Surgical Care Group

Treatment For Varicose and Spider Veins

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.

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.

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.

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.