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NICE recommends cost-saving newer treatments for severe varicose veins instead of surgery



Patients with severe varicose veins should be offered newer and cheaper alternatives to surgery, according to new NICE guidance released today on the diagnosis and management of the condition.

The health regulator has ruled that endothermal ablation – either radiofrequency ablation of varicose veins or endovenous laser treatment of the long saphenous vein – and ultrasound-guided foam sclerotherapy are clinically effective and cost effective alternatives to surgery.

Patients should now only be considered for surgery if neither of these treatments are suitable, while only those patients unsuitable for any of these interventions should receive treatment with compression hosiery.

NICE says the new guidance – the first of its kind – should save the NHS both time and money, and lead to more standardised care of people with varicose veins across the UK.

Up to now there has been no clear guidance on which treatment is the best choice for patients requiring intervention. The new guidance aims to offer treatment options according to the severity of symptoms.

Professor Alun Davies, professor of vascular surgery and honorary consultant surgeon at Imperial College NHS Trust, London, who chaired the guidelines development group, said: ‘Varicose veins are a common problem, with around 35% of the UK population being affected. Treatment offered, however, varies on where you live.

‘This guideline shows quite clearly that interventional treatment for some patients who are suffering from symptomatic varicose veins is a better alternative to surgery and is both clinically and cost-effective. It will help standardise care for all those with this condition.’

NICE clinical guideline 168 – Varicose veins in the legs