Frequently Asked Questions, Varicose Veins

Q For the past 20 or so years I have noticed more tiny red vessels erupting on my legs. They don't really hurt but my leg get achy toward the end of the day. I am concerned because my mother had large ropey veins on her legs and she had to have a vein stripping. What should I do?

A Tiny red vessels under the skin and deeper, large ropey veins that are deeper are separate but possibly related issues. Ropey veins are typically varicose veins and are the result of abnormally increased pressures. The strategy of treatment is to decrease the pressure in the varicose veins. This can usually be accomplished by wearing properly fitted support stockings and elevating the legs. If the problem is serious and progressive, then remedies include a combination of laser, sclerotherapy injections, and microphlebectomy. Spider veins can often be simply treated with sclerotherapy or external laser.

Q I have large varicose veins and I am looking for a guaranteed cure so that I don’t have to wear those uncomfortable, embarrassing compression support hose.

A There is not a permanent “cure” for varicose veins. However, there are tried and true strategies to minimizing the symptoms and actually removing the varicose vessels. If you have dutifully worn your support hose and are elevating your legs and still have bothersome symptoms you are probably a candidate for procedural treatment—phlebectomy, endovenous laser ablation, or sclerotherapy. Even after treatment, I will always recommend that a person wear compression support hose as often as possible, but I am aware that life is about compromise. If you understand the alternatives, risks, and benefits you can decide when and where to wear the support hose.

Q I am trying to pick the right time to have my varicose veins treated. I have large ropey vessels as well as many red spider vessels. I am planning to go to the beach this winter and I want to be in good shape.

A From a functional standpoint the recovery after vein procedures is only a matter of days at worst. If a person has large ropey varicose veins and many spider vessels, noticeable results are appreciated immediately; however, I advise patients that the entire process can take up to a year for the best results. Depending on on a person’s unique vein problems, a combined approach may be necessary over time to get the optimal result—phlebectomy, laser ablation, and sclerotherapy. Keep in mind that the ultraviolet radiation from the sun has a detrimental effect on healing skin if a trip to the beach is planned.

Q My father had a vein stripping a number of years ago. Exactly what is a vein stripping?

A A formal vein stripping is where where a tool is placed inside of the problematic vein near the level of the knee and threaded up to the groin region where an opening is made in the skin. At the groin level the vein is attached to the tool which is withdrawal out the opening at the knee level; thus, stripping out the vein as the tool with pulled back. At one time this was one of the best approaches for treatment. Endovenous laser ablation and sclerotherapy initially were viewed as an alternatives but now are used more often than stripping.

Q I had a vein stripping 15 years ago. I had a great result for a number of years but the varicose veins are back and worse than before the stripping. Is there anything that can be done?

A A clinical evaluation in conjunction with a ultrasound should determine the cause and source of the varicose veins. With this information a surgeon can discuss the alternatives, risks, and benefits of various strategies. Approaches may include support hose, weight loss, exercise, leg elevation, laser treatment, sclerotherapy, or microphlebectomy (direct excision).

Q How does laser treatment of varicose veins work?

A A laser focuses electromagnetic energy to a very specific spot that can change the molecular structure of the tissues. Varicose veins can be the result of a significant feeder vessel extending from the groin to the knee region. A tiny laser fiber is passed inside of the feeder vessel where the energy is deployed resulting in the vessel closing down and healing shut. With the feeder vessel closed the varicose veins are relieved of the abnormally high venous pressures.

 

page last updated 14-aug-13
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