Venous Procedures

 

Venaseal ™ (Glue) Instructions

 

Before your procedure:

·         You may eat and drink normally

·         Take a warm bath or shower and wear loose comfortable clothes

·         If you take medication routinely, please take it on the day of your procedure unless you are directed otherwise

·         If there is a plan to treat other veins with injections at the end, please bring a 20-30 mm Hg thigh high medical compression stocking (you must be measured for stockings and ordered, please plan ahead at least 4 days prior)

·         Have someone driving yourself to and from the clinic.

·         You will be required to sign an informed consent just prior to the procedure.

 

During the treatment:

An ultrasound scan will be done on your leg to identify the veins to be treated. An injection will freeze the skin and a small special intravenous catheter will be inserted on your leg. Through that, a small flexible wire will be passed into the vein. A fine tube is passed over this wire and then the treatment catheter is threaded though the tube. The position of the catheter will then be checked again by ultrasound.

Once the delivery catheter is advanced into position at the top of the vein being treated, the proximal vein is compressed and a measured dose of cyanoacrylate glue is delivered through the tip of the catheter to seal the vein. The catheter is withdrawn in stages and the steps repeated to close the vein using ultrasound imaging to monitor progress. You should not feel anything during the treatment. When the vein has been closed the catheter is removed and a small paper tape is used to cover the small opening made by the intravenous.

Sometimes to improve the results of your treatment the surgeon will also inject some of your veins with a foam solution (Foam Sclerotherapy) designed to block smaller veins that cannot be treated with the Glue. These injections can leave a brownish discolouration in place of the vein, but this almost always disappears within 12 months. Alternatively, the more prominent veins may be removed under local anaesthetic, through small incisions in the skin (phlebectomies) after the initial procedure. Your surgeon will discuss this treatment with you at the time of your treatment if it was not yet discussed during the pre-operative visit.

As with any surgical procedure there is a small risk of blood clots forming in the main leg veins (DVT). Allergic reactions to the chemical used during the treatment can occur. However, both complications are quite rare.

         Normally there is no need to wear stockings immediately after the procedure, unless the surgeon combined Foam Sclerotherapy to treat visible large varicosities.

 

After the Treatment:

·         Walk around for a few minutes before going home.

·         You should have someone to take you home, and if you are travelling for more than an hour from the clinic you should sit on the back seat with your leg(s) up. Stop every hour and walk around for 5- 10 minutes.

·         Use the Voltaren® Gel prescribed starting the following day of the procedure, apply over the veins twice a day. It helps to reduce the inflammation which naturally occurs and pain /discolouration that may also occur

·         Most patients do not require anything for pain or if they do nothing stronger than Acetaminophen (Tylenol®) or Ibuprofen (Advil®).

·         You may have some bruising or tenderness along the line of the treated veins that can last for a few weeks, and there can be inflammation (phlebitis) in some branches of the treated vein. This can leave a hard-tender lump that may take a few months to settle, and on occasion there can be brown discolouration of the skin that takes some time to disappear.

·         Normal activity, including work, can be resumed as soon as you like, although contact sports, heavy exercise and swimming should be avoided for 2 weeks.

·         You could wear the stocking during the day for 1 to 2 weeks, but remove it at bedtime or for bathing. This is NOT essential, like in other treatments for varicose veins (Laser or stripping), unless you are directed otherwise.

·         Walk on the day of your procedure for a minimum of 30 minutes at least twice daily, and then continue walking 45 minutes to an hour every day.  That will reduce the chances of complications such as blood clots.

·         You should receive, as par of your Procedure Package, information about your next scan, which will check for blood clots and assess your results along with the date of your next appointment in the clinic after 4-6 weeks.

·         Avoid hot baths, Jacuzzis or hot tubs for 2 weeks after sclerotherapy.

·         Avoid the sun or tanning beds for 2 week after treatment. For the first 2 months, you should use sunblock in the leg treated, since permanent discoloration can occur

·         Avoid prolonged standing and lifting over 20 lb for the first week

·         There may be a few visible varicose veins left after treatment, but these rarely cause symptoms and become less prominent with time. Otherwise, additional treatment for these residual veins can be discussed in your visit after the procedure

·         We do not advise patients to undertake long haul air travel within 4 weeks of the procedure due to small risk of blood clots. Short flights may be acceptable, but if you have any doubts please contact your consultant’s secretary before attending for treatment.