Varicose veins are common and cause a variety of symptoms in both men and women. It is estimated that 80 million Americans are affected by varicose veins. For women age 40-50, approximately 41% are affected and this percentage increases with age.
The symptoms caused by varicose veins range from a cosmetic nuisance to an aching, heavy sensation, to a painful condition which limits enjoyable activities and even the ability to work. The most severe cases can lead to ulcer formation and darkening of the skin on the legs.
DEFINITION OF VARICOSE VEINS
Veins normally function to return blood to the heart. Valves in the veins close after blood travels up the vein, preventing blood from backing up (refluxing) down the vein. Valves can become abnormal, or incompetent for a variety of reasons, including trauma, pregnancy, or hereditary factors.
Once a valve becomes incompetent, the vein below the valve is exposed to higher pressure, and can become larger (dilate). Other valves and veins nearby are exposed to the higher pressure and can also dilate. Varicose veins commonly appear on the legs as raised, often ropy, enlarged veins. They can cause the legs to swell, throb, and in severe cases, can lead to inflammation, ulcers and blood clots.
TREATMENT OF VARICOSE VEINS
There are many effective treatments for varicose veins. These include laser ablation of large veins, injection sclerotherapy and minimally invasive surgical treatments. These can almost always be performed in our office under local anesthesia.
Dr. Ellis uses the Dornier™ D940nm laser to close problem veins. Local anesthesia is used to comfortably numb the treatment area, where safe and effective laser energy is delivered into the vein wall, causing it to collapse and seal shut. Once the diseased vein is sealed, healthy veins take over and redirect the blood flow. This technique requires no stitches and offers minimal or no scaring. Patients resume normal routine activity in just a few days.
For the great majority of patients a single history and physical exam in our office is all that is necessary to establish the cause of their varicose veins.
At this initial consultation we perform a venous duplex ultrasound examination which provides a detailed “road map” of the superficial and deep veins in the legs and aids in the planning of the best course of treatment.
What is vein ablation by laser?
This is a state-of-the-art laser procedure that involves placing a thin laser filament into the vein through an IV catheter and using laser energy to heat the vein from inside, causing it to close down. Closure by laser has a 97% rate of completely closing down the vein. The laser procedure can be performed on most patients whose varicose veins are due to an incompetent saphenous vein. Each patient will be evaluated to determine which treatment is best for him or her.
Does this replace vein stripping ?
Yes. Surgically removing the great saphenous vein, or “vein stripping”, is rarely needed. An ambulatory phlebectomy procedure is done under local anesthesia in our office for removal of the bulging varicose vein branches. It is much less traumatic to the leg than traditional varicose vein removal. Patients walk comfortably out of the office; most are able to go back to work within a few days.
What about just injecting all the veins?
That method alone results in a higher chance of varicose veins returning. We do not use injection sclerotherapy for very large veins. We will offer the best treatment for each individual’s vein problem, which typically requires minor surgery to get the best long-term result.
Before and After