How are varicose veins treated?
Varicose veins may sometimes worsen without treatment. Our vascular physician will first try methods that don't require surgery to relieve your symptoms. If you have mild to moderate varicose veins, elevating your legs can help reduce leg swelling and relieve other symptoms. Our vascular physician may instruct you to prop your feet up above the level of your heart 3 or 4 times a day for about 15 minutes at a time. When you need to stand for a long period of time, you can flex your legs occasionally to allow the venous pump to keep blood moving toward your heart.
For more severe varicose veins, our vascular physician may prescribe compression stockings. Compression stockings are elastic stockings that squeeze your veins and stop excess blood from flowing backward. In this way, compression stockings also can help heal skin sores and prevent them from returning. You may be required to wear compression stockings daily for the rest of your life. For many patients, compression stockings effectively treat varicose veins and may be all that are needed to relieve pain and swelling and prevent future problems.
When these kinds of treatments alone do not relieve your varicose veins, you may require a surgical or minimally invasive treatment, depending upon the extent and severity of the varicose veins. These treatments include sclerotherapy, ablation, vein stripping, and laser treatment.
During sclerotherapy, your physician injects a chemical into your varicose veins. The chemical irritates and scars your veins from the inside out so your abnormal veins can then no longer fill with blood. Blood that would normally return to the heart through these veins returns to the heart through other veins. Your body will eventually absorb the veins that received the injection.
To perform vein stripping, our vascular physician first makes a small incision in the groin area and usually another incision in your calf below the knee. Then your physician disconnects and ties off all major varicose vein branches associated with the saphenous vein, the main superficial vein in your leg. Our vascular physician then removes the saphenous vein from your leg. A procedure, called small incision avulsion, or sometimes ambulatory phlebectomy, can be done alone or together with vein stripping. Small incision avulsion allows our vascular physician to remove individual varicose vein clusters from your leg using hooks passed through small incisions. In a similar procedure called TIPP, our vascular physician shines an intense light on your leg to show your veins. Once our vascular physician locates a varicose vein, he or she passes a suction device through a tiny incision and suctions out the vein. Although these procedures sound painful, they cause relatively little pain and are generally well tolerated. Our vascular surgeon will advise you regarding which procedure is the best for your particular situation.
Ablation and Laser Treatment
Ablation uses a thin, flexible tube called a catheter inserted into a vein in the leg. Tiny electrodes at the tip of the catheter heat the walls of the vein and destroy it. Similarly, laser treatment uses a tiny fiber that is placed in the vein through a catheter. The fiber sends out laser energy that kills the diseased portion of the vein, and the vein closes off. These two modes of treatment frequently replace the stripping that is performed on the saphenous vein that is described above. The objective is to destroy the saphenous vein that is providing the source for varicose vein development. It can be performed alone or in conjunction with ambulatory phlebectomy, which removes individual clusters of varicose veins from the leg. Our vascular surgeon will advise you regarding which procedure is best for your particular situation.