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Minimally Invasive Revolution in Varicose Vein Treatment

Why do I have varicose veins?

Varicose veins are very common and 70% of all women and 30% of all men will develop some form of venous disorder in their lifetime. The average age of people developing varicose veins is 35-65. The incidence increases with age. Varicose veins occur largely due to heredity but can be caused by injury, weight, pregnancy, and hormonal changes. Varicose veins occur when the valves in the superficial system stop working correctly as seen in the diagram. There are several systems or "trunks" that can be involved in the leg. The valves are designed to help propel blood back up the leg toward the heart, but when these valves do not function properly, the blood falls back down the leg. Over time, the veins become larger and form the lumpy bumpy appearance of varicose veins. Varicose veins occur for a number of reasons including age, prior pregnancy, weight gain, hereditary factors and prolonged periods of standing. Frequently, the cause cannot be identified.

What are the common symptoms of varicose veins?

Symptoms can vary but the most commonly experienced symptoms are pain, aching, fatigue, itching, heaviness, restless leg, and swelling. Left untreated an ulcer or sore can form that will not heal until treated.

We will evaluate the veins in your legs for spider veins and varicose veins. We refer patients to physicians who can diagnose and treat varicose veins and their underlying causes. This must be understood in order to individualize the treatment to obtain the best results.

How are varicose veins treated today?

There are many exciting new treatment options available today for varicose veins and they include laser ablation, micro phlebectomy and sclerotherapy. All of these procedures are performed in the office setting safely and easily using a local type anesthetic. The laser is used for closing the main "trunks" that cause the bulging veins. A very small laser fiber is placed inside the vein through a small needle and positioned under ultrasound guidance. Once numb, the laser is activated and slowly pulled through the vein. This causes the vessel wall to be damaged so blood can't flow the wrong way anymore. The blood now returns to the heart through the remaining normal veins.

You can return to work the day after the procedure. Other activities, such as walking and light daily activities are possible and encouraged immediately following the procedure. Patients are encouraged not to over-do-it for a couple of days, however being sedentary is discouraged. There is minimal discomfort after the procedure. It is helpful to take an anti-inflammatory medication such as Motrin (Ibuprofen) for a week following the procedure. You will also be asked to wear compression stockings for a period of 2-3 weeks after the procedure.

The large "bumps" can be removed with a procedure called micro-phlebectomy (or ambulatory phlebectomy). Micro-incisions are made after numbing with a small needle so there are no scars and rarely are stitches used. Many times this procedure is done in conjunction with the laser procedure.

Conservative management of varicose veins

Varicose veins may be treated with conservative measures including compression stockings, elevation, weight loss and exercise. They are not dangerous and do not lead to blood clots or serious medical conditions. These methods have been proven successful in reducing the pressure that builds up in your veins and can improve your symptoms.

Prescription strength compression stockings aid in the treatment of varicose veins by helping squeeze the blood back out of your legs, preventing congestion. Ideally, compression stockings should be worn all day until you are able to elevate your legs at night. This may relieve discomfort but patients frequently have difficulty wearing these tight-fitting stockings. Patients routinely complain of heat and difficulty placing the stockings. If you are able to wear compression stockings, they certainly do reduce the discomfort and swelling associated with venous reflux and varicose veins.