What are the treatments for varicose veins?

There are many types of treatment available for varicose and spider veins. Generally, the smallest veins are injected and the larger veins are micro-surgically removed. A number of new techniques and devices have made treatment simpler and more effective. Removal is minimally invasive and usually done on an outpatient basis, usually without general anesthesia. Radiofrequency energy, lasers, and convergent light are some of the newest tools that have expanded the established treatment options.

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What is radiofrequency endovenous ablation (VNUS Closure®) treatment?

Radiofrequency endovenous ablation (VNUS Closure®) is a new procedure that provides a minimally invasive, highly effective outpatient alternative to greater saphenous vein stripping.

The 45-minute procedure is done with local anesthesia, conscious sedation, (“twilight sleep”), or general anesthesia. A tiny incision is made near the patient's knee and a slender catheter is then inserted into the vein. Electrodes inside the catheter are heated by radio-frequency energy. The catheter delivers this heat to the vein wall, causing it to collapse and seal shut. After the vein is closed, the remaining healthy veins take over and continue their normal function.

After the catheter is removed, a bandage is placed over the insertion site and the leg is wrapped to aid healing. Most patients resume normal activity immediately.

Possible complications are similar to those of other venous procedures: numbness, bruising, and phlebitis (inflammation of the vein).

Radiofrequency endovenous ablation  (VNUS Closure®) are not suitable for patients with pacemakers or internal defibrillators, or those who have aneurysms in sections of the varicose vein.

This procedure is relatively new, but careful observation of the early data suggests that it is a highly successful and durable treatment.

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Phlebectomy

What is ambulatory phebectomy ( vein micro-extraction)?

The term 'phlebectomy' means 'to surgically remove veins'. It applies to all methods of taking out varicose veins.

“Ambulatory Phlebectomy” is a relatively new name for outpatient surgery that has been performed by physicians for many years. It involves the use of small skin punctures to extract large varicose veins near the surface of the skin. A series of tiny  skin incisions, one to three millimeters (less than one quarter of an inch) are made, through which long portions of the veins are gently pulled out using specialized surgical hooks. The incisions are closed with sterile tape and usually do not require sutures. This results in almost no scarring. Ambulatory Phlebectomy causes less hyperpigmentation (brown spots) and ulceration than sclerotherapy. The hooks could possibly damage a small sensory nerve during removal, but such an injury is rare and the nerve heals quickly.

Treatment of Varicose and Spider Veins is a process that often requires a number of procedures to achieve optimal results. It is frequently necessary to “stage” ambulatory phlebectomies in combination with sclerotherapy.

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What is sclerotherapy?

Sclerotherapy is a safe, proven, and effective non-surgical procedure used to treat various sizes of veins. A specially trained physician performs this procedure using a tiny needle to inject a safe, effective sclerosing agent directly into the vein. The solution displaces the blood in the vein, causing the vein to immediately appear lighter in color. Further, the solution irritates the vein lining, causing it to collapse, and blocking it from getting more blood. Within a few weeks the unused vein is absorbed by the body and disappears.

After the treatment is completed, the leg is wrapped with a light compression bandage or support stocking. The patient is to wear this support according to the treatment philosophy of the physician. Some physicians believe there is no need to wear tight compression hose or confining bandages to promote healing or enhance the result of sclerotherapy.

Sclerotherapy is performed on an outpatient basis in the physician's office. No anesthesia is used. There is no pre-treatment preparation. Patients can immediately resume normal activity after leaving the doctor's office.

Sclerotherapy, unlike surgery, leaves no scars. Eighty-five percent of patients suffering from the discomfort and pain of varicose veins find that sclerotherapy relieves their symptoms. The tremendous cosmetic improvement is an added, and greatly desired, bonus to the outcome of treatment.

The treatment is not painful but individual injections can cause a slight burning sensation, similar to an insect bite, for a few seconds. The number of treatments required varies greatly from patient to patient. Several visits, usually fifteen to thirty minutes long, are scheduled a few weeks apart.

Effectively treated varicose veins do not grow back. However, there are patients for whom varicose veins are a recurring problem. We cannot alter the causes. There is no avoiding heredity and aging. However, eliminating varicosities actually improves blood flow by redirecting the blood to the healthy veins. Sclerotherapy not only achieves cosmetic improvement, but also improves circulation, resulting in significant symptomatic relief. For more information on Sclerotherapy click here.

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What are laser treatments?

There are various Laser treatments available today. They work on the same basic principle: a light beam is pulsed onto the veins in order to seal them off and causing them to dissolve. A series of treatments is usually required and is often done in conjunction with sclerotherapy. The Modesto Vein Center uses the Lyra® 1064 nm laser which is benefits patients of all skin types.

Lasers are best used to treat smaller spider veins, especially on the face and upper body. Red spider veins [telangiectasias] on the face respond well to laser treatment. We use the state-of-the art Aura® Laser system.

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What is ligation & stripping?

Vein ligation and stripping is the surgical removal of large varicose veins. It is an extremely effective method of extracting unwanted and useless superficial veins.The Modesto Vein Center employs outpatient minimally invasive techniques when performing this procedure. Local anesthesia, conscious sedation (“twilight sleep”) or general anesthesia may be used. Patients are encouraged to ambulate immediately and resume their normal activities the following day.

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Common questions regarding vein surgery?

The majority of vein surgery is entirely straightforward and performed without complications, however, no procedure has a one hundred percent cure rate, or is performed with zero risk. Fortunately, complications with vein therapy are uncommon and relatively minor. Possible complications include unexpected bleeding, infection, scarring, and nerve damage. A very small number of people have serious reactions to anesthesia but this is rare because modern anesthesia is extremely safe.

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Fiber-optic light guided injections and ultra sound guided vein injections

For a long time, it has been recognized that high-pressure veins deeper under the skin are actually feeding skin blemishes, spider veins, and thread veins. These flat, blue-green veins (“reticular veins”) are in close relationship to the spider veins. The Modesto Vein Center uses a bright Halogen light transmitted through fiberoptics applied directly to the skin. This bright light shows very clearly the veins under the skin that contribute to the formation of spider veins.Using the bright light as a guide, sclerotherapy injections are made directly into the feeding vein, thus providing more effective treatment for small varicosities and spider veins.

This technique decreases the number of injections necessary and appears to be more permanently effective than current techniques. This new method goes by the tongue-twisting name of transillumination sclerotherapy. Despite the name, the bright light considerably improves the pre-treatment physical examination and more accurately directs therapy. Naturally, there are no side effects of the transillumination and, in fact, it is interesting for patients to view the underlying veins. Although the veins are usually invisible, they can be seen clearly with the aid of the Halogen light.

Ultrasound guided vein injections use Duplex ultrasound technology to locate and inject deeper veins not visible with either the surface magnification or fiberoptic transillumination.

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What is sclerosant foam?

For nearly half a century, destruction of spider veins and some varicose veins by injection treatment has been standard practice. The technique uses various liquids, all of which cause destruction of the treated veins. Gradually, it has become recognized that making the solution into a foam increases the effectiveness of the treatment. It is possible now to create foam within a syringe and use this in treatment of small varicose veins and spider veins. This technique minimizes the number of repeat injections and makes each treatment much more efficient. This is achieved without increasing discomfort or dangers of the procedure. In proper circumstances, the use of sclerosant foam appears to be a truly new development.

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Does insurance cover my treatments?

In many cases insurance companies will pay for surgical treatment of vein disorders as well as for injection treatment and VNUS Closure® treatments. If you have any questions please call our office.

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