Conservative
Varicose veins may not require any treatment at all if they do not bother you and they don’t cause any symptoms of aching, swelling or skin changes. Conservative treatment includes life-style changes such as weight loss, exercise, elevation, and compression stockings. These methods have proven successful in reducing the pressure that builds up in your veins and can improve your symptoms.

Compression hose
Prescription strength compression stockings aid in the treatment of varicose veins by helping squeeze the blood back out of your legs, preventing congestion. This may relieve discomfort but patient compliance is very difficult. Ideally, compression stockings should be worn all day until you are able to elevate your legs at night. Patients routinely complain of heat and difficulty placing the stockings. However, they certainly do reduce discomfort and swelling associated with venous reflux and varicose veins.

Ambulatory phlebectomy
Often used after endovenous laser ablation, phlebectomy involves the actual removal of branches of varicose veins through tiny incisions in your skin that are usually closed with only tape strips. The skin is numbed with a local injection and special instruments are used to remove the veins through tiny incisions. In most cases, you can resume normal activities the following day. When you leave the office after phlebectomy, those big bulging veins that have bothered you for years will be gone!! Tiny spider veins may persist and can be treated with sclerotherapy if they do not go away.

Sclerotherapy Your physician will develop a treatment plan for your individual case. Spider veins can be successfully treated with injection sclerotherapy. Sclerotherapy is the most popular method of eliminating spider veins. This is the “gold standard” and is more effective than lasers (for spider veins, not varicose veins). An FDA-approved medication called sotradecol is injected into the veins using very tiny needles.

This solution causes an irritation to the inner lining of the vein resulting in closure of the vein. The vein stops carrying blood and therefore disappears with time. The majority of people who have sclerotherapy performed have satisfying results and little discomfort.

Treatment differs from patient to patient, depending on the extent of the varicosities (size and number). An average of three to four treatments is required in most cases to achieve a 70%-80% clearing; 100% is not a realistic goal. The treatment sessions last approximately 15 minutes and are done at four to six week intervals to achieve optimal results. You should avoid sunlight for 6-8 weeks after sclerotherapy for optimal fading.

Sclerotherapeutic Progress

After completion of the initial series of recommended treatments, successfully treated veins are either gone or are much less noticeable. However, patients with a history of spider veins tend to develop new ones (with or without treatment) and a yearly touch up may become necessary. If you have leaking valves in your deep veins, you will likely continue to develop spider veins if the underlying cause is not treated.

Sclerotherapy is a treatment for spider veins, not a cure.

Laser / Closure Procedure (Endovenous Saphenous Vein Ablation) Your physician will develop a treatment plan for your individual case. Varicose veins caused by reflux in the superficial saphenous vein can be successfully treated with endovenous ablation. Lasers and Radiofrequency ablation (high energy ultrasound) have been used safely for many different medical applications throughout the body. In recent years, small fibers have been used successfully to deliver heat energy to treat varicose veins. These methods allow your doctor to close off the diseased superficial vein that contains leaking valves, thus preventing any further reflux (backwards flow of blood) into your varicose veins.

The procedure is usually performed in the doctor’s office with numbing medicine and Valium, thus eliminating the need for hospitalization and general anesthesia. Recovery is quick. Patients are encouraged to return to normal activities the day after the procedure. The vast majority of patients have very satisfying results and little discomfort.

Once you have decided to proceed with endovenous laser therapy, you will be asked to come to the office to view a video on the procedure, discuss pre-procedure guidelines, discuss consent and sedation if desired, review financial issues with insurance and be measured for new stockings, if you need them. This visit usually takes about 30 minutes and any further questions will be answered.

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