Varicose Veins

Treatment

Sclerotherapy/Microsclerotherapy

This process may be used to close small- and medium-sized varicose veins. The doctor injects the veins with a solution that causes a scar to form in the vein, which forces the vein to close and the blood to reroute through healthier veins. The procedure does not require anesthesia and can be done in the doctor's office.

Microsclerotherapy is a new and improved type of sclerotherapy that uses improved solutions and injection techniques that increase the success rate for removal of spider veins.

Laser surgeries

Laser surgery works by sending strong bursts of light into the vein that make the vein slowly fade and disappear. The treatment is often less effective than sclerotherapy and can have side effects. The physician will help decide which treatment is best for each patient.

Catheter-assisted procedures

This minimally invasive surgery is a newer treatment, usually for larger varicose veins. Patients are able to go home the same day and resume activities within a day.

In the procedure, the surgeon inserts a very thin tube (catheter) into the enlarged vein and applies heat through the tip of the catheter. When the catheter is withdrawn, the heat causes the vein to collapse and the blood to reroute through healthier veins. Catheter-assisted methods can use radio waves, or lasers to close the main vein or a mechanical blade to remove the branch varicose veins.

Surgical vein stripping

This procedure involves removing a long vein through small incisions and is an outpatient treatment for most people. Patients are typically able to resume normal activities within two weeks.

Ambulatory phlebectomy

In this procedure, the doctor removes smaller varicose veins through a series of tiny skin punctures. The patient is given local anesthesia and goes home the same day. Scarring is generally minimal.

Endoscopic vein surgery

This procedure is used only when the patient has advanced to the stage of having leg ulcers. Through a small incision, the doctor inserts a thin video camera to visualize and close varicose veins.

Often, to achieve optimal results, patients may receive a combination of therapies. In considering treatment, patients should:

• Inquire about insurance coverage. Most health plans don't cover elective cosmetic surgery for varicose veins, but may cover treatment if there are signs or symptoms such as swelling and bleeding.
• Understand the health risks and side effects. Current treatments are highly successful, however it is possible for varicose veins to recur and reappear.

Self-care and home-based therapies

An important aspect for treating varicose veins is for patients to take steps they can do themselves. Such home-based therapies include:

• Leg elevation: Raising the legs above the heart for 10 to 15 minutes, three to four times daily, will drain pooled blood from the legs.
• Compression therapy: The patient wears elastic support stockings all day to help keep blood flowing up from the legs to the heart. Special compression stockings are available through pharmacies.
• Exercise: Any activity that gets the legs moving, such as walking, swimming or dancing, will stimulate good blood flow in the veins and strengthen the cardiovascular system.
• Weight loss: Excess body weight adds stress and strain to the leg veins.
• Avoiding long periods of sitting or standing. Doing such activities for a prolonged time impedes blood flow to the heart.
• Avoiding sitting with legs crossed.
• Avoiding high heels and tight clothing that can restrict blood flow in the legs.
• Good skin care, such as using skin lotions to prevent fragile skin from cracking, and avoiding sun or using sunscreen, especially for fair-skinned people.