Varicose Vein Treatments

About 90% of people who have visible varicose veins have a problem in one of the underlying veins that are not visible from the surface. In those cases, treating just what is seen is less likely to relieve the varicose vein symptoms — the patient is more likely to have early recurrence of varicose veins. A thorough evaluation by a vein care specialist (phlebologist) combined with an ultrasound of the leg veins allows a more appropriate course of treatment to be chosen. Varicose vein treatment is less likely to be effective without the evaluation and ultrasound.

Treating Varicose Veins via Lifestyle Changes

In some cases, simple lifestyle changes may help relieve the symptoms. This includes things like:

Elevating the Legs Periodically

This treatment allows gravity to help relieve the pressure on the varicose leg veins.

Walking, Rather than Sitting or Standing in One Place

The contraction of your calf muscles is what provides the pump to push blood through your leg veins back toward your heart.

Wearing compression stockings

This treatment provides some support to the veins from the surface, preventing them from becoming as swollen. Graduated compression stockings are specially designed to be tightest at the ankle and slightly looser up the leg to promote the flow of blood the right direction through leg veins.

Most insurance companies require that patients try these lifestyle changes for a period of time — typically 6 weeks to 6 months — before they will pay for a more definitive treatment option. We can help you figure out what your insurance company requires if you are unsure.  You do not need to wait before coming in for a consultation.

Medical Treatment of Varicose Veins

Endovenous Ablation

If the ultrasound shows that the problem is caused by reflux (backward flow of blood due to damaged valves) in one of the underlying veins, this needs to be corrected with an endovenous ablation. This is a procedure done in the office under local anesthetic. A special catheter or laser fiber is inserted into the malfunctioning vein through a small puncture in the skin. The vein is numbed, then heat is applied to seal it shut. This forces the blood to circulate through the healthy veins instead of pooling in the diseased ones. In many cases, this procedure alone relieves the pressure on the surface veins and no treatment is needed to directly address those veins.

Medical Treatments for Surface Varicose Veins

In people who have had venous disease for many years, the surface veins may not have enough elasticity left to snap back after the pressure is relieved. These people may need another procedure at the same time or subsequent to the endovenous ablation to target the surface veins. Depending on the size, location, and extent of the varicose veins, microphlebectomy or sclerotherapy may be offered.

Microphlebectomy means removing a vein through a tiny puncture in the skin. This is done in our office under a local anesthetic. The punctures are small enough that no stitches are required and they typically leave no visible scar.

Sclerotherapy is an option for smaller varicose veins and spider veins. It involves injecting a solution directly into a diseased vein in order to close it off. The solution causes irritation of the vein wall, causing it to collapse and seal shut. Once the vein is closed, blood reroutes through the remaining healthy veins around it.

Sclerotherapy can be used for very tiny spider veins or for larger varicose veins. The concentration and amount of the solution injected is adjusted depending on the size of the vein being treated.

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