What treatments are available for varicose and spider veins?
The primary treatments used to treat varicose veins today are radio frequency and laser catheter ablation techniques, and sclerotherapy .
Ablation techniques apply laser or radio-frequency energy to vein walls causing the veins to collapse. This procedure is done by a radiologist.
Scelerotherapy is the injection of chemicals (sclerosants) into the veins in treating small varicose and spider veins.
In the past, surgical treatments such as ligation (tying off a vein) and stripping (removing a vein) were the commonly recognized treatments for varicose veins in this country. Today, however, surgery is only necessary in a low percentage of patients and is usually used on larger varicose veins. Minimally invasive surgical procedures are now employed when operative approaches are necessary. Please see our Treatment Options page for more information.
How does the physician determine the appropriate course of treatment?
The physician will conduct a physical examination and may use a noninvasive diagnostic test such as duplex ultrasound scanning. The venous duplex examination permits our physician to see the anatomy and check the flow characteristics of the veins beneath your skin. Useful information is gathered that will be used to adequately diagnose your specific vein problem and to plan and guide treatment.
What are laser and radiofrequency sealing of veins?
The catheter ablation techniques of light energy (laser) or electrical energy (radiofrequency) may be used to seal shut abnormal main superficial truck veins. Both treatments involve the application of heat energy into the abnormal vein(s).
Usually treatment of the greater saphenous vein (GSV) starts at a location in the vein at or below the knee. The GSV is then treated from its junction to the deep system at the level of the groin down to the entry site near the knee. Ultrasound guided injections may also be used to seal the GSV or lesser saphenous vein (LSV).
What is sclerotherapy?
Unwanted leg veins (spider veins), known medically as "telangiectasias" or superficial varicosities are dilated skin capillaries. These may become unsightly with time and may also lead to dull aching of the legs after prolonged standing.
Sclerotherapy is the technique of injecting a solution into these vessels (tiny capillaries or larger varicose veins) with a small needle. The solution irritates and destroys the inner lining of the blood vessel so it ceases to carry blood. The body then replaces this damaged vessel with scar tissue. Several injections may be needed for a specific area of telangiectasias. Fading of the vessels is a slow process which may take up to 6 – 12 months. The goal is to produce a 75% to 90% improvement in both appearance and symptoms.
Will my insurance provide benefits for treatment?
Many of our patients are concerned that varicose vein treatment is not a covered benefit with their health insurance.
Varicose veins can be a serious medical condition and nearly all insurance companies recognize this fact and provide payment for treatment.
Cosmetic treatments may not be covered by some health insurance companies.
When can I walk, exercise, drive and resume other activities of daily life?
You are encouraged to walk as soon as possible after your operation. You may climb stairs and gradually resume other activities as tolerated. Also, you should avoid sitting with your legs hanging for long periods or standing in one place. When sitting, it is best to elevate your legs on a foot stool.
You should avoid high impact aerobic activities for about two weeks after your surgery. This includes running, playing basketball, biking, etc. You should not swim until all of your incisions are healed.
You may return to driving your car when you leg is comfortable, you are pain free, and you are no longer taking any prescription pain medications.
Can I be cured of my varicose veins?
Varicose veins are a problem that can be successfully treated but the disorder cannot be permanently cured. The treatment of the abnormal veins does not remove the original tendency of a patient to develop varicose veins. Therefore, many patients need to return for maintenance treatments after their initial treatment is completed.
Do I have to treat both legs?
The abnormal limb or limbs should be treated thoroughly for best results. They may be treated at the same time or after one another.
Why can't I just have the branches injected or removed if the main superficial trunk is abnormal?
For the treatment of the visible veins to last a long time, the source that may not be visible to the naked eye must be controlled as well.
How will the blood in my veins get back to my heart after all of the abnormal veins are removed or destroyed?
The backward flow of blood in varicose veins, the greater saphenous vein (GSV) and lesser saphenous vein (LSV) actually interfere with the normal venous return of blood. Removal of these areas of abnormal circulation actually improves circulation of blood in the treated limb. It is this improvement in limb circulation that causes improvement of symptoms of tiredness and heaviness in the limb.
Why do doctors recommend graded compression stockings?
How does vein treatment affect my candidacy for by-pass grafts
Veins that have been stretched, dilated and weakened by varicose vein disease are unsuitable veins for donor purposes for arterial by-pass grafts. In many situations, other segments of veins are left untreated and thus may be suitable for grafting purposes. Alternative surgical procedures such as internal mammary artery grafts and balloon angioplasty are available for coronary artery re-vascularization.
What new treatment options exist for patients who have abnormal blood flow in the major vein trunks other than vein stripping?
In order to control the backward flow of blood in these large veins, the vein that is the source of the visible varicosities must be sealed shut or removed. The vein may be sealed shut using energy sources such as a laser, or radiofrequency energy electrical energy.