CLARIVEIN PATIENT INFORMATION YOU SHOULD READ THIS INFORMATION CAREFULLY

CLARIVEIN PATIENT INFORMATION YOU SHOULD READ THIS INFORMATION CAREFULLY






CLARIVEIN PATIENT INFORMATION YOU SHOULD READ THIS INFORMATION CAREFULLY

CLARIVEIN PATIENT INFORMATION


You should read this information carefully. It will help you to understand the cause of your vein disease and the nature of the proposed treatment.


Clarivein is the trade name for mechanochemical endovenous ablation. The Clarivein device is produced by a company called Vascular Insights. Clarivein is approved for use in both the United Kingdom and United States, where it has been used for over five years with good results.


What types of veins are suitable for Clarivein?

Clarivein is used to treat lumpy varicose veins in patients’ legs. It does NOT treat spider or thread veins (although treating varicose veins is a necessary first step to allow successful treatment of thread and spider veins). To use Clarivein (or other catheter based techniques such as laser or radiofrequency), the main vein feeding the varicose veins must be straight rather than curly. About 80% of varicose veins patients have a straight feeding vein and are suitable for a catheter based technique. If you had varicose veins treated before, it is less likely that you will have a straight feeding vein and be suitable.


How does it work?

Veins in the leg are designed to keep blood flowing from the foot all the way up to the heart, against gravity and with a low blood pressure. To manage this, the veins have valves along them, which normally prevent blood being pulled back down the vein by gravity. In varicose veins, these valves are not working properly in the main superficial veins, so blood tends to pool in the veins and the surface veins swell up.


Previously, the faulty superficial veins would have been stripped. This forces the blood into deeper veins which are working properly and the varicose veins settle down. Clarivein does not rely on removing the vein. Instead, the Clarivein device roughens the inner lining of the vein through a combination of a spinning tip (mechanical ablation) and injection of a chemical sclerosant (chemical ablation).


Once the inner lining of the vein has been roughened up, the veins blocks off. Over the next few weeks and months, it forms scar tissue. Blood can no longer pass through the vein and instead passes into deeper, properly functioning veins. The surface bumpy veins usually shrink and disappear. Sometimes, if the surface veins are very large, some foam sclerosant is injected into them at the end of the Clarivein procedure.


What will happen during the treatment?

You will be asked to sit on a surgical couch, similar to a dentist’s chair. The couch will be tilted so that your legs are lower than your heart. This fills up the veins, just like when you stand up. The main feeding vein in the thigh or at the back of the calf will be identified using ultrasound. A small local anaesthetic injection will be given at the point where the Clarivein catheter is to be passed into the vein.


Under ultrasound control, a fine needle will puncture the feeder vein and a wire will be passed into it. A fine tube called a sheath will be passed over the wire and then the Clarivein catheter will be passed through the sheath. The tip of the catheter will be placed near the top of the vein and the position confirmed using ultrasound. Once the position has been confirmed, the Clarivein catheter will be switched on for a few seconds to allow you to become accustomed to the feeling it produces in your leg. Most patients say it feels like a fluttering inside.


The catheter is then switched on continuously and is pulled slowly down the vein. At the same time, liquid sclerosant is injected through the catheter. It takes about 7 minutes to treat a 40cm length of vein. Once the vein is treated, the catheter is removed, leaving only a 1 millimeter skin puncture which does not require any stitches.


A tight compression stocking is applied straight away and worn continuously over the first seven days and nights. It is then worn during the day for the next seven days. The nursing staff will perform some routine checks and once you will be allowed home. You should not drive yourself home on the day of the procedure.



What can I expect afterwards?

Some patients report mild discomfort in the area of the treated vein over the first few days. Simple pain killers such as paracetamol (1 gram every 4 to 6 hours, not exceeding 4 grams in 24 hours) usually prove very effective. Some patients prefer a mild anti-inflammatory such as ibuprofen (400mgs every 8 hours) although you should not take this if you have a history of asthma or stomach ulcers. Both of these pain killers are available ‘over the counter’ without any need for a prescription. Stronger pain killers are only very rarely needed.


You can resume normal activity immediately. Over the first two days, we ask that you exercise for 5 minutes in every hour during the day e.g. get up from a desk and make a cup of tea or walk around the office for a few minutes. Very heavy physical activity in the first few days e.g. distance running, contact sports should be avoided as the treated vein may become very inflamed, triggering phlebitis.


The compression stocking is a very important part of the treatment. If the stocking is discarded early, it is unlikely that the treatment will work and it could need to be repeated. It can be rolled down to allow washing but otherwise MUST remain on 24 hours a day for the first seven days and during the daytime for the next seven days.


Why use Clarivein and not one of the other catheter techniques like laser?

Clarivein has a number of advantages when compared to the other catheter based procedures such as endovenous laser. It is performed in an ambulatory setting, taking about 45 minutes. It allows immediate resumption of most normal activity. There are no incisions. Unlike conventional surgery or laser, there is no risk of nerve damage. Clarivein requires only a single local anaesthetic injection per feeding vein treated whereas laser requires injections every 1cm along the 40cms of vein usually treated i.e. 30 to 40 injections in total.






What problems can occur?

No interventional procedure is 100% safe and Clarivein is no exception. Serious complications are rare. Complications which may occur are:



Can the veins come back?


It is very important to realise that, regardless of the treatment type, varicose veins recur. The best available data show that 50% of patients have more veins in the treated leg 5 years after their procedure. There is no difference between the treatment types (surgery, laser etc) with respect to recurrence. You should also bear in mind that 5 years is the average length of time before veins recur – in some patients they recur faster and in some, more slowly. They can be treated again when they recur.


I have thread veins – will this procedure help?

90% of patients with thread veins have underlying varicose veins which should be treated before the thread veins. If the underlying varicose veins are ignored, the thread veins will recur rapidly after any treatment. It is important to understand, though, that treating the varicose veins alone will not improve the thread veins. You should not expect any improvement in thread veins after varicose vein treatment alone.


When will I be seen after the procedure?

You should have a follow-up ultrasound scan at 6 weeks post-procedure to ensure that the treated vein has sealed. We ask that you telephone 0894625405 to book this appointment.


If you are having problems, you should contact the office on 0894625405 and an earlier review appointment will be arranged.










Vein Treatment Consent


YOU MUST READ THE INFORMATION SHEETS PROVIDED BEFORE COMPLETING THIS FORM


YOUR PLANNED VEIN TREATMENT WILL NOT BE UNDERTAKEN UNTIL THIS FORM IS COMPLETED. PLEASE BRING THE COMPLETED FORM TO YOUR PROCEDURE APPOINTMENT.


  1. I have read the information sheet provided regarding my proposed vein treatment

Signed: Date:

  1. I am aware of the following potential complications as outlined in the information sheet:

    1. Clots in the leg or lung which in extremely rare cases may be fatal

    2. Phlebitis (inflammation) in the treated vein

    3. Cellulitis (infection) from the injection or catheter sites

    4. The veins may not seal (occurring in about 1 vein in 30)

    5. Occasionally, veins recur rapidly (less than six months)

    6. Occasionally, thread or spider veins may develop

    7. Some brown skin staining may occur in the area of the treated vein

    8. Sometimes, not all the superficial bulging veins resolve and may need further injection treatment

Signed: Date:

  1. I understand that thread and spider veins will not be improved by this procedure and that I should not expect any improvement in them without further specific spider and thread vein treatments

Signed: Date:

  1. I understand that following the procedure I should telephone 0894625405 to arrange a follow up appointment for 4 to 6 weeks

Signed: Date:




PATIENT INSTRUCTIONS FOLLOWING CLARIVEIN


You must wear the stocking 24 hours a day for the first seven days and then during the day time for the next seven days. Discarding the stockings early may cause the treatment to fail.


Over the first 5 days, please try to walk around or exercise gently for about 5 minutes every hour during the day.


Very heavy physical activity in the first few days e.g. distance running, contact sports should be avoided as the treated vein may become very inflamed, triggering phlebitis.


Some patients report mild discomfort in the area of the treated vein over the first few days. Simple pain killers such as paracetamol (1 gram every 4 to 6 hours, not exceeding 4 grams in 24 hours) usually prove very effective. Some patients prefer a mild anti-inflammatory such as ibuprofen (400mgs every 8 hours) although you should not take this if you have a history of asthma or stomach ulcers. Both of these pain killers are available ‘over the counter’ without any need for a prescription. Stronger pain killers are only very rarely needed.


If problems occur, please contact the office on 0894625405


PLEASE TELEPHONE 0894625405 IN THE NEXT WEEK TO BOOK A FOLLOW-UP SCAN APPOINTMENT

www.irishvascular.ie

Correspondence Address: St Edmunds Kiltannon Croagh CO Limerick







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