Varicose and Spider Vein Treatment Options
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Endovenous laser therapy (EVLT)
Endovenous laser therapy (EVLT) uses heat to ablate incompetent main veins (such as the greater saphenous vein, lesser saphenous vein, etc.) which are often the source of varicose veins and venous ulcers. A tiny nick is made and a thin catheter containing the laser fiberoptic tip closes the incompetent vein from the inside. The vein is therefore ablated, or gone, which is comparable to surgical vein stripping, wherein the incompetent vein is physically removed after making a groin incision. EVLT eliminates the dysfunctional circulation system, allowing the functional deep venous circulation system to take over. EVLT has been shown to have the same efficacy as radiofrequency ablation (RFA), and has only a 2% recannalization rate compared to RFA’s 7.5% recannalization rate.
With ambulatory microphlebectomy, tiny incisions are made over large varicosities and a small hook is used to remove the varicose vein forever. This minor, outpatient procedure is performed under local anesthesia. No stitches are needed, and there is minimal to no scarring afterwards. The area is bandaged, and patients return in 24 hours for bandage removal. Patients are then provided with a compression stocking to be worn for two weeks to promote healing and minimize bruising and discomfort in the leg.
Varicose veins are initially treated with conservative compression stockings. Compression stocking have an evenly distributed calibrated pressure, which helps squeeze leg muscles in order to push blood up through incompetent veins and back to the heart more effectively. Compression stocking treatment should be coupled with regular exercise, which helps to prevent further progression of venous disease. If worn every day, compression stockings need to be changed every six months. Patients can purchase additional stockings at our office.
Sclerotherapy is the injection of medication via a tiny needle to destroy the vein wall. It is for the treatment of symptomatic residual varicose veins and symptomatic spider or reticular veins. Sclerotherapy is a safe in-office procedure, and there is minimal pain (no more than having shots). Most patients will have 1-3 sclerotherapy treatments in order to achieve a satisfactory result. Patients are instructed to wear their compression stockings for one week after sclerotherapy. Occasionally, trapped blood or hematoma in the sclerosed vein will need to be evacuated due to minor discomfort.
What to expect following vein treatment
Outpatient procedures are performed under local anesthesia. Patients are instructed to remain active following their procedure in order to prevent DVT, and walking is highly encouraged. Stockings are provided for patients to wear immediately after their procedure, and are to be worn for two weeks following the procedure. Patients may experience bruising, soreness, and tugging sensations during the first two weeks after the procedure which resolve with time, scheduled intake of over-the-counter pain medications, and the aid of compression stockings.
Most interventional radiological vein procedures are short and comfortable. Several vein treatment procedures, such as EVLT and microphlebectomy require sedation. Learn more about conscious sedation.