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Disease Information : Varicose Veins : Treatment

Varicose Veins : Treatment

Varicose Veins Treatment Options

The treatment of primary varicose veins depends on the extent of the varicosity. Graduated elastic compression stockings may reduce the symptoms of varicose veins, prevent leg swelling, and decrease the risk of blood clots. However, in hot environments, the use of elastic stockings may be impractical. Sclerotherapy is an injection of a sclerosing solution into spider veins (telangiectases), reticular, or small varicose veins to block these veins. It is considered a minimally invasive outpatient procedure offering best resultsfor small varicose veins and spider veins.

Ambulatory phlebectomy is also a minimally invasive outpatient procedure that can be performed under local, epidural, or general anesthesia. Varicose veins are removed with hooks through small skin incisions. Stitches are not necessary, and the incision edges are held together with fine paper-tape.Variable size varicose veins scattered over the calf and thigh mayalso beeliminated via two small skin incisions alone, with a powered mechanical aspirator system (Trivex), in contrast to the multiple stab wounds of the standard phlebectomy procedure. A strong light-source inserted under the skin through one of the incisions illuminates the varicose veins, which are eliminated with a thin mechanical aspirator inserted through the other incision.

Neither sclerotherapy or phlebectomy treat the primary cause of varicose veins, which is valvular incompetence of the great saphenous vein. New minimally invasive nonsurgical treatments performed using only local anesthetic in an outpatient settingare now available to treat valvular incompetence of the great saphenous vein. A radiofrequency (Closure) or laser energy (Endovenous Laser Therapy, EVLT) catheter is threaded into the great saphenous vein at the level of the knee, through a small needle puncture, and is advanced to the groin, where it is positioned using duplex ultrasonography. Release of radiofrequency or laser energy at the tip of the catheter, as it is shifted from the groin to the knee under ultrasound guidance, results in an effective, long-term closing of the great saphenous vein. Sclerotherapy can be done after these procedures to remove any remaining varicose veins.

Venous stripping was historically the standard treatment of valvular incompetence of the great saphenous vein, and is rarely still done today. Vein stripping surgery involves creating an incision at the groin. A portion of the great saphenous vein is stripped (removed) after its junction with the deep veins and its branches are disconnected (a procedure called high ligation) through a small groin incision. Multiple fine incisions are made to allow removal of the varicose veins. The procedure is performed under general, epidural, or spinal anesthesia, and is considered significantly more invasive than the catheter procedures described in the previous paragraph.

What You Can Do

You can’t do anything about your heredity, age, or gender. However, you can help delay the development of varicose veins or keep them from progressing.

Varicose Veins section was last modified: December 21, 2010 - 06:08 pm

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