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Vein Diseases: Varicose Veins

Varicose veins are superficial veins that have enlarged due to increased pressure in your veins caused by incompetent, or leaking, valves that are much larger than spider veins. They are a problem for millions of adults. You are not alone in your desire to rid yourself of these unsightly and painful veins. You may have had them for years or they may have just recently become a problem for you.

Varicose veins may be inherited from your parents and may worsen with weight gain, pregnancy or may simply occur for no identifiable reason.
Your insurance company will usually cover treatment of your varicose veins if they cause significant symptoms and if you have attempted conservative treatment for 3-6 months sometime in the past without relief (elevation, compression stockings, exercise and weight control).

The Cause
Incompetent faulty valves in your veins result in Reflux (downward, backwards blood flow in veins) and lead to varicose veins.

Veins in your legs are tubes that carry blood from your feet toward your heart. One-way valves are located inside your veins and should only allow blood to flow up, out of your legs and back to your heart. When valves go bad for different reasons, blood flows backwards and builds up or pools in your leg veins. The backwards flow of blood in your veins is known as reflux and places excess pressure on the vein walls. This causes veins to expand and become varicose and can result in leg swelling, permanent skin changes and non-healing ulcers as pressure is transferred to the skin.

In the case of varicose veins (big bulging rope-like veins visible on the skin), they are often related to leaking valves in the Saphenous Vein (the vein which is just under the skin and runs along the inside of your calf and thigh).

Should an ultrasound confirm reflux in the saphenous system, a procedure called endovenous laser ablation or Closure can be used to eliminate the underlying reflux by closing off the leaking vein which is the source of the problem.
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 Lorazepam, thus eliminating the need for hospitalization and general anesthesia. A laser catheter is placed into the diseased vein. Laser energy is delivered to close off the diseased vein. 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.