Everybody would like to have the advantages of surgery, but without pain, scars or the risk of infection. The new Sonovein S (HIFU or high intensity focused ultrasound) is getting as close as possible to this ideal.
You can read a patient experience of Sonovein treatment of varicose veins in the May edition of Good Housekeeping. This edition is out now.
Varicose veins are one of the most common conditions to affect people. Approximately 30-40% of adults will develop varicose veins or “hidden varicose veins” in their life.
Although once thought to be cosmetic only, it is now known that leaving varicose veins untreated can lead to decreased quality-of-life. Indeed a major randomised controlled study showed that treating varicose veins gives patients a better of quality-of-life than leaving them to deteriorate.
Therefore, since June 2013, the NICE clinical guidelines have said that anyone who has varicose veins and symptoms, or signs, should have them treated.
⦁ troublesome lower limb symptoms
⦁ skin changes of the lower leg
⦁ pigmentation (red or brown)
⦁ “phlebitis” (medically called “superficial vein thrombosis”)
⦁ venous leg ulcer – defined as “a break in the skin below the knee that has not healed within 2 weeks”
⦁ healed venous leg ulcer.
Anybody who has any of these symptoms or signs, and has varicose veins or “hidden varicose veins” which can only be found on duplex ultrasound, should be treated.
Many years ago treatment was by surgery – stripping the veins. Fortunately, in all good vein practices, this stopped 15 years ago or more. Up until recently, treatment meant putting devices or chemicals inside a vein, which would then close it. This is called endovenous surgery. It is the current approach to treating varicose veins.
However, there is now a completely new way to treat veins from outside of the body. This amazing new technique is called “high intensity focused ultrasound” or HIFU for short. The machine that has been made to do this is called the Sonovein machine.
Sonovein (HIFU) is completely different from any other treatment for varicose veins. Although endovenous laser, radiofrequency ablation, foam sclerotherapy and all of the other new techniques such as glue or mechanochemical ablation are “minimally invasive”, they still need to be pushed inside the vein. This means that a needle or tube has to be passed through the skin and into the vein, in order for the device or chemical to be inserted. With some devices, further local anaesthetic needs to be injected around the vein.
However, Sonovein (HIFU) treatment is the only treatment available that is completely non-invasive. The Sonovein ultrasound device sits on the skin, just like the ultrasound that is used to look at a baby in a pregnant mother. A gel is put on the skin to improve contact.
The ultrasound is able to see all of the structures under the skin. Any underlying incompetent veins that are causing varicose veins or other problems can be found. Once identified, high intensity focused ultrasound can be focused on this vein.
Beamed through the skin, the ultrasound passes through the tissue towards the vein. Because it is focused, the ultrasound is completely harmless to the skin. However, as the ultrasound starts concentrating towards the focal point, the energy increases. At the point of focus, tissue is heated in a very small area, completely destroying the target.
Sonovein (HIFU) closes saphenous vein and/or perforating veins that are causing the varicose veins or other problems.
The original Sonovein often needed a little bit of local anaesthetic to be injected. However, with the new Sonovein S, the treatment is much faster. Many patients do not need any local anaesthetic at all. In these cases, the treatment is performed without a single needle passing across the skin from beginning to end.
This means that there is no risk of any infection, no risk of bruising and much-reduced pain. Nothing is put inside the vein so there is no chance of anything flowing up through the circulation.
Most patients finish the treatment and are able to walk home immediately without even needing a support stocking.
Depending on the pattern of veins, some patients are completely treated by Sonovein S. Others come back at a later stage for foam sclerotherapy to any remaining surface varicose veins, and/or microsclerotherapy to any cosmetic thread veins.
In the May edition of Good Housekeeping (on sale now), there is a double-page article all about varicose veins and the new techniques of how they can be treated.
In addition, there is a patient experience story from a journalist who had her varicose veins treated by Prof Mark Whiteley with Sonovein just over a year ago.
It is well worth a read!