You have been advised that your varicose veins are suitable for treatment with VNUS Closure. Here is some information regarding the procedure and aftercare.

The Procedure

VNUS Closure is a treatment for varicose veins that seals the main varicose vein from the inside using heat from microwaves. It is performed under local anaesthetic on an outpatient basis. The whole episode from admission to discharge usually takes about 3 hours. Usually only one leg is treated at a time, although this can be discussed with your consultant. 

Before the treatment, your leg will be scanned with ultrasound by the consultant and some pen marks made on the leg. In the procedure room, the leg is cleaned with antiseptic, and sterile drapes are applied. A small amount of local anaesthetic is injected, and a fine catheter (tube) is inserted through a tiny puncture into the main varicose vein using ultrasound guidance. A further larger volume of local anaesthetic is then injected along the line of the varicose vein containing the catheter. The catheter is connected to a machine that heats the tip using microwaves, and this seals the vein from the inside as the catheter is slowly withdrawn. 

There may be some additional small varicose veins which can be removed at the same time under local anaesthetic through tiny incisions, which are then closed with a paper strip. This will be discussed with your consultant before the procedure starts. 

After the procedure, a full-length stocking will be applied to the treated leg(s). You will then leave the procedure room on a trolley, and will rest with your legs elevated for about an hour.  It is advisable to arrange a lift home from the hospital.

Progress after discharge

Most patients feel only minimal discomfort following VNUS Closure and 40% of patients do not require any painkillers at all. If you do wish to take something, simply take whatever you would use for a headache such as neurofen or paracetamol. The stocking should not be removed at all for the 48 hours after the procedure. After that, the stocking can be removed for a shower and a clean stocking (which we will provide) put on. You should plan to wear the stocking day and night for one week, and day only for a further week, removing it to shower. 

There are no particular restrictions on exercise or activities following VNUS Closure, but you may feel you do not want to do vigorous exercise, such as jogging, for a week, and you will be wearing a stocking for 2 weeks. 

You should not plan to fly short-haul for 2 weeks or long-haul for 6 weeks following treatment. 

If you have had any varicose veins removed through small incisions, the paper strips used sometimes drop off on their own. They can be peeled off after 7 days if they are still there. There may be some initial lumpiness and bruising and the treated vein can sometimes be felt under the skin, like a cord. It may feel a little tight at first if you are exercising or stretching, but it softens up quite quickly and within a few weeks disappears altogether.

Complications following VNUS Closure

Studies have shown that VNUS Closure is a very safe and effective way of treating varicose veins. There is less bruising and discomfort compared to other methods of treatment, such as EVLT (laser) or surgery. It is approved by the National Institute for Clinical Excellence (NICE). 

If you have had veins removed through small incisions at the same time, these will leave small scars on the leg, which should be hardly noticeable. In about 3% of patients, there may be some tenderness and slight lumpiness of treated veins (phlebitis). This will disappear over a few weeks. Approximately 2% of patients may have some altered sensation of the skin due to heat damage of skin nerves. In most cases this will completely recover. There is a rare incidence (less than 1%) of deep venous thrombosis following VNUS Closure. 

Follow-up after VNUS Closure you will normally be seen in the outpatient clinic by the consultant in the weeks following VNUS Closure. The consultant will examine your treated leg to check on progress. You will have the opportunity at review to ask your consultant any questions or discuss any aspect of your treatment.