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Venocuff™ For Varicose Veins
If you would like to see Mr Braithwaite as a Private Patient for Venocuff or other varicose vein treatment, please contact him at either the Park Hospital or Nottingham Nuffield.
What is the Venocuff™ treatment? The Venocuff™ is the name for a new technique to treat varicose veins? It was developed in Australia but has not been available in the United Kingdom until recently. Traditional varicose vein surgery, VNUS, EVLT and Varicofoam all involve removal of the long saphenous vein (LSV) in the thigh. The Venocuff™ technique is designed to make one of the broken valves in the vein work properly. This usually means the LSV does not need to be removed.
The main factor contributing to the development of varicose veins is malfunctioning one-way valves that are unable to prevent the back-flow of blood. Each valve consists of two cusps or halves that when separated cease to function. The Venocuff is a small, thin, Dacron-reinforced silicone cuff or band that Mr Braithwaie surgically implants around a malfunctioning valve and tightens until the valve resumes its normal operation. The aim of using the Venocuff is to realign the two cusps to prevent leakage and once implanted it is left in the body permanently. Its appearance is similar to a clamp used on hoses in a car engine. It should be emphasised that this type of silicone is solid and inert and not the same type of silicone used in cosmetic or reconstructive breast surgery. What are the advantages of the Venocuff™ treatment? The Venocuff has several advantages over other methods of treatment for venous disease. If valves are present and the cusps undamaged, the Venocuff IIJ will restore them to working condition alleviating the symptoms of the disease. This may require anything from one to several Venocuffs placed at strategic points along the length of the vein.
For the treatment of simple varicose veins, the Venocuff procedure is less traumatic than vein stripping. Placed around the main valve in the groin, the greatest advantage of the technique is that most of the vein, the long saphenous vein, is not removed or damaged and, when the top valve is repaired, the faulty valves in the vein below this can return to normal. This is especially important, as the long saphenous vein is most commonly used as a transplant conduit for major surgery such as heart bypass operations and the treatment of blocked arteries in the legs. If you are a smoker or have high blood pressure then you may need your LSV so the Venocuff might be suitable for you.
Is everyone suitable for the Venocuff™ treatment?
No. Some people are not suitable for the treatment. Mr Braithwaite will be able to discuss this with you.
The Venocuff is only applicable to major valve sites. Small superficial veins may require more conventional management such as avulsion or sclerotherapy. Some small superficial veins may lighten following the procedure as the Venocuff operation, and if there are still small veins present, these are treated with sclerotherapy.
The Venocuff procedure is not suitable for patients whose venous valves are either missing, damaged by a blood clot (DVT).
Venocuff cannot be used in patients whose varicose veins have been subjected to excessive pressure for too long. This results in massive swelling or distension of the veins, with the result that they are no longer function normally and are not suitable for use in bypass surgery.
The Venocuff is also not applicable in some cases of recurrent varicose veins, especially where there has been an incision in the groin. In these cases, the important veins and valves are usually removed. Veins unsuitable for Venocuff repair can be treated by conventional methods such as varicofoam, avulsion, Traditional ligation, VNUS, EVLT or stripping.
Does the Venocuff™ treatment hurt?
The procedure is far less painful than conventional "stripping" operations. A small amount of discomfort, which varies from person to person, is experienced in the weeks following the surgery. This is not due to the Venocuff IIJ device, which you cannot feel as it is implanted deep within the leg, but relates to the operative procedure itself. The size and number of varicose veins are a good indication of how much discomfort you may have following surgery. Even so, almost everyone can walk the evening after surgery and, depending on the type of operation, can go home the same day or within one to three days. Once the surgical incisions in the groin and/or behind the knee have healed, you may feel some minor pain, but you will be able to resume normal activities within a few weeks.
Is the Venocuff™ treatment available on the NHS?
The government medical advisory agency, NICE, has not considered the Venocuff. This means it is not available on the NHS except as part of a clinical trial. Mr Braithwaite has organised a study on the Venocuff to help determine if it should be used routinely.
If you would like to be considered for the Venocuff, please contact Mr Braithwate:
Are there any alternatives to Venocuff™ treatment? Varicofoam, foam injection of varicose veins is another new technique used by Mr Braithwaite. A technique using a laser to heat the blood in the long saphenous vein is available. The procedure, known as EVLT, can be performed entirely under local anaesthetic. The treatment helps with the aching of the legs associated with varicose veins but people still need to have the lumpy veins in the area of the calf removed. This can be by injection or removal under local anaesthesia. EVLT is a new technique that is now available for some NHS patients.Long term results are not known.
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