Varicose veins

Dr Marios Agathangelou performs endovenous ablation for varicose veins in Nicosia and Limassol, Cyprus — covered by GESY, €0 for GESY beneficiaries. Endovenous ablation treats varicose veins at their source: the faulty saphenous vein is closed from the inside using thermal energy or medical adhesive, through a single needle entry at the knee or ankle.

Blood immediately reroutes into healthy deep veins. Bulging veins collapse and fade, heaviness and night cramps ease — without stripping surgery, general anaesthesia or hospital admission.

Usually home the same day No general anaesthesia No stripping surgery Cosmetic + symptom relief

The procedure is fully covered by GESY. It is done as an inpatient admission, and that admission includes the treatment — you pay nothing for the procedure.

Separately, the outpatient visit — the initial assessment, where it is decided whether the treatment suits you — may carry a small co-payment, usually €0–10, as any specialist visit within GESY does.

The co-payment is per activity, and it stops once your total co-payments for the year reach €150 — past that you pay nothing. Some categories of beneficiary have different limits.

Both need a valid referral, from your personal doctor or from a specialist.

Outside GESY, or with private insurance? We provide the documentation your insurer asks for, and a clear cost estimate at your consultation, before you decide anything.

Varicose veins are not only a cosmetic matter. Heaviness and aching towards evening, ankle swelling, night cramps, itching and colour changes in the skin around the ankle are signs that the vein's valves are not closing properly. Once the skin hardens or an ulcer forms, treatment is no longer a cosmetic choice.

Varicose veins are not only a cosmetic matter, and they are not an emergency either. In most people they stay much the same for years.

What does not repair itself is the valve failure underneath. Left alone, venous reflux tends to progress, and over time it can lead to chronic venous insufficiency.

In practice that means swelling, darkening of the skin around the ankle, eczema, hardening of the tissue under the skin — and, at the far end of the range, a venous leg ulcer.

Two complications can arrive sooner: inflammation and clotting in a surface vein, and bleeding from a varicose vein that ruptures.

How often does it get that far? Rarely. About 1% of adults have a venous ulcer at any one time, and about 4% are at risk of one. The large majority of people with varicose veins never reach that point.

When an ulcer does appear it is a long problem — it often lasts years and tends to come back. Treating the underlying reflux helps both with healing and with fewer recurrences.

Take your time. We will explain whatever you need, as many times as you need — and the decision stays yours.

Not every varicose vein is suitable for endovenous treatment. If the problem lies in the deep venous system rather than the surface vein, closing the surface vein solves nothing and may do harm. Active clotting, infection at the site, pregnancy and significant peripheral arterial disease are reasons to wait or not to proceed at all. The ultrasound scan beforehand is not a formality — it is what shows whether treatment makes sense.

Closing the vein succeeds in roughly nineteen cases out of twenty with a thermal method — the same as surgical stripping, with fewer complications and less pain. The improvement in quality of life is clear and measurable in the studies.

The other side: varicose veins can come back. At five years, depending on the method and on how recurrence is defined, the rates vary considerably and are not always better than surgery. The vein that is closed does not reopen; new veins can widen.

Most people have no trouble at all. Tightness along the treated vein, bruising and mild soreness are common in the first days and settle on their own.

The serious risk worth knowing about is a clot in the deep venous system. It is rare. In a nationwide record of 43,203 patients in Japan, pulmonary embolism occurred in 0.0067% — fewer than 1 in 10,000. Clotting that needed blood-thinning treatment affected about 0.12%, roughly 1 in 800.

The risk is not the same for everyone. A previous clot, a known clotting disorder, active cancer, prolonged immobility or hormone treatment all raise it. These are assessed before the procedure, and in some cases they change the plan.

Less often, and less seriously: inflammation of the surface vein, temporary numbness from irritation of a nearby nerve, and very rarely a skin burn.

In this practice every patient has an ultrasound scan after the procedure and wears class 2 graduated compression stockings for one month.

We will go through all of it before you decide.

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