Varicose Vein Treatment Exam

Varicose veins are abnormal veins that develop in the soft tissue just beneath the skin. They are often painful and appear swollen and knotted. Other issues include itching, swelling, skin irritation, discoloration of the skin, and inflammation (phlebitis). These veins do not do a good job of transporting blood back to the heart. At their worst, they can be dangerous and crippling, causing foot and ankle sores, changes in the toenails, small clots, and blockage of blood flow. Varicose veins commonly occur in the legs but can also appear in other parts of the body. Their removal using EVLT can improve venous circulation.

Spider veins, which are related to varicose veins, are a group of dilated veins that look like spider webs or tree branches. They are smaller, appear closer to the surface of the skin and are purple, blue, or red. They are most commonly found on the legs and face. Spider veins are often treated with sclerotherapy. Also related are reticular veins—small green or blue veins that are visible under the skin and can be the underlying cause of spider veins.

About 50 to 55% of women and 40 to 45% of men in the U.S. suffer from some type of vein problem.

• A heavy or achy feeling in the legs
• Burning, itching, or throbbing
• Swelling, particularly in the ankles and calves
• Muscle cramps
• Discomfort when exercising or doing daily activities
• Leg fatigue
• Night cramps
• Cosmetic concerns about the appearance of the veins
• Embarrassment about wearing shorts or skirts

• Expert technicians at ARA imaging centers can examine your legs with ultrasound. This exam is available free by appointment at any ARA facility offering ultrasound. You will not need a provider referral for this free exam, but you will be asked to provide the name of your physician, so a report can be delivered.
• If the free ultrasound determines that you are a likely candidate for varicose vein treatment, you will make an appointment for a consultation with one of ARA’s interventional radiologists and a treatment plan will be developed for you.

• Varicose veins are caused by the pooling of blood in veins. Pooling results when the one-way valves that help blood flow back to the heart become weak and fail. The pressure from the pooling blood causes vein walls to balloon and swell, resulting in a ropy, enlarged appearance. When a person with varicose veins stands, the blood in the legs should flow back to the heart, but instead it flows downward through superficial veins, increasing pressure and causing varicose veins.
• Conditions that contribute varicose veins include:
  • Prolonged standing
  • Obesity
  • Heredity/family history
  • Pregnancy
  • Aging
  • High-heel shoes
  • Straining
  • Prior trauma or surgery

Not all varicose veins can be prevented. However, there are ways you can reduce your chances of getting new varicose veins:

• Elevate your legs above your heart when resting
• Wear sunscreen to limit skin damage
• Exercise to improve circulation
• Control weight to avoid putting pressure on your legs
• Don’t cross your legs while sitting
• Avoid standing or sitting for long periods
• Avoid wearing high heels
• Wear compression stockings to help keep blood from pooling in the legs

Benefits

• EVLT is a nonsurgical procedure. The procedure is done through a small nick in the skin that does not have to be stitched, avoiding the surgical incision often used.
• Compared with traditional methods, EVLT has few complications, less pain, quicker recovery, and highly successful outcomes.
• With EVLT, there is little or no scarring and the varicose vein virtually disappears.
• No sedation is required—the procedure can be done easily at an ARA imaging center.
• Most patients will experience immediate symptom relief and will be able to resume their normal activities right away.

Risks

• There may be bruising and tenderness after the procedure, but compression stockings can bring relief.
• Inflammation of the vein (thrombophlebitis) can happen but generally is easily relieved using over-the-counter anti-inflammatory drugs.
• To reduce risk of leg blood clots, you are encouraged to walk and be active after the procedure.

• Report to your scheduler and your doctor all medications that you are taking, including supplements, and any allergies you may have, especially to local anesthetics, general anesthesia or contrast materials containing iodine.
• If you take any blood-thinning medications, aspirin, or products containing aspirin, please contact our office for instructions on discontinuing the medications prior to your procedure.
• Wear comfortable, loose-fitting clothing. You will need to remove clothing in the treatment area and may be asked to wear a gown.
• Since you will undress from the waist down for the exam, you may wish to wear a two-piece outfit.

• Using leading-edge techniques, procedures like EVLT are performed by a specially trained physician called an interventional radiologist.
• EVLT is done on an outpatient basis at ARA’s Midtown location, in our specially designed and equipped interventional suite.
• IV sedation, given through a vein in the arm or hand, is available for your maximum comfort. You may also choose not to have sedation or to receive a mild oral sedative.
• The area to be treated will be sterilized and covered with a surgical drape.
• You will be asked to wear protective glasses when the laser is in use.
• The radiologist will numb the area where the catheter will enter the vein with a local anesthetic and use the ultrasound probe (transducer) to map the vein being treated.
• A small nick is made above the vein and the catheter (tiny tube) is inserted and guided through the vein using the ultrasound image. Once the catheter is properly positioned along the length of the vein, the laser is inserted into the catheter and guided through to the end. Local anesthetic is injected around the vein. As the catheter is slowly withdrawn, laser energy is applied.
• Pressure is applied as needed to prevent bleeding and the nick in the skin is bandaged.
• The procedure usually takes about 30 minutes per vein.

• Patients are able to get up and walk immediately after the procedure. Mild or moderate tenderness is sometimes noted. You may resume your normal activity, but immediate air travel and prolonged sitting are discouraged. Remaining active will help decrease the chance of complications and reduce the possibility of forming new varicose veins.
• Following the procedure, you will need to wear gradient compression stockings to help reduce tenderness, bruising, and minimize the rare possibility that blood clots may form.
• EVLT has a very high success rate and the chance of having the treated vein return is very small. You may develop new varicose veins over time for the same reasons you first developed them. Ongoing treatment can keep these under control. Wearing compression stockings can help prevent new varicose veins from developing.

To schedule your free ultrasound screening exam for varicose veins, please call (512) 453-6100 or toll free at (800) 998-8214. A provider referral is not required for the free screening, but you must make an appointment and be prepared to provide the name of your physician.

To schedule a consultation with an interventional radiologist, please call our interventional team at (512) 467-XRAY or (512) 467-9729 . A provider referral is required to make an appointment.

Please keep in mind that some insurance companies require patients to wear compression stockings for a prescribed length of time before they will cover EVLT. Compression stockings can make your legs feel better when you have varicose veins and can help prevent swelling and blood pooling. They do not usually improve the basic condition that causes varicose veins.