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Vein Treatments |
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Click on the following links for answers to frequently asked questions about vein treatments.
- What are the treatments for varicose veins?
- What is Sclerotherapy?
- Laser and pulsed light treatments?
- What is Photoderm VL Light Treatment?
- What is Ligation & Stripping?
- What are Endovenus Closure and VNUS CLOSURE® Treatments?
- What is Ambulatory Phebectomy ( Vein Micro-Extraction)?
- What is Transillluminated Powered Phlebectomy: The Trivex™System?
- Common questions regarding vein surgery?
- Fiber-optic light guided injection and ultra sound guided vein injections
- Laser light vs saphenous stripping
- What is sclerosant foam?
- What are the most common concerns about vein surgery?
- Does insurance cover my treatments?
What are the treatments for varicose veins?
There are many types of treatment available for varicose and spider veins. Generally, the smallest veins are injected and the larger veins are removed. A number of new techniques and devices have made treatment simpler and more effective. Removal is minimally invasive and usually done on an outpatient basis, often without general anesthesia. Radiofrequency energy, lasers, and convergent light are some of the newest tools that have expanded the established treatment options.
Sclerotherapy is a safe, proven, and effective non-surgical procedure used to treat various sizes of veins. A specially trained physician performs this procedure using a tiny needle to inject a safe, effective sclerosing agent directly into the vein. The solution displaces the blood in the vein, causing the vein to immediately appear lighter in color. Further, the solution irritates the vein lining, causing it to collapse, and blocking it from getting more blood. Within a few weeks the unused vein is absorbed by the body and disappears.
After the treatment is completed, the leg is wrapped tightly with a light compression bandage or support stocking. The patient is to wear this support according to the treatment philosophy of the physician. Some physicians believe there is no need to wear tight compression hose or confining bandages to promote healing or enhance the result of sclerotherapy.
Sclerotherapy is performed on an outpatient basis in the physician's office. No anesthesia is used. There is no pre-treatment preparation. Patients can immediately resume normal activity after leaving the doctor's office.
Sclerotherapy, unlike surgery, leaves no scars. Eighty-five percent of patients suffering from the discomfort and pain of varicose veins find that sclerotherapy relieves their symptoms. The tremendous cosmetic improvement is an added, and greatly desired, bonus to the outcome of treatment.
The treatment is not painful but individual injections can cause a slight burning sensation, similar to an insect bite, for a few seconds. The number of treatments required varies greatly from patient to patient. Several visits, usually fifteen to thirty minutes long, are scheduled a few weeks apart.
Effectively treated varicose veins do not grow back. However, there are patients for whom varicose veins are a reoccurring problem. We cannot alter the causes. There is no avoiding heredity and aging. However, eliminating varicosities actually improves blood flow by redirecting the blood to the healthy veins. Sclerotherapy is not only cosmetic 'maintenance' but it also improves circulation, resulting in significant symptomatic relief. For more information on Sclerotherapy click here.
Laser and pulsed light treatments?
There are various Laser and Pulsed Light treatments available today. They work on the same basic principle: a light beam is pulsed onto the veins in order to seal them off and causing them to dissolve. A series of treatments is usually required and is often done in conjunction with sclerotherapy.
Lasers are best used to treat smaller spider veins, especially on the face and upper body. Red spider veins [telangiectasias] on the face respond well to laser treatment. There are promising new lasers in development but at the moment, they are of limited value in the treatment of varicose and spider veins in the legs.
What is Photoderm VL Light Treatment?
PhotoDerm VL light treatment is a non-invasive technology. Photoderm uses the heat energy from an intense pulse light source to selectively damage or destroy abnormal veins. The advantage of this procedure is that it is non-invasive (no needles) and non-toxic.
What is Ligation & Stripping?
Traditionally, varicose veins were treated surgically either by ligation or 'stripping'.
Surgical ligation is the tying off of the main superficial vein, the saphenous vein, at the groin, to reduce venous pressure. It is often done under local anesthesia.
RECENT ADVANCES IN MINIMALLY INVASIVE SURGERY
What are Endovenous Laser Closure and VNUS CLOSURE® Treatment?
Endovenous Laser Closure and VNUS Closure® are new procedures that provides a minimally invasive, highly effective outpatient alternative to the rigors of saphenous vein stripping.
The 45-minute procedure is done with local or regional anesthesia at a surgical center or even in a doctor's office. A tiny incision is made near the patient's knee and a slender catheter is then inserted into the vein. Electrodes inside the catheter are heated by radio-frequency energy. The catheter delivers this heat to the vein wall, causing it to collapse and seal shut. After the vein is closed, the remaining healthy veins take over and continue their normal function.
After the catheter is removed, a bandage is placed over the insertion site and the leg is wrapped to aid healing. Most patients resume normal activity immediately.
Possible complications are similar to those of other venous procedures: numbness, bruising, and phlebitis (inflammation of the vein).
Endovenous Laser Closure and VENUS Closure® are not suitable for patients with pacemakers or internal defibrillators, or those who have aneurysms in sections of the varicose vein.
This procedure is relatively new, but careful observation of the early data suggests that it is a highly successful and durable treatment.
Phlebectomy
What is Ambulatory Phebectomy ( Vein Micro-Extraction)?
The term 'Phlebectomy' means 'to remove veins'. It applies to all methods of taking out varicose veins.
'Ambulatory Phlebectomy' is a relatively new name for outpatient surgery that has been performed by physicians for many years. It involves the use of small punctures to extract large varicose veins near the surface of the skin. A series of tiny (one to three millimeters or less than one quarter of an inch) punctures are made, through which long portions of the veins are gently pulled out using specialized surgical hooks. The vein is totally removed in one treatment, as opposed to sclerotherapy, which requires several treatments.
The incisions are closed with sterile tape and usually do not require sutures. This results in almost no scarring. Ambulatory Phlebectomy causes less hyperpigmentation (brown spots) and ulceration than sclerotherapy. The hooks could possibly damage a small sensory nerve during removal, but such an injury is rare and the nerve heals quickly.
What is Transillluminated Powered Phlebectomy: The Trivex™ System?
Transillluminated Powered Phlebectomy is a new procedure to remove varicose veins using a powered vein extracting device and transcutaneous illumination. It is performed under general anesthesia on an outpatient basis.
The procedure begins with two small incisions that are made near the cluster of varicose veins. A small fiber optic light is inserted into one of the incisions and gives the surgeon direct visualization and a distinct endpoint to the removal of veins. A special blade that rotates is inserted into the second incision. The surgeon is accurately guided by the light and uses the blade to remove the entire vein.
Transillluminated Powered Phlebectomy is proving to be a safe, effective procedure. TriVex™ requires a minimal number of small incisions and a brief recovery time. It is performed in half the time of a traditional Phlebectomy and gives the patient a good cosmetic result.
Common questions regarding vein surgery?
The majority of vein surgery is entirely straightforward and performed without complications but no medical therapy has a one hundred percent cure rate or is performed with zero risk. Fortunately, complications are uncommon and relatively minor. Possible complications include unexpected bleeding, infection, scarring, and nerve damage. A very small number of people have serious reactions to anesthesia but this is rare because modern anesthesia is extremely safe.
Fiber-optic light guided injections and ultra sound guided vein injections
For a long time, it has been recognized that high-pressure veins deeper under the skin are actually feeding skin blemishes, spider veins, and thread veins. These are flat, blue-green veins that are in close relationship to the skin blemishes. Now, very bright Halogen light transmitted through fiberoptics can be applied directly to the skin. This bright light shows very clearly the veins under the skin that are the cause of the skin blemishes and extends the observation powers of the physician doing the treatment. Using the bright light as a guide, injections can be made directly into the feeding vein, thus providing more effective treatment for skin blemishes.
The technique decreases the number of injections necessary and appears to be more permanently effective than current techniques. This new method goes by the tongue-twisting name of transillumination sclerotherapy. Despite the name, the bright light considerably improves the pre-treatment physical examination, makes the diagnosis more accurate, and directs therapy. Naturally, there are no side effects of the transillumination and, in fact, it is interesting for patients to view the underlying veins. Although the veins are usually invisible, they can be seen clearly with the aid of the Halogen light.
This new noninvasive, painless technique may change the old time-honored injection sclerotherapy and make it better.
Ultra sound guided vein injections is similar to the Halogen light location except it is better for deeper hard to find veins.
Laser light vs saphenous stripping
Vein stripping continues to be an unpopular term, both for physicians and for patients who have heard of the vein stripping operation. In its most precise term, vein stripping means removal of a vein from the circulation and that can be achieved by various techniques, none of which remove the vein from the body. The radiofrequency VNUS Closure® system has proven itself as a practical substitute for saphenous vein stripping (removal). Now, the use of electromagnetic waves in a slightly different spectrum allows destruction of the saphenous vein from within by the use of laser light. The laser light source and fiber are now in use at the American Vein Institute at Dallas. It is effective in destroying the saphenous vein and removing it from the circulation. It does so as part of a surgical treatment in which the varicose veins are removed as well. The surgical procedure is mainly done with large amounts of local anesthetic although it can be done with the patient lightly asleep. The use of laser light delivered by quartz fiber looks to be a truly new development in varicose vein treatment.
For nearly half a century, destruction of spider veins and some varicose veins by injection treatment has been standard practice. The technique uses various liquids, all of which cause destruction of the treated veins. Gradually, it has become recognized that making the solution into a foam increases the effectiveness of the treatment. It is possible now to create foam within a syringe and use this in treatment of small varicose veins and spider veins. This technique minimizes the number of repeat injections and makes each treatment much more efficient. This is achieved without increasing discomfort or dangers of the procedure. In proper circumstances, the use of sclerosant foam appears to be a truly new development which is worthy of pursuing.
What are the most common concerns about vein surgery?
The majority of vein surgery is entirely straightforward and performed without complications but no medical therapy has a one hundred percent cure rate or is performed with zero risk. Fortunately, complications are uncommon and relatively minor. Possible complications include unexpected bleeding, infection, scarring, and nerve damage. A very small number of people have serious reactions to anesthesia but this is rare because modern anesthesia is extremely safe.
Does insurance cover my treatments?
In many cases insurance companies will pay for surgical treatment of vein disorders as well as for injection treatment and venus treatments. If you have any questions please call our office.