Varicose Vein Treatment

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What are varicose veins?

Varicose veins are enlarged and twisted unsightly veins of the lower extremity. These may present as leg heaviness, leg ache or visible spider veins or bulging veins.

What causes varicose veins?

Varicose veins are most commonly due to the presence of incompetent valves in the leg veins-leading to reflux disease of the superficial veins.

How are varicose veins diagnosed?

You need to consult your physician to perform a thorough clinical evaluation as well as perform a duplex ultrasound study of the lower extremities venous system.

How are varicose veins treated?

The primary goal in the management of varicose veins of the legs is to treat the reflux disease of the vein. This can be done by vein stripping or by endovenous ablation.

Vein stripping removes the saphenous vein through surgical incisions. This is done under general anesthesia and requires hospitalization. Endovenous ablation using laser therapy obliterates the saphenous vein by heat using laser fiber inserted through the vein distally. This is an office procedure and performed under local anesthesia.

Conservative management of poor risk patients include using compression stockings, leg elevation for 15 minutes several times a day and avoiding constricting ligaments.

Endovenous Laser Therapy (EVLT) for treatment of varicose veins

Endovenous Laser Therapy (EVLT) is a minimally invasive, no-surgery, no-scar treatment for varicose veins. This is an outpatient procedure that will take less than an hour in your doctor's office. Your doctor uses ultrasound to map out your vein and then apply local anesthesia to the area to be treated. A thin laser fiber is inserted through a tiny entry point, usually near the knee. Laser energy is delivered to close the faulty vein, eliminating the cause of bulging. Blood circulation will not be harmed and the legs remain healthy. The procedure offers immediate relief of symptoms with very low risk of post-operative pain and infection.

What are the preparations for the procedure?

You need to see your doctor so he can discuss with you the procedure, expected results and its benefits. He would also need to conduct the following:

  • Take your medical history and the list of your current medications like aspirin, vitamins, herbal supplements, alcohol and drugs
  • A complete physical examination which may include an ultrasound to properly identify the cause of the condition
  • Take photographs of the affected area for before-and-after assessments

What can I do after the operation?

Pressure bandages are applied to the treated area and a twenty-minute walk immediately after the procedure is encouraged. Normal daily activity can be resumed. However, rigorous activities such as heavy lifting or squatting should be avoided.

There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter non-aspirin pain relievers as needed.

Would I need additional procedures after EVLT?

Depending on the extensiveness of the varicose veins, additional procedures like microphlebectomy, sclerotherapy and superficial laser treatment may be needed to completely treat residual varicosities. All these supplemental procedures can be done as outpatient procedures, under local anesthesia.

Excerpt from Varicose Vein Treatment, St. Luke's Medical Center advertorial.