A guide to varicose vein treatment costs

In this guide to varicose vein treatment costs, we look at what the NICE (National Institute for Clinical Excellence) consider best practice and what patients should consider when evaluating the relative costs of London providers.

Varicose vein treatment, "the gold standard"

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• Early treatment is recommended to slow down disease progression and avoid nasty complications
• Duplex ultrasound should be used to assess the level of reflux within the venous system
• Endothermal ablation is the preferred, stripping of veins no longer consistent with best practice
• Endovenous radiofrequncy is found to be less painful, deliver more consistent results and facilitate minimum downtime.

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Helpfully NICE provide 3 specific quality statements to guide us on best practice for treatment pathways.

Quality Statement 1

Varicose veins should be treated by a specialist vascular service! Symptoms are likely to continue unless treated, but in some cases will lead to further complications such as bleeding, skin damage and even ulceration.  Vein disease, like gum disease, affects many of us, especially as we get older and treatment can reduce symptoms, improve quality of life and reduce progress of the disease.

Quality Statement 2

A consultation is relatively worthless unless it includes a non-invasive scan using duplex ultrasound.  A hand-held doppler doesn’t provide sufficiently detailed information to assess blood flow and any damage to valves that are causing the varicose veins.  A vascular sonographer should be used to undertake this initial scan, which is an extremely important part of the process.

Quality Statement 3

Surgery, or stripping, alongside compression were the default treatment for sufferers of varicose veins. More recently, endothermal ablation and if unsuitable, ultrasound-guided foam sclerotherapy are more common.  The use of glue is widely used in the United States but currently doesn’t appear in this NICE statement as a treatment option. Endothermal ablation is significantly less invasive, ensuring a more rapid recovery.  It is less risky when compared to traditional hospital-based methods.

Providers will use either laser, known as EVLA, or radio frequency, known as EVRF, to remove the varicose vein.  The Rassmussen study in the British Journal of Surgery, 2011 considers the relative benefits of each technology.

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Varicose vein treatment failure and recovery rates

The Rasmussen study concluded that “the failure rate was lowest for both EVRF and stripping (4.8%)at year one.  EVRF and foam sclerotherapy demonstrated faster recovery (normal activity and return to work) and less post-operative pain than EVLA and stripping."

Varicose vein treatment cost

There are many varicose vein providers in the London area to choose from. Many are clinic based, largely in and around Harley street, and some based within a hospital setting.  It is increasingly common to see procedures performed under local anaesthetic within a clinic environment.  This is arguably a more pleasant experience and significantly reduced the cost of treatment for patients.

What patients should expect from a provider

• Considerable venous experience - this is a specific distinction to vascular work.
• Treatment pathway should be straight forward. Duplex scan, treatment recommendation, treatment and follow up.
• Prices should be fixed based on treatment recommendation.
• Endothermal ablation is the gold standard for the treatment of truncal veins.
• Truncal vein closure should be guaranteed by the treatment provider

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All providers should be Care Quality Commission (“CQC”) registered.  CQC guidelines cover procedures, policies and management of a clinic or hospital, ensuring that treatment is being conducted in a safe way.

Look for a provider who has considerable experience in the procedure itself.  It’s a truism in healthcare that treatment results are correlated to the experience and education of the consultant undertaking the procedure.  

At UK Vein Clinic, our scanning is undertaken under the leadership of Fabrizio D’Abate, a specialist Vascular Sonographer and award-winning Clinical Vascular Scientist. Usually based at St George’s hospital in London, he has tutored on several training courses in vascular ultrasound and holds prizes from the Society of Vascular Technology.  Professor Stephen Black leads the clinical team and is one of the country’s leading consultant vascular surgeons, responsible for training many of the surgeons in this field.  A fellow of the European Board of VascularSurgery, he’s usually based at London’s Guys and St Thomas’s hospital, where he leads the department.

Only UK Vein Clinic exclusively use Radio Frequency technology which has the lowest failure rate, post-operative pain and most speedy return to normal activity.

Treatment Pricing

Patients should know what costs they’re exposed to, before they commit time and money to any particular provider.  The procedure price should be fixed and include all of the consultations, scans and routine follow up required to complete treatment. Fixed price procedures have been available for many years now and there really is no excuse for opaque pricing for largely routine, minimally invasive procedures.

Most reputable providers such as Veincentre and UK Vein Clinic will charge an inclusive fee of £250 to cover the initial consultation and scan.  The scan will help to confirm the most viable way forward.  Treatment prices start from c.£2,100.

The Rasmussen study shows that treatment results can be unpredictable, recurrence of veins typically ranging from 4.8% to 11.6%. Currently in the UK, only UK Vein Clinic overtly offer to guarantee the closure of truncal veins.