A Completely New Approach to the Treatment of Vein Conditions

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					A Completely New Approach to the Treatment of Vein Conditions

A Clinic dedicated to the Care of       Dr Haroun Gajraj, FRCS
all Vein Conditions Using the           Consultant Vascular Specialist
Latest Diagnostic & Treatment
Methods                                 Mr Robin Windhaber, FRCS
                                        Consultant Vascular & Endovascular
Vein conditions are common and          Surgeon
distressing with approximately 40%
of adults currently troubled by vari-    Innovation in Vein Care
cose veins and thread veins. Not            Laser Treatment EVL
only do they cause significant dis-         VNUS ClosureFAST
comfort and embarrassment, vari-            Foam Sclerotherapy
cose veins can be complicated by            Venaseal™ (Superglue)
varicose eczema, bleeding, leg ul-
                                            Treatments carried out under ultrasound
ceration and phlebitis.                      guidance
                                            One stop consultation and duplex scan
Unfortunately such vein conditions
                                            Microsclerotherapy for thread veins
are not a priority in the NHS. You
can now have access to high quality         Advice on DVT prevention

advice and treatment in one clinic.         Medical Compression hosiery
                                            All Assessments based on comprehensive
                                             venous duplex ultrasound scan
The VeinCare Centre specialises in
the treatment of varicose veins and
thread veins at clinics across south-
west England. All of our vein treat-
ments are performed by our experi-
enced consultant vascular surgeons
under local anaesthetic as a walk
in, walk out procedure.

 The VeinCare Centre
 The Melbury Clinic
 Higher Barn, Holt Mill
 Dorset DT2 0XL                                            0800 698 3467
                              Dr Haroun Gajraj FRCS
                              Founder of The VeinCare Centre

                              “I have over 25 years’ experience treating
                              people with varicose veins, thread veins and
                              other vein complications such as phlebitis,
                              varicose eczema and varicose ulcers. After
                              13 years as a consultant in the NHS, I now
                              specialise exclusively in providing the latest
                              treatments for these very common problems

I founded The VeinCare Centre to provide the latest treatment
options and the highest standard of care”.

Training and Experience

   Medical Graduate of Kings College Hospital, University of London
   Specialist Vascular Surgery training at St Thomas’s hospital and St
    George’s hospital in London
   Fellow of the Royal College of Surgeons of England
   Member of the Vascular Society of Great Britain and Ireland
   Member of the Royal Society of Medicine and Venous Forum
   Member of the American College of Phlebology
   Founding member of the British Association of Sclerotherapists
   Director of VeinCare Training
   Director of The Melbury Clinic
   Previously Consultant Vascular Surgeon in the NHS for 13 years
   Previously Clinical Director of Surgery at Yeovil District Hospital
    and previously Surgical Tutor Royal College of Surgeons of England                                      0800 698 3467
                              Robin Windhaber MB BCh (Wales)
                              MSc (Oxon) MD (Bristol) FRCS (Eng)

                              "I am a consultant Vascular and Endovascular
                              surgeon with specialist interests in the mini-
                              mally invasive treatment of varicose veins un-
                              der local anaesthetic and vascular ultrasound.
                              I have over 10 years’ experience in the man-
                              agement of varicose veins and in addition to
                              my work in The VeinCare Centre at The Mel-
                              bury Clinic, I work as a consultant Vascular
                              Surgeon in Dorset County Hospital where I
                              treat a wide range of arterial and vein-
                              related conditions.
During my surgical training I spent a year teaching anatomy at the Univer-
sity of Oxford and was awarded an MSc in Physiology from Trinity College.
The majority of my surgical training was undertaken in the South West re-
gion and my other qualifications include an MD from the University of
Bristol and the Fellowship of the Royal College of Surgeons of England."


   Royal College of Surgeons of England
   Vascular Society of Great Britain and Ireland
   European Society of Vascular Surgeons
   British Society of Endovascular Therapists
   British Association of Sclerotherapists

We are supported by a team of specialists
Ros English      Clinic Manager and co-ordinator of the Clinical & Administrative
                 activities of the Melbury Vein Clinic
Tina McLean      Office Administration Manager
Wendy Parsons    Ultrasonographer and Vascular Technologist
Emma Davies      Aesthetic Nurse & Specialist Sclerotherapy Practitioner                                         0800 698 3467
Varicose Veins
                             Women tend to seek advice for their varicose veins
                             more than men for many reasons:

                                They are more concerned about the cosmetic
                                Women tend to access health advice more than
                                 men for a whole range of health issues
                                Women tend to visit their GP more often for
                                 other reasons such as family planning and to
                                 accompany children

                             This has led some to believe incorrectly that vari-
                             cose veins are more common in women than men.
                             In fact some studies have suggested the opposite -
                             that varicose veins may actually be more common
                             in men than women

What causes varicose Veins?

No-one knows for sure, but varicose veins are
probably due to a failure of the valves that pre-
vent the down flow of blood in the wrong direc-
tion. Normally, the flow of blood in the veins is
towards the heart and in the legs the flow is
from the feet upwards. Abnormal down flow is
called reflux and this leads to varicose veins. Im-
portant factors are:

   Heredity
   Pregnancy
   Overweight
   Lack of exercise
   Smoking
   Unhealthy lifestyle
   Standing for long periods                                          0800 698 3467
What do veins do?

There are two sets of veins in the leg. A
deep set within the muscles and a su-
perficial set just underneath the skin.
Veins carry blood back from the leg to-
wards the heart and most of the blood
(more than 95%) is carried back in the
deep system. Very little blood is actual-
ly carried back in the superficial veins.
The small amount of blood that is car-
ried up by these veins finally enters the
deep system at certain points called
perforators. The most important drain-
age points are in the groin and behind
the knee.

As the muscles of the legs contract, the
deep veins are squeezed and blood is
pushed up against gravity towards the
heart. When the muscles relax, the
blood is prevented from coming back
down the leg towards the feet by the
closure of valves, which are delicate
folds of the lining of the veins. The
combined action of the muscles con-
tracting and the valve shutting keeps
blood moving in the correct direction.

If the valves are not working properly,
 blood may spill down in the wrong di-
 rection (called reflux), filling the super-
 ficial veins and causing varicose veins.
 An ultrasound scan is very important in
 identifying the exact position of the
 faulty valves.

We believe that all vein assessments and treatments should be
based on duplex ultrasound.                          0800 698 3467
Are Varicose Veins Simply Cosmetic?

The majority of people with varicose veins come to no harm at all.
Even those people who have ache, discomfort and swelling are un-
likely to develop serious complications. For this reason, many doc-
tors believe that varicose veins are not important. Indeed, the
treatment of varicose veins is not a priority in the NHS and some
people are denied NHS referral and treatment. To some extent this
is understandable as the NHS has many pressures requiring its valu-
able resources such as the treatment of cancer, heart disease, dia-
betes and care of the elderly - to name just a few. Even if your
varicose veins are severe, your GP may not be able to help and
may not be able to refer you for treatment. Nevertheless, varicose
veins cause severe embarrassment for many, who are unable to
wear shorts, go swimming or enjoy holidays on the beach.

What complications can arise?

Varicose veins are associated with abnormal down flow of the
blood, called reflux. When this is present for a long time, the skin
may be damaged and a condition called varicose eczema develops.
This is a warning sign that the skin is unhealthy and vulnerable. A
trivial injury can cause a leg ulcer, such as a knock from a shop-
ping trolley.

Although many people with varicose veins are concerned about a
leg ulcer, in fact the majority will not develop this condition. If
however the skin around the ankle develops any eczema-like
changes, advice should be urgently sought.

DVT is a feared complication of varicose veins and although it is a risk factor, for-
tunately DVT is very rare. More significant factors are admission to hospital, major
surgery, previous history of DVT, family history of blood clots, long-haul flights and
journeys, pregnancy and inherited blood-clotting disorders. Diagnosis can be very
difficult, but swelling of one calf is suggestive.

We believe that early treatment improves results

In some cases, NHS treatment for varicose veins will only be available after
complications have arisen. Many vein specialists believe that treatment at an
earlier stage improves the cosmetic results and prevents these complications.                                            0800 698 3467
What treatments are available for varicose veins?

There isn’t yet a perfect treatment for varicose veins. A perfect treatment would
remove all the varicose veins completely to give you the blemish-free legs you had
when you were younger, the varicose vein would never return and there would be
no side effects or complications from treatment. If the assessment is based on a
comprehensive ultrasound scan and the treatment is performed under ultrasound
guidance, the majority of people get an excellent result and are very pleased.

The four main treatment options are:

   VNUS Closure Fast and Endo-venous laser (EVL)- these in-
    volve the use of fine catheters placed inside the vein to
    heat it and seal the varicose veins
   Injections of solutions called sclerosants into the vein
    which start a healing process in which the vein shrinks and
   A non-thermal medical adhesive called Sapheon
    Venaseal™. A fine catheter is inserted into the refluxing
    vein and a medical "superglue" is administered inside the
    vein causing it to permanently close
   Microsurgical removal of veins called Microphlebectomy

Few clinics are able to offer all four treatment options. At The VeinCare Centre,
your needs are assessed and a tailored treatment plan is formulated for you. This
may consist of more than one option to get the best result. For example a combi-
nation of VNUS ClosureFast followed by injections may be appropriate for you. In
such cases, the pros and cons will be discussed in detail and you will have access
to all the latest treatments.

At each stage you will receive written information about the recommendations
including the costs and you will be given time to make your decision based upon
this information.                                         0800 698 3467
VNUS ClosureFast

VNUS ClosureFast is the latest “state of the art” treatment for varicose veins. It produces
rapid results and an excellent cosmetic outcome. The treatment is usually carried out un-
der local anaesthetic as a day case or “walk in, walk out” procedure. This means that
charges are reduced, time off work is minimal and therefore the treatment is highly cost
effective. Your suitability for VNUS ClosureFast is assessed by a comprehensive ultrasound

After numbing the skin with local anaesthetic (similar to a dentist’s injection) and clean-
ing the skin with antiseptic, a fine needle is inserted into the refluxing veins under ultra-
sound guidance and then a fine catheter is passed up the vein. At all times, the exact po-
sition of the catheter is monitored by ultrasound. The precision radio frequency energy (a
little like microwaves) seals the vein instantly and the catheter is gently withdrawn along
the length of the unhealthy vein. The whole process is checked at every stage by ultra-
sound to ensure excellent results.

After the procedure, a high quality medical graduated stocking is worn for 7 days contin-
uously and thereafter during the day for two more weeks. Walking and normal activities
are encouraged. Most people can get back to normal activities such as work and driving in
a day or two. Simple painkillers such as paracetamol and ibuprofen are only rarely re-

With VNUS ClosureFast treatment, the veins with faulty valves are sealed under local an-
aesthetic without surgery. The highly-targeted energy gets your leg looking and feeling
better fast.

     Treatment in less than 2 hours
     Local anaesthetic, day case or “walk in walk
     out” treatment
     Little or no time of work
     No painful cuts or scars in the groin
     No painful stripping
     Rapid return to normal activities including
     Excellent cosmetic results with no ugly scars
     Low risk of recurrence

The treatment is carried out under the “watchful eye” of the ultrasound equipment to
ensure successful closure of the faulty veins. As there are no surgical cuts, there is virtu-
ally no risk of infection, which can occur occasionally after traditional operations.                                              0800 698 3467
Endo-Venous Laser (EVL)

This procedure uses the precision of laser energy and is performed under local anaesthesic. A fi-
ne catheter is inserted into the affected veins under ultrasound guidance using a small needle.
The laser fibre is positioned in the groin at the root of the reflux.

The position of the laser fibre is checked using ultrasound. Using laser energy the vein is heated
and sealed. Surgical cuts in the groin are avoided and there is virtually no risk of infection or
wound healing problems. There is no stripping out of the vein and so bruising and pain is mini-

      Minimally invasive non-surgical treatment
      No painful cuts or scars in the groin
      No painful stripping
      Rapid return to normal activities including driving
      Excellent cosmetic results
      Relief of symptom
      Low recurrence of vein problems

The specialists at The VeinCare Centre are able to advise you about your suitability for VNUS
ClosureFast and Endo-Venous laser following your ultrasound scan. Not all clinics are able to
offer both treatment options.

Sapheon Venaseal™ "Superglue" For Varicose Veins

From 1st September 2012, The VeinCare Centre is able to offer the new Venaseal™ or
"superglue" treatment by Sapheon to private patients.

Venaseal™ or "superglue" treatment by Sapheon is a unique non-surgical treatment that uses a
medical adhesive to safely and effectively treat varicose veins. Unlike other treatments,
VenaSeal™ does not require tumescent local anaesthetic around the vein, so there are far fewer
injections. The VenaSeal™ procedure also eliminates the use of heat (or thermal energy) so there
is virtually no risk of nerve or skin injury. As the medical "superglue" sets within a few minutes,
there is not the prolonged healing process associated with ultrasound-guided foam sclerotherapy
and medical stockings are not required afterwards.

How does the VenaSeal™ system work?

A tiny catheter is positioned inside the unhealthy vein using ultrasound through a small puncture
in the skin. Next, a small amount of adhesive is delivered inside the vein using a special dis-
penser to seal the vein which has been identified as being unhealthy and which is causing the
varicose veins. After the treatment, blood then travels back to the heart in nearby healthy veins.
The glued vein is then absorbed by the body's natural healing processes.                                                   0800 698 3467
Is the VenaSeal™ adhesive used during the procedure safe?
The VenaSeal™ adhesive that is used during the procedure is made with a medically approved
type of Cyanoacrylate, which has a proven track record of over 50 years of use in the field of
medicine. The VenaSeal™ system uses a unique formulation of the compound and it is specifi-
cally designed for the treatment of varicose veins. Being such a new procedure, the Venaseal™
or "superglue" treatment by Sapheon does not have a procedure code and it is therefore not
covered by private medical insurance such as BUPA, WPA, AVIVA or Simply Health. It can only
be offered to those patients who are paying for themselves. Patient suitability for the
Venaseal™ or "superglue" treatment will be determined after a full consultation and duplex ul-
trasound scan. After your assessment, the Venaseal™ or "superglue" treatment will be discussed
as well as more established alternatives such as VNUS Closure, Endovenous Laser (EVL) and Ul-
trasound Guided Foam Sclerotherapy. The early results of international research do look very
promising. However, because the Venaseal™ or "superglue" treatment for varicose veins is so
new, there isn't sufficiently long clinical follow up to confirm that it keeps the vein closed in
the medium to long term in every case. The Venaseal™ or "superglue" treatment for varicose
veins reduces the number of local anaesthetic injections significantly, but if additional proce-
dures are needed such as phlebectomies, then additional injections may be needed. Finally, as
the Venaseal™ or "superglue" treatment for varicose veins is so new, the cost is higher than that
of Endovenous Laser or VNUS Closure

The VeinCare Centre is very happy to offer the Sapheon Venaseal™ or "superglue" treat-
ment to patients on the understanding that:

    It is not a completely injection-free procedure
    The results of long term follow up are not available as it is so new
    Private health insurance companies do not pay for this procedure

Foam Sclerotherapy

Ultrasound-guided Foam Sclerotherapy

Injection treatments have been used for many years to treat varicose veins. Two recent deve-
lopments now allow us to use an injection technique to treat varicose veins that was previously
only treatable by surgery. These are the use of ultrasound to guide the injection and the prepa-
ration of the chemical as foam. Over the last 10 years or so, the use of foam injection was
widespread in France, Spain and Italy and more recently the technique is being used in the
USA. The treatment can be performed as a “walk in, walk out” or “lunch hour procedure”.

What is Foam Sclerotherapy?

The solutions that are injected are exactly the same as those which are already used to treat
varicose veins. These are mixed with air to create foam, which looks a little like hair mousse,
or shaving foam. Many medical and scientific studies have confirmed that Foam Sclerotherapy
has an excellent safety record and that it produces excellent results in the treatment of vein
reflux and varicose veins.                                                   0800 698 3467
How does the foam work?

After injection, the foam pushes the blood out of the way and completely fills the vein. The lin-
ing of the vein is instantly removed by the foam (this doesn’t hurt) and the vein responds by
shrinking and the vein walls stick together. The channel through the vein is sealed and over the
course of a few months the vein is completely absorbed by the body’s healing processes.

The treatment

Treatment is performed in a treatment room and not an operating theatre. The patient rests
comfortably on an examination couch. A small amount of local anaesthetic is used to numb the
skin of the leg and a small needle is inserted into the refluxing vein that is feeding the varicose
veins. The position of the needle is carefully monitored using ultrasound so that feeder veins are
closed. Foam is then injected and its progress into the feeder veins and varicose veins is careful-
ly monitored with ultrasound. The whole treatment usually takes no more than 45 minutes. Fi-
nally a firm bandage is applied to the leg. The aim of this is to keep the veins compressed so
that they do not fill with blood when the patient stands up. The bandage is usually worn for a
week followed by an elastic compression stocking for a further week. When the bandages are
removed at the follow-up appointment it is usual to find that all the varicose veins have been
sealed. The leg may be a little bruised at this stage, although this is usually fairly minor. If any
varicose veins have not been completely treated in the first session, they are injected and band-
aged to complete removal of all veins. If varicose veins are present in both legs, the treatment
is given to one leg at a time with an interval of one to two weeks.

Who is suitable for Foam Sclerotherapy?

Most people with small or moderate sized varicose veins can be treated in this way. People with
severe vein reflux are usually best treated by Laser or VNUS Closure FAST to obtain a more rapid
improvement. People with large varicose veins lying close to the skin are also better treated by
Microphlebectomy to avoid the brown discolouration of the skin which may occur after Foam

Key features

      Ultrasound-guided Foam Sclerotherapy is a new method of treating varicose veins
      There is no need for an operation under general anaesthetic
      The treatment involves injections under local anaesthetic
      A treatment session is complete in about 45 minutes
      The treatment is carefully monitored using ultrasound
      A firm compression bandage must be worn for a week afterwards
      The cost of treatment are much lower than for surgical methods
      Minimal or no time off work

The VeinCare Centre has been at the forefront of the introduction of Ultrasound Guided
Foam Sclerotherapy into the UK and its specialists have many years experience of its use in a
wide variety of vein conditions.                                                    0800 698 3467
For some people, “surgery” is appropriate. At The
VeinCare Centre, the removal of varicose veins is
carried out under local anaesthetic on a “walk in,
walk out” basis using microsurgical techniques and
delicate instruments, thereby producing excellent
cosmetic results. The techniques used by The Vein-
Care Centre are associated with high patient satis-
faction rates. Each procedure is tailored to the pre-
cise pattern of reflux identified by the ultrasound
scan. Early diagnosis and treatment ensure that the
condition is not allowed to deteriorate.
In our opinion, large varicose veins very close to the surface of the skin are best
treated by a procedure called Microphlebectomy which gives excellent cosmetic
results very quickly. The skin is numbed by local anaesthetic, very much like a
dentist’s injection and a micro-incision is made in the skin, slightly larger than a
needle prick. The varicose veins are extracted with special instruments which do
not cause pain and then the micro-incision is closed with surgical tape and no
stitches are needed.

Combination Treatments

For many people, a combination of treatments is the most effective plan. For ex-
ample VNUS Closure and EVL are very effective in dealing with reflux from the
groin and this can be followed by Microphlebectomy for the varicose veins. For
some people who have developed more varicose veins after a previous operation
(so called “recurrent” varicose veins), Foam Sclerotherapy injections for the re-
flux and Microphlebectomy for the surface varicose veins are the best combina-
tion. These combination treatments are usually performed in one session to
achieve rapid results with a minimum of inconvenience. Our team can provide all
the latest treatment options and therefore we can tailor an effective treatment
based on the precise nature of your vein problem and your particular circumstanc-
es and requirements.

All the procedures are performed in treatment areas regulated by the Care
Quality Commission. You can be assured of the highest standards of hygiene
and clinical care.                                           0800 698 3467
What Treatments are available for thread Veins and Spider Veins?

Thread veins on the legs, often known as spider veins or broken veins, are very
common and can be very unsightly. In addition, they can cause ache, tired legs,
itch and ‘burning’ discomfort. Symptoms are often worse at the times of a period
for women or in warm weather. The veins can vary from fine red marks to
larger purple or deep blue veins. They can cause significant cosmetic embar-
rassment and many women will not wear short skirts in the summer months.

The reason why people develop thread veins on the legs
is not fully understood but important associations are he-
redity, pregnancy and hormonal factors. They can also follow
minor injuries. In many cases, they can be caused by deeper
varicose veins and reflux.

Many regard thread veins as simply cosmetic. However, they
often cause symptoms and these symptoms are helped by treatment. In addi-
tion, they often indicate that there is abnormal backflow (reflux) in the
veins nearby. Once again, NHS treatment is not available for thread veins.


To get the best results from treatment, it is very im-
portant to have a proper assessment of the whole vein
system in the leg to see if there is any connection between
the superficial thread veins and the deeper veins. This is
very important, because if there is a connection which is
not treated, then back flow and high pressure will work
against the treatment, making it less effective. At The Vein-
Care Centre, we specialize in the treatment of varicose veins
and thread veins on the legs and an ultrasound examination
of the whole vein system is part of the consultation.

Recent research has shown that nearly all thread veins have a ‘feeder’ vein nearby
that also needs treatment. These veins are called reticular veins. As part of
the consultation and examination, a careful search is made for these reticular
veins.                                        0800 698 3467

                      After treating any underlying varicose veins or superficial
                      venous reflux, an injection technique called Microsclerotherapy
                      is used to treat the thread veins directly. A non-toxic chemi-
                      cal is injected through a very fine needle directly into the
                      vein. This irritates the lining of the vein causing the walls
                      to stick together and prevent blood flowing through the vessel.
                      Over a period of time the blood vessel is gradually absorbed by
                      the body and disappears. After several treatments a 80-90% im-
                      provement can be expected.

                      The ‘feeding’ reticular veins can be several centimeters away
                      from the thread veins and they are usually invisible. We
                      use the Veinlite system to identify the reticular veins for
                      treatment. A high-energy halogen light beam is focused into the
                      deeper part of the skin and the feeder veins can then be seen
                      and injected.

Facial Thread Vein

                      These are different. Whereas thread veins on the legs are con-
                      nected to veins, thread veins and spider veins on the face are
                      often connected to small feeder arteries. The treatment of
                      facial thread veins is also different. We use electro-coagulation
                      to seal these veins rather than injections. The technique is
                      rather like electrolysis. The results are usually very good and
                      most people are very pleased.

Our team of specialists at The VeinCare Centre are regarded as national
experts on the treatment of thread veins and run training courses for
doctors and nurses throughout the country.                                            0800 698 3467
Other Vein Conditions
What is Deep Vein Thrombosis (DVT)?

This is a clot in the deep system of veins. It is a potentially
serious condition, as sometimes the clot can leave the leg
and travel to the heart and lungs – an embolus. DVT is
a potential problem after admission to hospital, major
surgery, illness and periods of immobility. Other risk factors
include smoking, oestrogen treatment, pregnancy and vari-
cose veins.

What are Venous Ulcers?

These are areas on the lower leg where there is a break in
the skin. Ulcers may be small, about the size of a coin,
or much larger, sometimes completely encircling the leg.
They are painful and sometimes odorous open wounds
which leak fluid. Leg ulcers can last for months or even years
and can often be socially isolating. Most leg ulcers occur
when vein disease – including varicose veins – is left un-
treated. They can be triggered by a trivial injury in a vulnerable leg where the skin has
been damaged by venous reflux. They are increasingly common amongst elderly people
who may have had vein problems for some time. A leg ulcer will affect approximately 2%
of the population at some time in their lives.

Compression Stockings

Medical Compression stockings are an important aspect of
the treatment of venous disease. The compression gra-
duates in intensity from the ankles up, with the greatest sup-
port at the ankles where swelling occurs and the lowest at
the thigh. The result is reduced pooling and significantly im-
proved blood flow back to your heart. They alleviate many of
the symptoms of varicose veins and venous disease such as
ache and swelling as well as preventing the complications of
venous disease such as phlebitis and venous ulceration. In ad-
dition, compression hosiery has been shown to reduce
the incidence of Deep Vein Thrombosis.                                              0800 698 3467
Tips for avoiding vein conditions

Varicose Veins

   Walk around as much as you can – don’t sit or stand in one place for long
    periods of time
   To help the blood to flow easily, don’t cross your legs when sitting
   Don't sleep sitting in a chair
   Get up and stretch when on long journeys such as on a coach or plane
   Graduated compression stockings promote the flow of blood in the deep
    veins of the legs. If you are diabetic or suffer with artery problems you
    should seek medical advice before using compression hosiery
   Watch your weight
   Make sure you have a healthy diet, with enough fibre to avoid constipation
   Elevate (lift up) your legs if you have been standing still for a long time to
    allow the blood in the veins to empty
   Don’t wear tight underwear or clothes
   Keep active by taking regular exercise
   Stop smoking

Deep Vein Thrombosis

Deep Vein Thrombosis (DVT) frequently develops during hospital admission. We
believe that all patients should have a risk assessment and receive appro-
priate measures to reduce the risk of developing DVT. An important aspect of
prevention is the use of good quality compression hosiery.


Pregnancy is a time when varicose veins may develop and DVT is a rare but im-
portant cause of complications during and after pregnancy. Good quality com-
pression hosiery can reduce these risks.

Family History

This is an important risk factor for the development of varicose veins.
Someone whose parents both have varicose veins has roughly an 80% chance of
developing the condition themselves. People with a strong family history
may wish to consider wearing medical grade compression hosiery.                                           0800 698 3467
How do I make an appointment?

The VeinCare Centre specialists see patients at:

   The Melbury Clinic in Holt Mill
   The Winterbourne Hospital in Dorchester
   The Harbour Hospital in Poole
   Litfield House Medical Centre in Bristol

Locations and directions can be found on the website

Self Referral

Your can make an appointment direct by calling The VeinCare Centre on
0800 698 3467.

The VeinCare Centre follows guidance from the General Medical Council (GMC)
and with your consent and agreement will keep your GP advised about your con-
dition and your treatment.

GP Referral

Dr Gajraj and Mr.Windhaber are pleased to receive referrals from your GP.
You will then be contacted with an appointment. Referrals should be sent
to :

The VeinCare Centre Head Office
The Melbury Clinic
Holt Mill
DT2 0Xl
Fax 01935 873 952

Private Medical Insurance

Those with private medical insurance should be referred by their GP as this is
normally a requirement of the policy for reimbursement. Dr Gajraj and Mr
Windhaber are recognised as qualifying specialists by all the major insurance
companies but please check with your insurer before incurring any costs.
Please quote Dr Gajraj’s GMC number 2648642 and Mr Windhaber’s GMC Number
4540162 in communications with your insurer.                                       0800 698 3467
              The VeinCare Centre offers excellent value for money

For self pay clients, The VeinCare Centre offers excellent value for money. For example
at your initial assessment you will have a consultation, duplex ultrasound scan and
detailed discussion of the findings and the treatment options all in one visit. This ‘one-
stop’ approach saves you time and avoids the inconvenience of multiple clinic visits. A
full report is sent to your family doctor and you will receive a copy. All of this for
£250. When you make comparisons with other clinics or private hospitals, do check
what is included in the initial assessment. Some clinics for example will arrange a
separate appointment for your ultrasound scan and then a further appointment to
discuss the results. Often these appointments are charged separately.

These fixed price quotes for your treatment are fully inclusive. There are no hid-
den extras or surprises such as charges for bandages, stockings or medications. Your
follow up consultation and scan after VNUS ClosureFAST or after Microphlebectomy at 6
weeks and 6 months are included. If any further minor treatments are required, such as
injections or Microphlebectomy, there are no additional charges.

During your recovery, you will have access to telephone advice and support from
your specialist and if you need to have an unscheduled appointment for any reason, no
additional charges will be raised. Foam Sclerotherapy charges are fully inclusive for as
many treatments as are required and a six-week and six-month follow up consultation
and scan are included in the fee. As for the other treatments offered, you will
have access to telephone advice and support from your specialist and if you need to
have an unscheduled appointment for any reason, no additional charges will be raised.

The aim of our service is to achieve the best possible outcome for your vein condition so
that your legs look and feel better as quickly as possible whilst providing excellent value
for money. When making cost comparisons with other clinics and private hospitals,
do check what services and treatments are included in the fee. The excellent quality
of care provided by The VeinCare Centre is recognized by all the major private
health insurance companies such as BUPA, WPA, AXAPPP, Standard Life and Norwich
Union. Depending on your level of cover, the fees are usually fully reimbursed.

You are strongly advised to check with your insurance company before undergoing any
treatment to check your level of cover and to be issued with an authorization number.
Please ensure that you have been referred to Dr Gajraj or Mr Windhaber by your family
doctor and when informing your insurance company please quote Dr Gajraj’s GMC num-
ber 2648642 or Mr Windhaber’s GMC number 4540162.                                                0800 698 3467
First Appointment     To include Consultation, Duplex Ultrasound Scan of both
£250                  legs, First discussion of treatment options and formulation
                      of treatment plan. Also includes a written report for you
                      (and your GP if requested).

Foam Sclerotherapy Fully inclusive of all treatment sessions, scans, consumables
£1000 one leg      such as bandages, one pair of medical compression stockings as
£1800 two legs     well as a follow up visit and treatment after 6 months
                   (does not include first appointment).

Microsurgery          Fully inclusive of surgeon’s fee, and hospital fee. Fixed price
£1995 one leg         quotes and finance can usually be arranged.
£2995 two legs

VNUS ClosureFAST      Fully inclusive of the specialists’ fee, anaesthetic fee and
£2995 one leg         facility fee. Also includes follow up assessment and full du-
£3995 two legs        plex scan 6 weeks and again 6 months after treatment.

Laser EVL             Fully inclusive of the specialists’, anaesthetic fee and hospital
£2995 one leg         fee. Also includes follow up assessment and full duplex scan 6
£3995 two legs        weeks and again 6 months after treatment.

Facial Thread Veins   £100 per electro-coagulation session. Up to 2 sessions may be
                      required. Ultrasound scan not required.

                      £300 per Microsclerotherapy session. Fully inclusive of one pair
Leg Thread Veins      of medical grade compression stockings and all other consuma-
                      bles. Up to 4 sessions may be required. For large areas you
                      will be advised if more than 4 sessions are likely to be required.

                      The costs of the Sapheon Venaseal™ or superglue" treatment are
                      £3895 for one leg and £4895 for both legs.
Sapheon Venaseal™

The specialists at The VeinCare
Centre are recognized by all the
major health insurance compa-
nies such as BUPA, WPA, AXA-
PPP, Standard Life and Norwich
Union. Please check cover with
your insurance company.

Fees correct as of 1st January 2011. Subject to change without notice. Please check for
current fee schedule. Written Quotations are provided prior to starting any treatment.                                              0800 698 3467
         Your first appointment at The VeinCare Centre

What happens at my first visit?

The consultation is thorough and unhurried. You will have ample opportunity to ask ques-
tions and every aspect of your care will be explained to you.

Medical History

The consultation starts with your symptoms, general health, any
previous treatment you may have had for your vein condition and
also any medication you may be taking. You will have ample op-
portunity to discuss any concerns that you have.

Medical Examination

In addition to a general examination, the state of your legs, the
extent of any varicose veins or thread veins and any leg swelling
or skin change such as varicose eczema will also be checked and
noted. Clinical photographs of your veins will be taken before and after treatment. These
are part of your medical record at The VeinCare Centre and they remain confidential. You
may be asked if these can be used for publication anonymously, but only with your written
permission and should you refuse, this decision will be respected and it will not affect
your relationship with your specialist.

Duplex Ultrasound Scan

This is an essential part of    the consultation. Sound waves are
used to build up a picture of   the deep veins, the superficial veins
under the skin and varicose     veins that may be present. The di-
rection of blood flow in the    veins is noted to diagnose sites and
pathways or reflux.

Findings Report

You will be given a full explanation of the findings and treatment
options will be discussed to help you decide what would be best
for you. You will receive a written report, which with your agreement will also be sent to
your GP.                                                0800 698 3467
                       Before and After Photographs
                            AH had severe recurrent varicose veins which he had al-
                            ready had stripped many years before. His brother had
                            leg ulcers and he was worried that he too would develop
                            them. He was treated by Ultrasound Guided Foam Scle-
                            rotherapy (see our website)

                            DC had very prominent and unsightly veins on her hands
                            with loss of skin elasticity and the bones and tendons
                            were very obvious. Her veins were treated by Foam
                            Sclerotherapy to shrink them and then the collagen was
                            stimulated by injections of Radiesse (see our website)

                            HM is a fit and healthy lady who developed varicose
                            veins in her teens and was told they were simply cos-
                            metic. Her legs ached and she could not wear dresses or
                            shorts. She was treated by VNUS Closure - now her legs
                            feel light and she has worn a swimming costume on holi-

                            DW is a very fit lady who enjoys walking. Her legs felt
                            heavy and ached and she was treated by VNUS closure

                            EH had unsightly thread veins on the outside of her thigh
                            which were treated by Microsclerotherapy injections

The specialists at The VeinCare Centre routinely take before and after photo-
graphs for all clients – they are confidential and form part of the medical rec-
ord. Many other clinics use third party photographs in their brochures and on
their websites.                                           0800 698 3467
                       Before and After Photographs

                        PN is a keen footballer who was worried he would injure his
                        veins. He is also self-employed so couldn't afford to take time
                        off. He had VNUS and was back to work in two days and foot-
                        ball in two weeks (see also website)

                        AS was treated by VNUS (see website also)

                        LC wouldn't go on holiday because of her veins – she was
                        treated by a combination of Foam Sclerotherapy and Mi-

                        SG had thread veins on her thigh and was treated by Micro-

                        KE had thread veins on the face and was treated by Short
                        Wave Diathermy

The VeinCare Centre only uses these images for promotional or educational ac-
tivities with the expressed and written permission of our clients. Many of our
clients are so pleased, they are very happy for us to publish the results and to
appear in video testimonials (see our website).                                            0800 698 3467
              What people are saying about Us and Our Service

“I am absolutely delighted with the foam sclerotherapy treatment provided by Dr Gajraj at the
Melbury Clinic. I had unsightly varicose veins in my left leg for about 4 years and I had been put off
treatment by the prospect of painful stripping surgery. When I heard about foam sclerotherapy, it
sounded ideal. I had one session of injections and my leg looks tremendous. Recently, I was able to
wear shorts on a holiday in France and I wasn’t at all conscious of my leg. The treatment
and service that I received were excellent”. Mr S G, Minehead, Somerset

“After noticing an article in the Somerset County Gazette explaining the treatments that
you had available, I decided to contact you regarding the vein in my leg. This vein was un-
sightly and I was extremely conscious of it. After my initial consultation with you, I opted for the
foam sclerotherapy as it meant I was able to have the treatment without having any time off work.
I found the treatment itself very quick, easy and completely painless, and was pleased that I was
able to drive straight away afterwards. When I removed the stocking after the first week, I
able to notice a difference immediately and was delighted with the result. Now, six months
on, there is no sign of the vein that had bothered me for so long and I am able to wear shorts with
confidence once more. I have already recommended the process to others and should I require any
treatment in the future I will not hesitate to contact you. Thank you once again”. Mr K M, Taunton,

“I am delighted with the results of the endovenous laser treatment performed on my left leg. Hav-
ing the procedure under local anaesthetic was on the whole, painless, only a feeling compared to a
bee sting every now and again. The results get better as the days go on. It is lovely to wake up in
the morning and see a young looking, pain free leg again. My leg has not looked this good for many
a year! Thank you once again.” Mrs J C, Castle Cary, Somerset

“Thank you so much for treating the horrible thread veins on my leg. I was very self-
conscious and wouldn’t wear shorts or dresses. After the injection treatment, I am now able to
show off my legs again. I have already recommended several people to you”. Miss F D, Taunton,

“I had varicose veins for 10 years. My left leg ached and the veins were getting worse and spread-
ing. I am a self-employed driving instructor and taking time off work for a stripping operation was
not an option. I had a VNUS operation done as a day case. I had treatment on Saturday and was
back to work as a driving instructor on Monday! I didn’t need any painkillers afterwards. I am very
pleased with the results. It has made a big difference to the way my leg looks and feels. I now have
no ache and my leg looks normal. I would definitely recommend the treatment to a friend” . Mr G
R, Taunton, Somerset

“My leg used to swell and a few years ago I had attacks of infection. My mother had varicose veins
that had turned into leg ulcers and I didn’t want the same thing to happen to me. I wanted some-
thing done, but I didn’t want my veins stripped. My GP referred me to Dr Gajraj of The VeinCare
Centre and he recommended laser treatment. It was really good! I didn’t need a general anaesthet-
ic and I didn’t have any big surgical cuts. I didn’t need any painkillers afterwards and I was able to
drive my car a couple of days afterwards. The unsightly varicose vein has gone and my leg feels
great. I am really pleased and now I can get on with my life without being self conscious”. Mrs. H
W, Dorchester, Dorset

“My legs haven’t looked this good for years. Thank you Dr Gajraj for giving me back my self-
confidence”. Mrs F P, Poole, Dorset                                                         0800 698 3467   0800 698 3467   0800 698 3467   0800 698 3467   0800 698 3467

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