Varicose Vein Treatment/Procedures

What are varicose veins?

Varicose veins are abnormally dilated blood vessels. They are veins which return blood from the legs. Normally, blood in the veins travels in one direction (towards the heart) because of one-way valves in the vein. If these valves are not working, blood can back-up in the veins, causing the varicose vein to enlarge. Varicose veins can occur anywhere in the body, and are often found in the legs. While they are often unsightly, they can also cause pain, burning, aching, and other symptoms.

What is EVLT?

EVLT® eliminates unsightly varicose veins with no hospital stay, typically no scarring and no lengthy recovery or significant side effects. In less than an hour you can be free from bulging, twisted varicose veins and back to enjoying your everyday activities.

EVLT® is safe, fast, and effective. EVLT® uses targeted laser energy to seal the vein shut and help you look and feel better fast.

Treatment in less than an hour.
EVLT® can be performed in the medical office.
Up to 98% success rate.
Immediate relief of symptoms.
Return to normal activity immediately – with little or no pain.
No general anesthesia or hospitalization.
Virtually no scars.

Here’s what to expect from the EVLT® procedure: Your doctor uses ultrasound to map out your vein. Local anesthetic is applied. A thin laser fiber is inserted through a tiny entry point, usually near the knee. Laser energy is delivered to seal the faulty vein. Walking immediately after the procedure is encouraged. Normal daily activity can be resumed; just avoid rigorous activities such as gym workouts. There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter, pain relievers as necessary.

Ambulatory Phlebectomy

What is Ambulatory Phlebectomy?
Ambulatory phlebectomy is an outpatient procedure that removes superficial veins through small, slit-like incisions in the skin. The procedure involves four different steps: 1. outlining or marking the veins to be treated; 2. injecting local anesthesia into the skin; 3. surgical removal of the bulging veins, segment by segment, through tiny incisions, and 4. wearing compression stockings for one week or more after the procedure.

What Should First be Done Before Considering Ambulatory Phlebectomy?
The patient should have a proper vein evaluation, which may include a relevant history and physical and a duplex doppler ultrasound examination. These tests evaluate such factors as: 1. are the varicose veins the main problem, or are they connected to other veins that may need to be treated first? 2. are there clots in the superficial or deep veins which may need to be addressed? 3. are other procedures needed in addition to ambulatory phlebectomy?

When is Ambulatory Phlebectomy Appropriate?
Ambulatory phlebectomy may be used to remove both asymptomatic and symptomatic superficial veins from the skin. Typically, treated veins are the larger, bulging (raised) varicose veins, although smaller veins may also be removed with ambulatory phlebectomy. Ambulatory phlebectomy may be combined with other therapies in the treatment of venous disease.

Who is Not a Candidate for Ambulatory Phlebectomy?
Patients who are not able to walk on their own and who cannot wear the compression stockings (arterial circulation problems) are not candidates for this procedure. Any active infection or rash in the treated areas needs to be resolved before the procedure.

Is Ambulatory Phlebectomy Painful?
Ambulatory phlebectomy is performed under local anesthesia. After surgery, discomfort should also be minimal to none, especially if compression stockings are worn as directed.

What are the Complications or Potential Side Effects of Ambulatory Phlebectomy?
Temporary bruising and swelling of the treated area is typical and is minimized with compression stockings. The small incisions heal well without sutures and typically after six to 12 months, they are practically imperceptible. (Note: In darker-skinned patients, the incision sites may be darker colored before fading). Although every attempt is made to remove the entire varicose vein, there may be small segments that remain in the skin. These fragments may become inflamed and irritated causing the condition thrombophlebitis. The residual vein may feel like a hard cord and may be tender. Over-the-counter medications, compression stockings and time usually resolve the condition. Rarely, a sensory nerve may be injured and skin numbness results. The skin numbness usually affects a small area only. Movement or leg function should not be affected.

What Can I Expect After Having Had Ambulatory Phlebectomy?
Bruising and swelling is normal and temporary. You can walk immediately after the procedure and carry on normal daily activities except for exercise and heavy lifting. You must follow the activity restrictions and wear the compression stockings as directed by your doctor. Your varicose veins are physically removed and therefore should not come back. However, depending on other factors such as family and personal history, new varicose veins may develop over time.

Spider Veins

What are spider veins?
Spider veins are similar to varicose veins, but they are smaller. They are often red or blue and are closer to the surface of the skin than varicose veins. They can look like tree branches or spider webs with their short jagged lines. Spider veins can be found on the legs and face. They can cover either a very small or very large area of skin.

What is Sclerotherapy?
This is the most common treatment for both spider veins and varicose veins. The clinician injects a solution into the vein that causes the vein walls to swell, stick together, and seal shut. This stops the flow of blood and the vein turns into scar tissue. In a few weeks, the vein should fade. The same vein may need to be treated more than once. Sclerotherapy does not require anesthesia, and can be done in the medical office.

The needles used are very small and feel like a mosquito bite. Most people find this relatively painless. Possible side effects include, the treated vein can also become inflamed or develop lumps of clotted blood. Lumps of coagulated blood can be drained.

How long will my treatment take?
Sclerotherapy treatment sessions usually last 20 minutes. Every patient is different, and the number of sessions needed varies depending on the severity of your condition. Most cases require 2-4 treatments, however, this is only a guideline and your individual case may be different. Your legs may begin to show improvement in as little as a few weeks, but the best results are usually seen after several treatment sessions. After healing has occurred, spider vein “road maps” and bulging varicose veins will be gone, leaving you with healthy, beautiful legs.

Will my insurance pay for treatments?
Generally treatment of spider veins is considered cosmetic by insurance companies and is not covered.

What should I expect after my Sclerotherapy treatment?

  1. You will need to wear the compression stockings for at least seven days after the procedure, longer if possible, and 24 hours per day if possible. If you have a follow up appointment, please bring the stockings with you.
  2. You will notice some bruising, aching pain and/or temporary cramping. These side effects usually take 1-4 weeks to heal; however, pigmentation irregularities can take months to heal.
  3. You should not experience severe pain. However, you may experience mild discomfort, which is easily treated with over the counter medication, such as Tylenol or Ibuprofen. This should be limited to 3 days. If pain persists beyond 3 days, please call our office to arrange for an immediate follow up with the clinician.
  4. Avoid direct sun exposure or tanning beds while there is bruising, brown streaks over the veins, or trapped blood in the veins (veins will feel firm and tender). If sun exposure is necessary, use sunscreen with SPF 25 or greater at all times.
  5. Avoid hot baths and/or hot tubs for at least 7 days.
  6. Avoid strenuous exercise for 3-5 days after treatment. We encourage you to walk daily while wearing your compression hose.

If you have any problems or questions, call our office at 678-626-0019.