Varicose Veins

Treating Varicose Veins

Nearly 40 million Americans have varicose veins — the blue, bulging, gnarled veins in the legs that show through the skin.
Telangiectasia, or spider veins, the more delicate red or blue tracings that can pop up on the skin’s surface like kinky spider webs, are a minor variation in the skin and can precede development of the more unsightly nests commonly found with this variety.

Fellowship Trained Vascular Surgeons Provide Comprehensive Care

Drs Nelson and Jundt make sure unsightly veins are your only problem before making any treatment recommendations.
Diagnosis of venous disease involves having a complete physical and talking with the physician about your health, lifestyle, family history and how the varicose veins affect your quality of life.
A color flow duplex ultrasound, the gold standard in the diagnosis of venous disease, is used to confirm diagnosis. Painless and noninvasive, the duplex ultrasound provides an accurate assessment of the size and shape of blood vessels as well as a functional evaluation of blood flow. The test is performed during the initial visit.

Leg Veins Defy Gravity

There are three types of veins in the legs: deep, perforating and superficial. Deep veins lie in groups of muscles, literally deep within the body, close to the bones. Superficial veins are on top, right beneath the skin. Perforating veins connect the superficial and deep veins. All three work together to bring blood back to the heart.
Leg veins are especially vulnerable to venous disorders because the blood in them flows upward, defying gravity.
To keep blood moving in the right direction, one-way valves within the veins open and close. When the heart relaxes in between beats, the valves close. When the heart beats, the valves open allowing the return of blood back to the heart. Too much pressure on the vein wall stretches the superficial veins, weakens their walls, and causes the valves to stop functioning properly or to become leaky. Blood refluxes back and forth within the superficial veins, causing their branches to bulge and twist.

Signs and symptoms

Women are most susceptible to varicose and spider veins, especially after multiple pregnancies, due to hormonal changes and weight gain. However, men can get them, too.
The risk factors include aging, weight gain or obesity, prior injuries or illnesses affecting the legs and jobs requiring standing for long periods every day. Those who have a family history of varicose veins may also be more susceptible to developing them as well.
Common symptoms of varicose veins include:

  • Pain, throbbing, fatigue, restlessness
  • Skin rashes, redness, itching or sores
  • Phlebitis, or vein inflammation
  • Superficial thrombosis or blood clots
  • Superficial thrombosis or blood clots
  • In rare cases, varicose veins can cause deep vein thrombosis (DVT), sudden, severe swelling in the legs. DVT is a serious condition and requires immediate medical attention.

Treatment Options

Medical science has advanced the treatment of varicose and spider veins, allowing vascular surgeons to successfully treat them in a number of different ways and all procedures can be done conveniently in the office.
Radiofrequency ablation (RFA) is performed on an outpatient basis and requires no incisions. A tiny catheter powered by radio-frequency energy delivers heat to the vein wall, which then shrinks and seals the vein. Patients who undergo RFA closures typically resume activities within one day.
Endovenous laser therapy (ELVT) is used most frequently and is a minimally invasive procedure performed in an outpatient office. The physician uses ultrasound guidance of laser energy to collapse and seal off the damaged vein. No surgical incisions are made and the procedure is performed under local anesthesia. Patients are back on their feet immediately and can resume all normal activities within a day.
Phlebectomy is used when the largest varicose veins become swollen and inflamed. Physicians remove individual varicose vein clusters from the leg through a series of small incisions. This minimally invasive procedure is done under local anesthesia using micro instruments and magnification. The incisions are so small that no stitches are required. Patients are back on their feet immediately and can resume all normal activities within a day.
Sclerotherapy is a non-surgical procedure that involves injecting a solution directly into the vein, usually the smallest veins. The treated vein will fade over time and the pain associated with the problem is reduced significantly after a few weeks. Multiple injections may be required and the number of veins injected in one session varies, depending on the size and location of the veins and the patient’s overall medical condition. Recovery from the procedure is minimal but the disappearance of the vein may take weeks to months.
ClariVein is a new option that is often simpler, faster and, according to research studies, up to 74 percent less painful than other minimally invasive peripheral vascular treatments. As no thermal energy is used, there is no need for the multiple needle-stick injections of anesthesia (pain-numbing) medication along the length of the treated area. This shortens the time the procedure takes, reduces pain and discomfort, and also eliminates bruising.
Compression Stockings are elastic hosiery that support the veins and stop blood from flowing backward. Doctors often recommend compression stockings as a first line of treatment for those with mild varicose veins. They can help heal skin sores and prevent varicose veins from returning. Patients may be required to wear compression stockings to relieve pain and swelling and prevent future problems.