Varicose veins are very common. It is estimated that over 30 million Americans are affected by venous disease. While some have no symptoms, others have symptoms of leg swelling, ache, skin changes and even venous ulcers. The vast majority of people remain untreated and continue to suffer with their disease. The good news is there are now increasingly no downtime varicose vein treatments.
What causes varicose veins?
When the valves in veins become weak over time and fail, gravity allows blood to pool in the lower legs This produces a back up of blood. As a result, pressure builds up and the diseased veins become enlarged, eventually bulging to the skin’s surface. When smaller veins are affected, they are typically called spider veins. When this impacts the larger superficial veins in the legs, its called varicose veins. Varicose veins are known to cause symptoms that may include leg aching, pain, heaviness, fatigue, ankle swelling, muscle cramping, restlessness, itching and burning. Pain in the legs is frequently related to abnormal leg veins. Severe varicose veins can compromise the health of the skin and lead to dermatitis or a rash, discoloration, or even ulceration of the lower leg. Since most veins lie deep to the skin’s surface, vein disorders are not always visible to the naked eye. As a result, diagnostic ultrasound is often used to determine the cause and severity of the problem. Some predisposing factors include aging, standing occupations, and leg injury or trauma. Heredity is the number one contributing factor that causes varicose and spider veins. Women are more likely than men to suffer from abnormal leg veins.
How are veins treated?
In the old days, varicose veins requiring treatment were addressed in the operating room at a hospital in an operation called vein stripping. This was painful, took a lot of time to recover, and thus there was a lot of down time after where patients had to take time off work and heal. That has changed considerably. Now there are no down-time options to treat varicose veins in the office setting under a local anesthesia. The patient walks in, is treated, then walks out. Many patients return to normal activities the following day. Examples include:
Endovenous Thermal Ablation is a treatment alternative to surgical stripping of varicose veins. This can be done with laser (known as endovenous laster therapy or EVLT), or radiofrequency ablation, such as Closurefast RFA. With ultrasound visualization, a small catheter or tube is inserted into the damaged vein, usually through a needle. Thermal energy, or heat, is then delivered inside the vein, which causes the vein to collapse and seal shut. The procedure is typically done in the doctor’s office under local anesthesia. Afterwards, a let wrap or prescription compression stocking is usually placed on the treated leg for 1-2 weeks. Patients are able to walk immediately after the procedure and most individuals are able to return to work the next day.
Ambulatory phlebectomy is a method of surgical removal of varicose veins at the surface of the skin. Small incisions are made next to the vein and sections of vein are removed through these small nicks. This is done in the doctor’s office using only local anesthesia and no stitches are required to close the skin as the incisions are only pin point in size.
Sclerotherapy can be used to treat both varicose and spider veins. A tiny needle is used to inject the veins with one of several different kinds of chemical irritant, or sclerosant, that irritates the lining of the vein. In response, the veins collapse, seal shut, and are reabsorbed by the body. Sometimes sclerotherapy is done with ultrasound guidance, and sometimes it is just done visually with the doctor treating the veins seen on the surface of the skin.
Venaseal is the mostly recent vein closure technology. This technique uses an FDA approved specialty formulation of high grade medical cyanoacrylate-based adhesive with a catheter engineered to be inert to adhesive and a dispenser gun designed to deliver adhesive doses precisely. The clinical results are equivalent to Closurefast RFA, and the procedure seems to have less discomfort than thermal based techniques such as RFA or EVLT.
Finding the right vein treatment options for you
If you have varicose veins and are curious in learning more about which treatment option might be best for you, simply call and make an appointment for a consultation. Our physicians can help assess your particular needs, and help develop a treatment plan that best fits your needs.