The latest quick fix for varicose veins: superglue

UNSIGHTLY varicose veins in the legs c o ul d be banished by injections of ‘ superglue’, after a new procedure was approved for routine NHS use. The move raises hopes that thousands more patients will now be offered the treatment.

Varicose veins are caused by defective valves within the blood vessels of the lower limbs. Normally these valves stop blood flowing backwards, but if they don’t work properly, normal circulation can be affected and blood can collect in the veins, causing the distinctive bulging. Age and genetics appear to be the biggest risk factors. Pregnancy, which puts a strain on the circulatory system, can also trigger the problem.

Despite being a source of embarrassment, they often cause no other symptoms, so treatment is denied to patients on the NHS. But when severe, varicose veins can cause pain and even leg ulcers, which can take months to heal.

The treatment involves injecting a medical glue to seal problematic veins. It takes 20 minutes and requires a single dose of local anaesthetic.

New guidance issued by watchdog the National Institute for Health and Care Excellence means it can now be used more widely in the NHS – the latest in a raft of speedy, less invasive treatment options for patients with varicose veins. However, doctors f ear many patients could still miss out on this vital care. Despite national guidance recommending patients experiencing discomfort receive treatment, decisions over whether to fund these procedures are made locally. Experts say that patients with varicose veins are often among the first to have their treatment rationed.

The problem is likely to worsen, as NHS waiting lists continue to grow, due to backlogs caused by the Covid-19 pandemic.

Manj Gohel, consultant vascular and endovascular surgeon at Addenbrooke’s Hospital, Cambridge, believes more patients should have access to varicose-vein therapies. ‘If you’ve got varicose veins with significant symptoms, the evidence is that you would benefit from treatment and that it would be cost-effective,’ he says. ‘ People with wiggly veins may have cosmetic concerns. But longstanding varicose veins can lead to a whole range of other problems.

‘People can have swollen, painful legs, which significantly impair their ability to work and live.

‘They can start to develop skin damage, disco lo ration, inflammation and leg ulcers .’

Leg ulcers affect more than 200,000 people in the UK and most are caused by varicose veins. They form when high pressure in the veins damages and weakens the skin in the lower leg.

Traditionally, varicose-vein patients would undergo a surgical procedure under general anaesthetic, known as stripping, to have affected veins surgically removed. This required a general anaesthetic and a lengthy recovery period. Now, surgeons most commonly use a laser or a radiofrequency procedure to destroy the vein. But this can be painful and need up to 20 local- anaesthetic injections. Another option involves injecting foam into the veins to seal them.

The latest treatment, using glue, has been shown in trials to be more than 90 per cent effective.

Each vein takes between 20 and 25 minutes to treat. Firstly, anaesthetic is injected into the vein, usually in the calf. Using ultrasound guidance, a tiny tube is then threaded up the vein until it reaches the groin. The glue, called Venaseal, is injected gradually, with pressure applied externally to push the walls of the vein together and seal it.

After this, the blood no longer collects in the faulty vein and visible, wiggly veins can disappear. Tahir Hussain, a consultant vascular surgeon at Northwick Park Hospital in London who has carried out the procedure in hundreds of patients, had it done on his own varicose veins in his lunch break 18 months ago after developing symptoms three years ago, aged 52.

‘Afterwards, I got up and carried on with the rest of my day,’ he says. ‘The following day I went on a 5k run. I had some visible veins and they shrank away – and after a few months, the aching had gone.’

Figures show fewer than 30,000 varicose-vein treatments are carried out on the NHS every year.

Last year, the All-Party Parliamentary Group on Vascular and Venous Disease called for better access to varicose-vein treatment.

Research has shown that treating varicose veins can speed up the recovery of leg ulcers by more than six weeks.