This is a restorative method rather than an ablative method of dealing with varicose veins.

The veins return blood to the heart.  This action is dependent on a series of one way or check valves that open to allow blood through then close to prevent blood it going back or refluxing down towards the feet with gravity.

In most varicose vein cases the valves of the long Saphenous vein have failed or become incompetent.  This process begins with dilatation of the vein which stretches the valve and prevents the valve leaflets closely precisely together.  The reflux causes high pressure in this vein which is transmitted to its thinner walled tributaries.  These tributaries dilate and become varicose.  Generally the Saphenous vein does not become varicose because it is quite thick walled even though it is the source vein.

If this process is caught early then the valve can be tightened and repaired with an external band called a venocuff.  This is inserted through a small incision made in the groin and saves you having the vein stripped out.

The varicose tributaries are still removed once the feeding vein is repaired.

To be suitable for this;

1. Patients must have a valve that is relatively normal and just dilated. If the valve is grossly distorted it cannot be fixed.

2. Patients with relatively early veins.

3. Not suitable in diabetics.

4. Patients who have not had surgery in the groin previously.

5. The reflux must begin in the groin.

Patients will have a scan to assess their suitability pre op.

During the operation the repair is tested and unless the valve function is restored then the vein is removed with conventional surgery.

Advantages to the procedure;

1. Less pain and bruising in the leg as the vein is left intact and not stripped out.

2. If the repair is successful then the chance of recurrent veins is lower.

3. Preservation of normal physiology.

4. The vein is available if needed in later life for other medical procedures i.e. arterial bypass surgery.

Possible downsides;

1. If the cuff gets infected it needs to be removed.

2. There is a chance of an unsuccessful repair even despite the intraoperative test.

3. Only 30% of patients are suitable candidates