treatments
In general, the treatment of varicose veins usually requires several steps. The type and number of treatments depends on the vein number, size, location and whether or not an underlying deeper problem exists. Since every patient and every leg is unique and different, diagnosis and treatment protocols are individualized. The first step is to determine if an underlying problem (source or feeding vein) exists. This is done with the aid of a hand-held Doppler (electronic stethoscope) and if indicated, a duplex ultrasound (detailed vein mapping) of the legs. Underlying source or feeding veins, if present, are always treated first (large veins before small). These underlying veins may not always be visible. Remaining visible veins are treated last after all source or feeding veins have been eliminated. This may require one or more sessions with a 2 to 4 week interval between sessions. The time between sessions ensures that the deeper underlying feeding veins have been completely eliminated before proceeding to treat the superficial visible veins. Treatment varies case by case and may involve one or more of the following procedures: Compression Sclerotherapy or Injection TherapyA solution (sclerosant) is injected, with the aid of the Vein Lite using
a micro-needle, into the vein which then collapses or closes the vein
off. This is usually reserved for smaller veins (spiders and/or reticular – bluish
veins). The number of treatment sessions is based on individual need,
but the average is anywhere from 2 to 6 sessions. The procedure usually
takes about 30 minutes. The needles used for injections are extremely
small and cause little pain. Walking and normal activities are encouraged.
No vigorous exercise for 3 days. Complications are rare, but include
skin pigmentation (a brownish stain) from leakage of the solution outside
the vein, bruising, blood trapping (mini clots that are not dangerous),
ulceration, scarring and allergies. All complications, if they occur,
usually resolve in 2 weeks to 6 months without consequence. It is a very
safe procedure in experienced hands. Sclerotherapy is highly effective
provided source or feeding veins are identified and treated first. Sclerotherapy
remains the best treatment for spider and reticular veins. Treated veins
usually do not come back. All procedures are performed by highly trained
phlebology physicians. Ultrasound Guided SclerotherapyAs with regular sclerotherapy, a solution is also injected into the vein. The difference is that this is done with the aid of an ultrasound machine. This allows the injection of deeper feeding veins beneath the skin that are not otherwise accessible or visible. Complications and results are similar to Compression Sclerotherapy. Ambulatory PhlebectomyA minimally invasive procedure used for the removal of larger visible
bulging veins. These veins are removed through tiny no-stitch incisions
(approximately 1 to 2mm) that leave little to no scars. This procedure
is done under local anesthesia on an outpatient basis. It usually takes
about 60 to 90 minutes. There is minimal discomfort if any associated
with the procedure that usually resolves in 1 to 2 days. Recovery is
fast with no down time. Walking and normal daily activities is the rule.
No vigorous exercise for 2 weeks. Relatively common minor complications
include bruising, tenderness and phlebitis (minor vein swelling). These
complications usually resolve in 2 to 4 weeks without additional treatment.
Rare major complications include infection, nerve sensitivity, skin staining
and blood clotting. Our minor complication rate is very low and we have
yet to experience any of the major complications. Results are excellent
with high patient satisfaction. Endovenous Laser Treatment (EVLT)An alternative to surgical stripping, EVLT is a highly effective procedure
that utilizes laser energy to treat damaged source veins. A thin laser
fiber is introduced under local anesthesia, through a needle stick in
the skin, into the affected vein. The laser energy is delivered through
the fiber to the precise location of the vein damage under ultrasound
guidance. This causes the vein to collapse and close. The blood that
flowed through the non-working vein is automatically redirected to existing
healthy veins improving circulation. Little to no pain is associated
with the procedure. Some tenderness, tingling or tightness may occur
after the procedure. This usually resolves in 2 weeks. The patient may
return to work and normal non-strenuous activities immediately and vigorous
exercise in 2 weeks. Complications include bruising, tenderness, skin
discoloration and phlebitis (minor vein swelling). These complications
do not always occur and usually resolve in 2 to 4 weeks. Other rare complications
are deep blood clots, infection and skin burns. We have yet to encounter
any of these complications having used this technology extensively prior
to FDA approval. Recovery is fast and there is no down-time. Endovenous
laser treatment has revolutionized the treatment of varicose veins and
has virtually replaced the traditional surgical stripping. Results are
remarkable. |