Is varicose vein surgery worth it?

Varicose veins are swollen, twisted veins that commonly occur in the legs due to weakened or damaged valves within the veins, causing blood to pool rather than flow efficiently back to the heart. They often appear as raised, blue or purple veins under the skin and may cause discomfort, heaviness, or pain, affecting daily activities and quality of life. Many people with varicose veins consider surgery to alleviate symptoms and improve leg appearance, but the decision to proceed with surgery depends on individual circumstances.

When should varicose vein surgery be considered?

Varicose vein surgery may be worthwhile if you experience the following:

• Persistent pain or discomfort: Varicose veins can cause aching, throbbing, and heaviness in the legs, particularly after prolonged standing or walking.
• Swelling and skin irritation: Varicose veins can lead to leg swelling, itching, and even skin changes or ulcers if left untreated.
• Impacts on daily life: If symptoms interfere with daily activities or exercise, surgery may improve mobility and comfort.
• Complications or worsening symptoms: In severe cases, varicose veins can lead to complications such as blood clots, leg ulcers, or bleeding. Surgery can help prevent these from worsening.

If symptoms are mild, conservative treatments, like compression stockings, exercise, and elevating the legs, are often recommended initially.

What are the surgical options for varicose veins?

Several procedures target varicose veins, each with its own benefits and considerations:

1.Endovenous laser treatment (EVLT)
This minimally invasive procedure uses laser energy to close off affected veins, diverting blood flow to healthier veins. EVLT is performed under local anaesthetic and typically has a short recovery time.

2.Radiofrequency ablation (RFA)
RFA is similar to EVLT in that it uses radiofrequency energy to heat and close off varicose veins. It’s effective for large varicose veins and has a high success rate, with patients experiencing relief from symptoms.

3.Sclerotherapy
A common treatment for smaller varicose veins, sclerotherapy involves injecting a solution into the vein to cause it to collapse and fade over time. This procedure is often used for cosmetic purposes or minor varicose veins.

4.Ambulatory phlebectomy
In this minimally invasive procedure, small incisions are made to remove varicose veins just beneath the skin. It can be effective for smaller, visible veins and requires minimal downtime.

5.Vein stripping and ligation
In cases of severe varicose veins, vein stripping may be considered. This involves removing the affected vein under general anaesthesia. It is less commonly performed today due to newer, minimally invasive procedures.

What are the benefits and success rates of varicose vein surgery?

The benefits of varicose vein surgery can be significant for those with moderate to severe symptoms. Successful surgery can lead to:

• Symptom relief: Pain, heaviness and swelling can often be significantly reduced or eliminated.
• Improved leg appearance: For many, surgery reduces the visibility of swollen veins, which can boost confidence and satisfaction with leg appearance.
• Enhanced mobility: Alleviating discomfort may enable patients to be more active and comfortable during daily activities.

Studies indicate high success rates, with minimally invasive procedures like EVLT and RFA having over a 90 per cent success rate for symptom relief and vein closure.

Are there risks and drawbacks to varicose vein surgery?

Like any surgery, varicose vein procedures carry potential risks, including:

• Infection, bruising, or bleeding: Though rare, these complications may occur, particularly with vein stripping.
• Blood clots: Although minimally invasive procedures have a low risk, surgery can cause blood clots in rare cases.
• Vein recurrence: There is a possibility of new varicose veins developing over time, especially if contributing factors remain, such as prolonged standing, obesity, or genetic predisposition.

Is it worth it?

For those with significant symptoms or complications, varicose vein surgery can be highly beneficial and worthwhile. Advances in minimally invasive techniques make the procedures safer, with shorter recovery times and excellent success rates. However, if symptoms are mild, conservative management may be effective and surgery may not be necessary.

Ultimately, deciding if varicose vein surgery is worth it depends on personal circumstances, severity of symptoms, and treatment goals. A consultation with a vascular specialist can provide tailored advice to help make the best decision for your health and well-being.