HOW ARE VARICOSE VEINS TREATED?

Not all varicose veins are in need of treatment.  Treatment is dependent on the symptoms and the severity of the varicose veins.  Consistent exercise and the use of medical support hose can relieve many of the symptoms of varicose veins.

A variety of treatment options are available for symptomatic varicose veins.  They are often used in combination to relieve the problem veins.  First, an ultrasound guided exam is performed to determine the source and the extent of the varicose veins.  Only then, can a specific plan be outlined to treat the problematic veins.

Sclerotherapy – This is a process of chemically collapsing varicose veins.  A foamed solution is injected into the vein, displaces the blood within the vein and kills the vein wall. The  body then slowly absorbs the sclerosed and collapsed vein over time.  The procedure is done in the office and the patient can resume normal activities without restriction.  Ultrasound is often used to accurately identify and inject problematic veins beneath the surface.  Medical strength support hose are required for 2-3 days following injections to better compress the veins.  Walking and exercise are encouraged following the procedure.

Vein Ligation  – This is a procedure of tying off a large vein that may be the source feeding the varicose veins.  This procedure can be performed under local anesthesia in an outpatient facility.  The patient usually resumes regular activities in a day or two. The remaining varicose veins are treated by Sclerotherapy at a later date.

Endo Venous Laser Closure – This procedure is used to close large varicose veins of the thighs.  A laser fiber is inserted into the varicose vein, then laser energy is delivered to heat the vein, thus collapsing and sealing it shut.  This procedure is sometimes used in combination with Vein Ligation for best results. In our opinion this procedure is not ideal for patients that have large varicose veins or who have other complications.  This procedure is done in office or at an outpatient facility, under either local or ‘Twilight Anesthesia’.  There is usually mild discomfort from this procedure, lasting from 1 to 2 weeks. 

Limited Vein Ligation and Stripping – This procedure is the actual removal of the affected varicose vein. This is typically done through a groin incision where the vein ligation is performed and a second small incision on the inside of the knee or calf. The varicose vein is then removed from the groin to the knee. The remaining smaller segments of the varicose veins are then collapsed by Sclerotherapy. This procedure is usually performed under ‘Twilight Anesthesia’ in an outpatient center.  Most patients return to work within one week.
This procedure gives the best results with the lowest rate of recurrence.

Resection of Vein Clusters or Miniphlectomy – This procedure is occasionally performed when patients have very large clusters  of varicose veins near the surface.  These veins can be removed through very small incisions giving a nice cosmetic and therapeutic result.  This procedure is usually performed in conjunction with the vein ligation and stripping.

Total Vein Ligation and Stripping  – This procedure is the old treatment of the varicose vein where many incisions were made on the leg removing all the veins.  We do not recommend this type of treatment because it causes a lot of pain and leaves many unsightly scars on the leg.