For many years, varicose veins were thought of as “only cosmetic”.
However, over recent years, it has become understood that varicose veins are a sign of a deteriorating condition. Research has shown that about 1in 30 patients with varicose veins deteriorate each year to the next worse clinical score. These clinical scores can be seen on https://thewhiteleyclinic.co.uk/self-assessment/ceap-classification/.
So, for instance, each year, 1 patient in every 30 with simple varicose veins will develop ankle swelling. One patient in every 30 with ankle swelling due to varicose veins will develop skin damage. One patient in every 30 with skin damage will develop venous leg ulcers.
Although 1 in 30 might not seem to be a lot to many people, when you think this is the risk each year, leaving varicose veins untreated for year after year results in a great number of people deteriorating towards leg ulcers.
Up until this research featured in the Daily Mail today, few people would have thought that varicose veins could cause life-threatening conditions.
Indeed most doctors and nurses were taught that when blood clots occurred with varicose veins, they were only in the superficial veins – a process called “superficial venous thrombophlebitis” or more commonly called “phlebitis” (see: https://thewhiteleyclinic.co.uk/conditions/phlebitis/).
However, as you will read from The Whiteley Clinic website, we have cautioned for several years that since 2012, superficial venous thrombophlebitis has been shown to extend into the deep veins in a proportion of patients. As such patients diagnosed with “phlebitis” should all have a scan and if the clot is near the deep veins, should be anticoagulated. Failure to do this can lead to the clot becoming a deep vein thrombosis (DVT). If this then breaks off and goes to the lungs, it becomes a pulmonary embolism (PE) which is potentially life-threatening.
The research from China that is quoted in the Daily Mail article (http://www.dailymail.co.uk/health/article-5441023/Varicose-veins-warning-sign-deadly-blood-clots.html) is a research study that takes the next logical step. It shows clearly that patients with leg varicose veins who do not get them fixed can get superficial thrombophlebitis which in a proportion go straight on to deep vein thrombosis and pulmonary embolism. Indeed they suggest that patients with varicose veins are five times more likely to develop a DVT than patients without varicose veins.
Not surprisingly the National Institute of Health and Care Excellence recommended in 2013 that patients with varicose veins and any symptoms or signs should get treatment (https://www.nice.org.uk/guidance/cg168/chapter/1-Recommendations).
However, this new research suggests that even patients who have varicose veins without any symptoms or signs should probably consider getting their varicose veins treated.
Treatment for varicose veins is now relatively simple and is performed under local anaesthetic as a walk-in, walk-out procedure, commonly using an endovenous laser, radiofrequency, MOCA, glue which is often backed up with additional ultrasound-guided foam sclerotherapy.
At The Whiteley Clinic, we optimise each individual’s treatment by personalising their treatment on their individual scans using The Whiteley Protocol. Our recently published 15-year results show the excellent long-term outcomes from this approach.