Varicose and Spider veins can be unsightly and often painful medical conditions that affect millions of women and men. Varicose veins develop when blood vessel walls weaken and create abnormal blood flow. Genetics is the main cause of varicose and spider veins; however, any condition or activity that puts pressure on the veins such as weight gain, sitting or standing for prolonged periods of time or pregnancy can contribute to their development.
Active medical intervention in varicose veins can be divided into surgical and non-surgical treatments. Some doctors favor traditional open surgery, while others prefer the newer methods. Newer methods for treating varicose veins such as Endovenous Thermal Ablation (endovenous laser treatment or radiofrequency ablation), and foam sclerotherapy are not as well studied, especially in the longer term.
Laser Vein treatments called EvLT utilize Endovenous Laser Treatment (EvLT) technology. EvLT treatment is covered by most health insurance plans and enables women and men of all ages to eliminate aching, throbbing, unsightly veins without conventional leg vein surgery such as varicose vein stripping. Treatment is quick and easy, and requires no lengthy recovery.
Patient satisfaction with EvLT treatments is high. This treatment can be performed on an outpatient basis under local anesthesia and has the following advantages:
A commonly performed non-surgical treatment for varicose and "spider" leg veins is sclerotherapy in which medicine (sclerosant) is injected into the veins to make them shrink. Sclerotherapy has been used in the treatment of varicose veins for over 150 years. Sclerotherapy is often used for telangiectasias (spider veins) and varicose veins that persist or recur after vein stripping. Sclerotherapy can also be performed using foamed sclerosants under ultrasound guidance to treat larger varicose veins, including the great saphenous and small saphenous veins.
Stripping consists of removal of all or part the saphenous vein (great/long and/or lesser/short) main trunk. During this procedure, the physician will make an incision at the groin to allow the greater saphenous vein to be tied off and cut.
The vein is then pulled out of the leg through an incision at the knee.
Due to the surgical nature of this procedure, down time can vary from two to three weeks, and is more painful than other non-invasive alternatives.
A minimally invasive surgical technique used to treat varicose veins that are not caused by saphenous vein reflux. The abnormal vein is removed through a tiny incision or incisions using a special set of tools. The procedure is done under local anesthesia, and typically takes under an hour. Recovery is rapid, and most patients do not need to interrupt regular activity after ambulatory phlebectomy.
This minimally-invasive treatment is an outpatient procedure performed using imaging guidance. After applying local anesthetic to the vein, the interventional radiologist inserts a thin catheter, about the size of a strand of spaghetti, into the vein and guides it up the great saphenous vein in the thigh. Then laser or radiofrequency energy is applied to the inside of the vein. This heats the vein and seals the vein closed.
Reflux within the great saphenous vein leads to pooling in the visible varicose veins below. By closing the great saphenous vein, the twisted and varicosed branch veins, which are close to the skin, shrink and improve in appearance. Once the diseased vein is closed, other healthy veins take over to carry blood from the leg, re-establishing normal flow.