FAQ’s– Frequently Asked Questions

Varicose Veins

Treatment of Leg Veins
If you suffer from problems related to varicose and spider veins, you are not alone. More than 50 million Americans suffer from some form of venous disorder. While some seek treatment for cosmetic improvement, others are looking for symptomatic relief. Whichever category you may be in, there is help available.

What are Varicose and Spider Veins?
Varicose veins are swollen and/or stretched veins, which protrude in a rope like manner from the skin. Normal veins, by virtue of one-way valves, channel oxygen-poor blood back to the heart and lungs to become oxygen-rich. When a valve becomes defective, it allows blood flow to leak down and collect resulting in congestion and dilation of the vein.

Spider veins or broken capillaries properly named telangiectasias are small red, blue, or purple web-like or linear veins (less than 2 mm in diameter, flat or raised) on the surface of the skin.

In addition to being unsightly and often embarrassing, varicose and spider veins can be symptomatic. Pain in the legs is frequently related to these abnormal leg veins. Symptoms, often made worse by prolonged standing or sitting include fatigue, heaviness, aching, burning, throbbing, itching, cramping and restlessness of the leg. In advanced cases, varicose veins can lead to skin rash, pigmentation changes, inflammation, ulceration and bleeding.

Why me?
Heredity is the number one contributing factor causing varicose and spider veins. Women are more likely to suffer from these abnormal leg veins. Up to 50% of American women may be affected. Hormonal factors include puberty, pregnancy, menopause, the use of birth control pills - estrogen and progesterone affect the disease. Other factors that can accelerate and aggravate the appearance of veins, beyond gravity and age, include pregnancy, leg injury, obesity, lack of exercise, weight fluctuation, constriction and prolonged periods of sitting or standing.

When and how are veins treated?
The most commonly asked questions are: Do veins require treatment and what treatment would be best? After obtaining a history and performing a physical exam the patient undergoes a noninvasive Doppler ultrasound and color ultrasound imaging to determine areas of venous disease (dilated veins, faulty valves and area of clot). Based on the above information, an individual treatment plan is formulated and discussed with the patient. Veins that are cosmetically unappealing or cause pain or other symptoms are prime for treatment.

There are many treatment options, but can be classified generally into two forms:
Supportive measures, which include (the 5 E's) - exercise, elevation, emollient (moisturizing lotion), elastic support hose, and evaluate.

Corrective methods include minimally invasive procedures - sclerotherapy, laser, ambulatory phlebectomy, and surgery (venous ligation and stripping).

Sclerotherapy
Sclerotherapy (injections) can be used to treat both varicose and spider veins. The procedure is simple. A tiny needle injects the veins with a medication that irritates the lining of the vein. Over a short time, in response to the irritation, the vein closes and is reabsorbed. The blood from the closed vein is routed to properly working veins, restoring correct circulation. Sclerotherapy relieves symptoms due to varicose and spider veins in most patients. With this procedure, veins can be dealt with an early stage, helping to prevent further complications and unsightliness.

You may need one to several sclerotherapy sessions for any vein region and the number of injections varies per session. Generally, normal activities can be resumed after sclerotherapy. Medically prescribed support hose and/or bandages may need to be worn for one day to several weeks to assist in resolution of the veins. The procedure usually causes only minimal discomfort. Bruising and pigmentation may occur after sclerotherapy. If bruising occurs, it usually disappears within 1-2 weeks. Although pigmentation almost always fades, it can last for several months. Scarring and other complications are rare.

Endovascular Laser Venous System (ELVS)
Endovascular Laser Venous System (ELVS) is a minimally invasive ambulatory treatment performed at the Vascular Suite. This is an alternative to surgical stripping of the greater saphenous vein. A small catheter is inserted, usually through a needle puncture in the skin, into the damaged vein. The doctor then numbs the vein and turns on the laser. Its targeted energy heats and seals to the vein shut. This procedure is performed using a local anesthetic in usually one hour. The patient is immediately ambulatory and ready to resume normal activities.

Ambulatory phlebectomy
Ambulatory phlebectomy is minimally invasive surgical technique performed under local anesthesia at the vascular suite. Punctures are tiny (sutures are generally not necessary) and typically leave nearly unperceivable scars.