» Clinic Treatments
Conservative treatment
Historically, patients with varicose veins were recommended conservative treatment options. Conservative treatment options refer to a non-invasive form of treatment, where medications and surgery are not used to treat varicose veins. Patients can make lifestyle changes, such as eating less, exercising more and wearing support hoses. This regimen has proven helpful in reducing leg pain and further deterioration of the venous system.
Conservative treatment will not remove existing abnormal veins, but it may be the treatment choice for patients that may not be able to undergo other treatment methods. These methods are frequently required by insurance companies prior to definitive therapy.
Sclerotherapy
Sclerotherapy is the most commonly used treatment for small diameter (<5mm) veins, such as spider veins. In sclerotherapy, a liquid is injected with a tiny needle into the vein that causes inflammation of the vein walls and causes the vein walls to stick to one another, collapsing the walls together. This solution and the use of a compression stocking, effectively prevents the vein from working and it stops carrying blood. As a result, the vein disappears with time.
Small veins are effectively removed by sclerotherapy but veins will often reappear if the underlying causes, incompetent blood vessels, are not treated.
Sclerotherapy is associated with brown discoloration of the vein that may take up to one year to disappear and usually requires repeated treatments. Although side effects are rare they can include skin ulcers. As with all medications, some patients may have an allergy to the solution.
Laser Treatment of Spider Veins
The Dornier D 940 laser produces a highly unique 940 nm wavelength, which safely passes through the skin and is selectively absorbed by the targeted blood vessel. The vein will gradually disappear, leaving the skin intact.
Ultrasound guided sclerotherapy
Ultrasound guided sclerotherapy is used for the treatment of deeper veins that cannot be seen or felt which may be contributing to more superficial spider veins. Using ultrasound, a solution is injected into the veins causing the vein walls to collapse. Compression stockings are then used to make sure that the vein walls stay collapsed. Ultrasound guided sclerotherapy requires expert knowledge that conventional sclerotherapy does not. Once again, as the larger veins are treated, smaller spider and reticular veins will often disappear.
The advantages are no scarring and smaller veins disappear, while the downside is brownish discolorations, allergic reactions and the rare development skin ulcers.
Saphenous Vein Ablation
This minimally-invasive treatment is an outpatient procedure performed using ultrasound guidance. After applying local anesthetic to the vein, the surgeon inserts a thin catheter into the vein and guides it up the great saphenous vein in the thigh. Then laser or radiofrequency energy is applied to the inside of the vein. This heats the vein and seals the vein closed. Reflux within the great saphenous vein leads to pooling in the visible varicose veins below. By closing the great saphenous vein, the twisted and varicosed branch veins, which are close to the skin, shrink and improve in appearance. Once the diseased vein is closed, other healthy veins take over to carry blood from the leg, re-establishing normal flow.
Endovenous Laser Treatment (EVLT)
The EVLT™ Procedure deals with the incompetence of the greater saphenous veins. Unlike surgical stripping, EVLT permanently closes off the vein while leaving it in place. It uses the energy from a 940 nm diode laser delivered by a fine fiber-optic probe. Only the probe and a slim sheath need to enter the vein. Therefore, the whole procedure is performed via a tiny skin nick, so there will be no post operative scarring. The probe is guided into place using ultrasound and the procedure is performed under local anesthetic to numb the treatment area.
Phlebectomy
Phlebectomy involves the removal of surface varicose veins through a series of very small incisions with specialized hooks and clamps. This is done under local anesthesia in the office. Phlebectomy may be used in conjunction with endovenous laser of the saphenous vein. There is minimal to no scarring with this technique. Because the vein is completely removed, the result is immediate, and recurrence unlikely. Complications are rare in the hands of an experienced surgeon.
