Vein Treatment Procedure Information
How are varicose and spider veins treated?
Before deciding on the treatment to follow a physical exam is needed which is primarily visual but may include a Doppler or even a venous duplex-sonogram.
Some available treatments include:
Sclerotherapy
This is the most common treatment for both spider and varicose veins and is considered the gold standard. A solution is injected into the vein causing it to eventually close and gradually absorbed. This stops the flow of blood and the vein turns into scar tissue. There can be transitory black-and blue marks or even staining which gradually go away. After a few weeks, the vein fades. The same vein may need to be treated more than once.
This treatment is very effective if done the right way. Most patients can expect a 80% to 95% improvement. Microsclerotherapy uses special solutions and injection techniques that increase the success rate for removal of spider veins. Sclerotherapy does not require anesthesia and is done in the office.
Possible side effects include:
- Temporary stinging Temporary red raised patches of skin where the injection was made
- Temporary small skin sores where the injection was made
- Temporary bruises where the injection was made
- Spots around the treated vein that usually disappear
- Brown lines around the treated vein that usually disappear
- Groups of fine red blood vessels around the treated vein that usually disappear
The treated vein can also become inflamed or develop lumps of stagnant blood. This is not dangerous. Usually pin-pricking of the area is done a week later to evacuate the blood. Applying heat and taking aspirin can relieve inflammation.
Laser treatment
Laser treatments can effectively treat spider veins in the legs. The laser sends very strong bursts of light onto the vein making vein fade slowly and disappear. Most skin types and colors can be safely treated with lasers.
When the laser strikes the skin, the patient feels a heat sensation that can be quite painful, some say it’s just as painful as injection sclerotherapy. Cooling helps reduce the pain. Laser treatments last for 15 to 20 minutes. Depending on the severity of the veins, two to five treatments are generally needed to remove spider veins in the legs. Patients can return to normal activity right after treatment, just as with sclerotherapy. For spider veins larger than 3 mm, laser therapy is not very practical.
Possible side effects of laser surgery include:
- Redness or swelling of the skin right after the treatment that disappears within a few days.
- Discolored skin that will disappear within one to two months.
- Burns and scars may result.
Endovenous laser–
This procedure has replaced surgery for the vast majority of patients with severe varicose veins. This technique is minimally invasive and is done in the office.
A small catheter is inserted into the vein. Once inside, the catheter delivers the laser light shrinking and eventually sealing the vein wall. Healthy veins around the closed vein continue the return blood flow. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques. Possible side effects include slight bruising, induration and discomfort and slight numbing.
Ambulatory Micro-Phlebectomy –
With this procedure, a special light source marks the location of the vein. Tiny punctures are made with a needle in the skin, and crochet-like hooks are used remove the veins. This surgery is done using local anesthesia. Large varicose veins can be removed with this treatment while leaving only the puncture scars. Patients can return to normal activity the day after treatment. Possible side effects include slight bruising, induration and discomfort and slight numbing.
Other Surgical Procedures
- Stripping & Ligation
- Flush Ligation & Phlebectomy
- Flush Ligation
At our Center these procedures are no longer necessary since the advent of laser.
Conservative: All of these methods are used to alleviate symptoms and do not resolve the problem.
- Leg Elevation
- Use of Compression Stockings
- Reduced Prolonged Standing or Sitting
Can varicose and spider veins return even after treatment?
Current treatments for varicose veins and spider veins have very high success rates compared to traditional surgical treatments. Over a period of years, however, more abnormal veins can develop. The major reason for this is that there is no cure for weak vein valves. So with time, pressure gradually builds up in the leg veins. Changes in lifestyle such as work, hormone intake and pregnancy can contribute to their return. Ultrasound can be used to keep track of how badly the valves are leaking (venous insufficiency). Ongoing treatment can help keep this problem under control.
The single most important thing a person can do to slow down the development of new varicose veins is to wear graduated compression support stockings as much as possible during the day.