At Vena, we offer several non-surgical, minimally invasive options for varicose vein removal. A patient may require just one of the treatment options or may require a combination of the treatments options discussed below.
In the past, if one of the major superficial venous structures such as the great, small saphenous vein or one of their major branch tributaries was found to be abnormally dilated with associated pathological reflux, the treatment was primarily limited to surgical ligation and stripping. This is an invasive, debilitating, painful procedure that often resulted in six or more weeks out of work or downtime from other activities.
Today the treatment of choice for reflux of abnormal major superficial venous structures is endovenous laser or radiofrequency ablation. Both of these procedures are routinely performed at Vena.
Ultrasound is utilized to find the lower portion of the abnormal vein in the thigh or calf region. After the skin is anesthetized, again using ultrasound, a needle is inserted into the abnormal vein. A thin guide wire is passed up the vein into the higher part of the leg. At that point, a thin catheter for laser or radiofrequency device is guided using ultrasound into the upper portion of the leg and positioned at the origin of the vessel to be treated. Tumescent fluid (anesthetic fluid) is infiltrated into the tissues around the length of the vessel that is to be treated. At that point, either laser or the radiofrequency device is activated. Each of these devices in a different way generates heat around the tip of the device. The heat that is generated injures the wall of the vein. While watching under ultrasound, the laser or radiofrequency device is withdrawn from the upper to the lower portion of the leg where it was original introduced, essentially cauterizing the length of the vessel.
You will be awake for your treatment. Following the procedure, you will need to wear medical grade compression stockings to help reduce bruising, tenderness and to minimize the rare possibility of the formation of a blood clot.
You can resume normal or near-normal activities often immediately and usually return to work in a day or two at most. You will be asked to refrain from air travel and long periods of sitting as can occur on a car trip in the immediate post procedural period. You will be required to wear compression stockings for up to a week and your normal exercise regimen may be modified for a week or two at most.
The number of endovenous treatments that you will need will depend on the severity of your varicose vein disease.
If you have large bulging veins, you may be in need of additional treatment. For these bulging veins we may elect to perform a procedure known as microphlebectomy. During this treatment, local anesthetic (lidocaine with and without tumescent solution) is utilized to infiltrate the tissues along the entire course of the bulging veins. Small 1-2 mm puncture marks are made along the length of the bulging vein. A special hook-like instrument is then utilized to pull the bulging vein to the surface of the skin where it is then removed. The procedure is safe and generally causes minimal discomfort.
For those smaller veins (including spider veins) that are visible to the naked eye, Sclerotherapy is performed. This treatment usually takes about 30 minutes or less and consists of a series of small injections which are made directly into the vein. The fluid that is injected is referred to as a sclerosing agent, and chemically is basically a detergent substance. The number of sclerotherapy treatment needed will depend on the severity of the problem.