Covidien, a leading global provider of healthcare products, has announced that a new guideline on the diagnosis and management of varicose veins has been issued today by the National Institute for Health and Care Excellence (NICE) – http://guidance.nice.org.uk/cg168.(1)
For the first time, NICE recommends heat ablation therapy as first line treatment instead of the more invasive surgical procedures currently being used.(1) This recognition signals a new era for the management of patients with varicose veins, who will benefit from a walk-in, walk-out procedure(2) requiring only local anaesthetic and allowing them to return to normal activities the next day.(3,4)
Varicose veins affect up to 3 in 10 adults in the UK(5) and their impact on quality of life is comparable with that of congestive heart failure and chronic lung disease.(6) Additionally, the burden to the National Health Service (NHS) of managing the impact of untreated varicose veins such as leg ulcers is estimated at £1bn annually.(7)
“Patients with varicose veins are understandably reluctant to agree to invasive procedures that require significant recovery time and may need further intervention,” said Mr Paul Flora, Vascular Surgeon, Barts Health NHS Trust. “The wider availability of heat ablation on the NHS is good news for these patients and has the potential to reduce the burden of managing the impact of venous ulcers.”
Heat ablation is a cheaper therapy associated with less pain and quicker recovery times for patients, compared with traditional surgery such as ‘vein stripping’ or ligation.(1,4)
Access to appropriate treatment can transform patients’ lives, as Dorothy Luke who was treated with radiofrequency heat ablation comments: “My varicose veins meant that I suffered a lot of pain and aching in my legs, which was really challenging because I’m on my feet all day. I was also embarrassed about the appearance of my legs. I didn’t want to undergo a general anaesthetic so radiofrequency ablation was an ideal solution. I was delighted with the treatment: it was straight-forward, fast and virtually pain-free. I was able to return to normal activities immediately and the improvement has been dramatic.” (Please note, this is the personal experience of this particular patient, and may not necessarily be representative of other patients’ experience.)
Within the heat ablation class of therapies, Covidien’s Venefit™ procedure using the ClosureFast™ catheter is the only one to use segmental radiofrequency ablation. Under ultrasound guidance, the catheter is inserted into the vein and directed to the area where treatment is required. The vein is heated, causing it to shrink and collapse, sealing the area around the varicose vein. Over time, the treated vein shrinks and is absorbed by the body. The procedure has been shown to cause less pain and bruising than conventional surgical treatments, with a faster return to normal activities and reduced risk of recurrence.(3,4)
“The Venefit procedure has been endorsed by the NHS Technology Adoption Centre (NTAC) providing safe and effective treatment for patients with varicose veins,” said Mark A. Turco, MD, Chief Medical Officer, Vascular Therapies. “The move towards newer, more patient-friendly treatments demonstrating safety, clinical effectiveness and economic value is likely to improve treatment options for patients in the UK affected by varicose veins and we are del”
- National Institute for Health and Care Excellence. The diagnosis and management of varicose veins. Clinical guideline. http://guidance.nice.org.uk/cg16826. July 2013.
- Nordon IM, et al. A prospective double-blind randomized controlled trial of radiofrequency versus laser treatment of the great saphenous vein in patients with varicose veins. Annals of Surgery. December 2011. 254(6): 876-881
- Almeida JI, et al. Radiofrequency ClosureFast versus Laser Ablation for the Treatment of Great Saphenous Reflux: a Multicenter, Single-Blinded, Randomized Study (Recovery study). JVIR; 2009; 20(6):752-9.
- Rasmussen LH, et al. Randomized Clinical Trial Comparing Endovenous Laser Ablation, Radiofrequency Ablation, Foam Sclerotherapy and Surgical Stripping for Great Saphenous Varicose veins. British Journal of Surgery. August 2011; 98(8):1079-87.
- Varicose Veins. NHS Choices. http://www.nhs.uk/Conditions/Varicose-veins/Pages/Whatarevaricoseveins.aspx. 20th August 2012 (Last accessed July 2013).
- Carradice D, et al. Modelling the effect of venous disease on quality of life.Br J Surg. 2011 Aug; 98(8): 1089-98
- Ruckley CV. Socioeconomic impact of chronic venous insufficiency and leg ulcers. Angiology. 1997; 48:67-9.