Evidence-Based Interventions: varicose vein surgery
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Evidence-Based Interventions: varicose vein surgery


>>Alun Davies: I’m Alun Davies, the Professor
of Vascular Surgery at the Imperial College, London and I have an honorary contract at
Imperial College NHS Trust. I am going to talk to you a little bit today
about the Evidence-Based guidelines that have been produced by the NHS.
Varicose veins effect up to thirty-five percent of the population. They basically are dilatations
of the veins in the leg which can often cause symptoms such as pain, itching and you can
get subsequent complications such as Phlebitis and ulceration. There are, however, a cohort
of patients in whom they are purely cosmetic, and that cohort of patients do not need to
have any form of intervention. Over the last 120 years we’ve seen significant
developments in the way in which varicose veins are treated, moving away from traditional
surgery, which involved a cut in the groin and people having to have general anaesthesia
which was painful, we’ve now developed a cohort, a group of endovenous techniques looking
at thermal ablation such as laser and radiofrequency or injections with something called foam sclerotherapy.
These newer techniques have all been evaluated through the NICE process and the NICE process
has come out with a recommendation that the endovenous technique should be used rather
than surgery and have also made it very clear that people who have got symptomatic varicose
veins should not be offered compression therapy as a first line treatment if they suitable
either for endovenous ablation or even surgery. My vascular surgical colleagues and I are
happy to support the NHS Evidence-based Interventions Programme, as this is fully supportive of
the NICE guidance with respect to the management of patients with varicose veins. This clearly
states that patients who have symptomatic veins should be referred to a vascular service
for evaluation and treatment. The key other factor is the fact that we want
to reduce the regional variation in referral patterns and treatments of patients with varicose
veins by having a country wide clear guidance in England as to whom should be referred and
who should be treated, should allow us to do away with the significant regional variation
that we see and should overall improve patient outcomes.

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