Varicose veins are large, visible, dilated veins that result from damaged valves. These veins no longer function to efficiently transport blood back to the heart. They cause pooling and stasis of blood which can lead to aching, burning, itching and restless leg syndrome, and nocturnal cramping, as well as the sensation of having a heavy or tired leg. Typically, symptoms are worse at the end of the day and are relieved with walking. Severe pain in the calf or thigh that forces you to stop is called claudication and is a sign of arterial, not venous, disease.
Left untreated, varicose veins can lead to thrombophlebitis (clots in the veins), bleeding from veins, and chronic venous insufficiency. Chronic venous insufficiency can ultimately lead to skin changes and ulcerations or sores at the ankles that are difficult to heal.
We offer minimally invasive treatment of varicose veins:
Endovenous laser treatment. This process uses a combination of ultrasound imaging and laser energy to seal large varicose veins shut, thus guiding the blood into normal veins. It is performed in the office under local anesthesia with oral sedation. There is little down time and immediate ambulation is recommended after the procedure. This is usually covered by insurance. An excellent resource about varicose vein disease treatment is available HERE . A video demonstrating the technique of endovenous vein ablation is shown below.
*Transcutaneous laser therapy. Laser and light energy are used to target the hemoglobin in the blood of small spider veins causing them to close and never reopen. This is best when combined with injection sclerotherapy.
*Injection sclerotherapy. In this procedure smaller veins are treated with injection of a detergent sclerosant that causes damage to the lining of the vein which leads to obliteration of the vein. No anesthesia is required and very small needles are utilized. We use sodium tetradecyl sulfate and polidoconol as our sclerosant. They both have a long use history (>30 years) and an excellent safety history for vein treatment. Injection sclerotherapy is often considered cosmetic by insurance companies and therefore is not typically covered.
*Ultrasound guided sclerotherapy. To treat larger, deeper varicosities not amenable to laser treatment, we use ultrasound guided sclerotherapy. In this procedure, a needle is introduced into the abnormal vein under ultrasound guidance. A sclerosant is then introduced, typically in a foamed form. This provides maximum accuracy and efficacy in treatment of deeper veins. Insurance often covers this procedure.
*Ambulatory phlebectomy. This is a procedure that is typically performed in conjunction with endovenous laser treatment. The large bulky veins not amenable to the laser are removed through small puncture wounds. This is performed in the office under local anesthesia with oral sedation. Minimal, if any, scarring results with this procedure. This is usually covered by insurance.
*Treatment of venous leg ulcers. It has been clearly shown that some venous leg ulcers will heal with treatment of abnormal superficial veins, even if previous treatment was unsuccessful. We offer a complete evaluation for venous disease and can offer minimally invasive treatment, if indicated. This evaluation and treatment is covered by insurance.
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*Individual results may vary