NICE Updates NHS Guidelines for Varicose Veins

Mr Costas Kyriakides
By Mr Costas Kyriakides

Mr Costas Kyriakides is Consultant Vascular Surgeon at The Private Clinic of Harley Street, and has over 15 years experience treating patients.

Guidelines for England and Wales from NICE (National Institute for Health and Care Excellence) now recommend laser and heat treatments for varicose veins over surgery.

The recommendations have been warmly welcomed by many people in both the NHS and the private sector.

Laser and heat treatments are cheaper and less invasive for the NHS than current surgical options, NICE note in their report, so the recommendations are a step in the right direction in delivering the best treatments for patients.

Varicose Vein Treatments

Varicose veins are a considerable cosmetic issue but also pose a threat to health. With 1 in 3 likely to develop varicose veins at some point in their life it’s also a common problem in the UK. The NHS has been under pressure from all angles to treat varicose veins with laser and heat (EVLA) treatments rather than the more invasive surgical options, which should only be used when minimally invasive options are unsuitable. NICE recommendations are in line with what many practitioners have been saying and doing for a number of years. Procedures like vein stripping are losing favour across the UK, especially as people seek out modern, less invasive procedures offered more widely in the private sector.

Varicose Vein Treatments

Conventional stripping methods have been in decline for a number of years for a number of reasons. Decreased risks, downtime, pain and increased success rates are just some of the reasons why treatments like EVLA are popular and effective. NHS costs can be cut because you cut out the hospital stay and all the associated costs with a surgical procedure of its kind. With risks like bleeding, infections, vascular injuries, deep vein thrombosis and nerve injuries, it’s little wonder why surgery is to be avoided where possible.

Modern treatments can be performed under local anaesthetic and patients can leave soon after the procedure, with fewer incisions as well, including EVLA, sclerotherapy and phlebectomy. I’ve been involved in promoting and refining laser ablation techniques for over 10 years. With my years of experience I’ve witnessed firsthand just how patients respond and with prior experience in conventional surgical procedures such recommendations are in line with my work.

Of course, as some clinics point out, there will be patients who will be unsuitable for the more modern methods of treating varicose veins. Saying that, I have personally treated over 3,500 patients with EVLA in the last 10 or so years and in this time only one patient has not responded to treatment. It’s simply quite unusual for a patient not to respond to EVLA. Naturally the right procedure depends on the patient


The Private Sector

Currently 35,000 varicose vein procedures are carried out by the NHS every year and switching treatments could save the NHS £400,000 a year so there’s also a financial incentive. Obviously this is good news for the NHS but what about the private sector? Hopefully these guidelines will help people become more aware of the most effective varicose vein treatments available.

It’s too early to say what kind of impact this will have on private clinics offering these treatments but it can only be good news when the most effective treatments are used on patients. The NHS is under a lot of pressure to become more efficient and sometimes this means changes to who will be treated are made.

No doubt if less people are treated by the NHS more people will turn to private clinics for treatment. As always people need to do a lot of research in order to find a reputable clinic and an experienced medical practitioner.


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