Conservative management - this might include advice on lifestyle, medication for skin damage and eczema and the fitting of graduated compression stockings to reduce aching, swelling and the risk of ulceration and thrombosis.

Sclerotherapy - this involves injecting your veins with a sclerosant to obliterate them. It is only recommended for very small varicose veins (‘reticular veins’) and spider or thread veins (‘telangectasia’).

Surgery - Most varicose veins require an operation for their effective treatment. This involves removing the varicose veins through very small ‘stab’ incisions, combined with a procedure to deal with the incompetent valves that are causing the varicosities. This may involve a skin-crease incision in the groin or behind the knee.

New Treatments – including VNUS Closure radiofrequency ablation, EVLA laser therapy or Foam sclerotherapy (see “what can be done to treat varicose veins”).

Exactly what is involved will obviously be discussed with you.

 
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