

Treatment
For Varicose and Spider Veins
General
Information
- Although most varicose and
spider veins are more of a cosmetic problem, they can
cause discomfort or aching. In severe cases, untreated
varicose veins can also cause phlebitis, bleeding or skin
ulcers. Various methods are used to treat varicose and
spider veins. Your surgeon can discuss your options with
you.
About Varicose and Spider Veins
- Varicose veins
represent abnormal dilations of blood vessels that occur
when the valves that control the flow of blood weaken and
fail to work properly. The blood that should be directed
back up to the heart, flows downward and pools in the vein
causing swelling and distortion. Men and women of all ages
develop varicose veins, but they most often affect women
of child bearing years and older. Varicose veins almost
always occur in the legs.
- Spider veins are
smaller thread-like vessels, appearing in
"starburst" clusters or a web-like maze on the
surface of the skin. Spider veins usually develop on the
thighs, ankles or feet, although they can also occur on
the face.
Cosmetic Vein Treatment
- Sclerotherapy is an
injection procedure that takes approximately one half hour
and is performed in the office. A tiny needle is used to
introduce an irritating solution into the vein with the
patient lying down. The leg is then placed in a
compression stocking which is worn for several weeks
daily. The procedure is quick and well tolerated. Several
treatment sessions may be required for complete resolution
of varicosities.
- Light therapy or laser
therapy is effective for very tiny thread-like varices
located on the legs or face. Generally these veins are red
in appearance and are not blue. The veins are no greater
than the edge of a paperclip in size. A laser beam is
applied over the vein and a short pulse is given to each
vein segment. Treatments average 15 minutes and are
performed in the office. Several treatments are necessary
for complete success and are performed over several months
for optimal results.
Surgical Options
- Vein surgery is reserved
for patients who have venous reflux in the saphenous vein.
This is diagnosed by venous duplex testing. Valves which
are present in the saphenous vein do not close properly
and are the source of varices in these patients. These
veins need to be treated surgically and not by
sclerotherapy.
- Ligation and stripping
is the standard surgical procedure by which the greater
saphenous vein is removed. A small incision is made just
below the knee and a tiny catheter is threaded to the top
of the vein in the groin area where another small incision
is made. The vein is then divided and removed through the
knee incision. The entire operation takes about 45 minutes
and is performed under general or spinal anesthesia.
- Radiofrequency vein
ablation is a new procedure and involves placing a
tiny catheter into the saphenous vein below the knee and
threading it up into the vein to the groin crease under
ultrasound guidance. The vein is then heated until it
shrinks down and effectively seals the lumen as the
catheter is withdrawn. This procedure can be performed
under local anesthesia with sedation, and the patient is
able to return to routine activity more rapidly.