Varicose Veins

Healthy veins have one-way valves to ensure blood flows in one direction, towards the heart. When valves fail or leak, the blood flows backwards causing it to pool in the veins. The increased pressure from the pooling stretches the vein, causing enlarged, twisted blood vessels. The resulting lumpy, rope-like veins are varicose veins.

While some varicose veins only pose a cosmetic problem, some cases may cause substantial discomfort and health complications. Left untreated, varicose veins can lead to swelling, increased pain, skin discoloration and ulcerations of the lower legs. These ulcerations are difficult to treat and can become easily infected and painful. Many of these symptoms and complications can be prevented by early treatment of varicose veins.

Many people living with varicose veins do not seek treatment. That’s because varicose veins are often thought of as just a cosmetic problem. Those who suffer from pain and heaviness in their legs, however, know differently. The good news is that there are minimally-invasive treatment options available for varicose veins and CVI.

Trivex is a transilluminated powered phlebectomy system that allows for removal of large clusters of varicosities through fewer incisions. The Trivex procedure uses a thin lighted wand inserted under the skin to illuminate the veins, while a second minimally invasive instrument is used to remove the varicosities. This procedure is performed in the operating room with anesthesia.

In the case of varicose veins, micro punctures are placed over the course of the bulging vein.  Through these, segments of the large varicose veins are able to be removed while the remainder of the varicosity will decompress and eventually be absorbed.  The micro punctures are closed with Band-Aids and you will return home the same day with minimal limitations over the following 24 hours.  Cosmetic results are excellent.

In some instances, patients may experience symptoms resulting from compression of the pelvic veins that carry the venous blood from the lower extremity (May-Thurner syndrome).  In this instance, the patient would undergo a minimally invasive venogram to further evaluate this vein with intravascular ultrasound.  In the case of a significant venous compression, a stent would be deployed to reopen this vein to its true size.  The patient would be monitored for a short period following the procedure and would return home the same day with minimal limitations over the following 24 hours.

Similar to ClosureFast radiofrequency ablation, Endovenous Laser Ablation is an in office minimally invasive procedure performed under local anesthesia to close malfunctioning veins from the circulation. A small needle is used to access the targeted vein, and ultimately a sheath is placed to deliver the laser fiber. Once the fiber is in place, energy in the form of heat is used to damage the collagen of the vein causing the vein to collapse and seal. The blood that was previously flowing through this poorly functioning vein is now rerouted into healthy veins that will return the blood more efficiently. A Bandaid is placed over the access site. The procedure usually lasts ~ 30 minutes and the patient can return to work the next day if needed.

Varithena Foam Sclerotherapy works very similarly to traditional liquid sclerotherapy.  In most cases, it is used for veins larger than spider veins (reticular veins and varicose veins).  The FDA approved sclerosant medication (Polidocanol) is mixed with air in a syringe to transform it into foam. In the case of Varithena, this foam arrives in its inject-able form and does not require mixing in the office.  This foam is then injected into the vein using a tiny needle. The mixture will irritate the walls of the veins, causing it to close down. Your body will then dissolve the treated vein over time.  Some patients require more than one foam sclerotherapy session. The number of sessions will depend on the size, location and number of veins present.