It is estimated that up to 40% of women and 20% of men in Houston will develop varicose veins in their lifetime. They are dilated and appear as ropy, blue vessels visible under the skin, often a ¼ inch or larger in diameter. Although they are unsightly, they usually indicate that venous insufficiency, a more serious medical condition, is present.
People in need of varicose vein treatment in Houston frequently complain of the following symptoms:
- Leg Heaviness
- Skin Discoloration
More About Varicose Veins
Women often notice that symptoms are worse just before their menstrual cycle, and during pregnancy.
It is important to see a vein specialist to have your varicose veins evaluated. If left untreated, you can expect any of the following to possibly occur:
Bulging varicose veins, worsening of the leg swelling, heaviness, leg tiredness, tenderness progressing to pain, superficial thrombophlebitis, skin thickening will discoloration, perhaps progressing to ulceration.
By treating varicose veins, an individual is improving their quality of life as well as keeping their legs and body in better health.
Treatment for Varicose Veins
Venous insufficiency may arise from either the deep or superficial veins. Fortunately, the majority of the time the insufficiency involves the superficial veins. The treatment of venous insufficiency involves the elimination of the abnormal vein(s). While we would not eliminate deep veins, any of the superficial veins may be eliminated if the deep veins are intact. Elimination of superficial veins is not a new concept. Up until 10 years ago the standard of care involved stripping the long saphenous vein. This was performed in an operating room setting using general anesthesia and involved surgically pulling the long saphenous vein out of the leg. In 1999, minimally invasive surgical procedures were approved by the FDA, which involved using heat to close the vein without removing it. These procedures could be performed in an office setting using a local anesthesia and were less invasive.
There are two broad categories of methods used to eliminate the saphenous vein with utilizing heat, these are Endovenous Laser Ablation (ELAS) and Endovenous Radio Frequency (Closure®). With each procedure the vein is mapped using ultrasound. The patient is then taken to the procedure room where the leg is prepped. The ultrasound is used to guide placement of a catheter into the vein, and tended for closure. The catheter is placed as low in the leg as the vein is abnormal and advanced towards the thigh. The position in relationship to the deep vein is verified by ultrasound and local anesthesia is injected along the length of the vein to be treated. The device is activated and slowly withdrawn and during the withdrawal the heat closes the vein.
Blood flow diverts spontaneously to the deep veins where the valves are almost always normal. Although we have both devices, Dr. Bardwil prefers the use of the laser to the VNUS Closure device. The laser is more versatile, has a lower reported risk of complications, and better long-term results. The new 1470 Wavelength Laser allows us to close the saphenous vein with about the same post procedure pain as the VNUS Closure device.
Once the pressure of the venous insufficiency has been eliminated the pressure in the leg veins will be reduced, the swelling will improve, and the varicose veins will shrink. If residual varicose veins persist, further treatments are available after the venous insufficiency has been addressed.
If the saphenous vein is normal and does not require treatment or if the saphenous vein has been treated and there are residual varicose veins, we turn our attention to the treatment of the varicose veins. Treatment of varicose veins involves elimination and this may be done by removing the veins through microphlebectomy or injecting the veins utilizing sclerotherapy with or without ultrasound guidance.
Microphlebectomy otherwise known as ambulatory phlebectomy is a minimally invasive surgical procedure, performed in an office setting utilizing local anesthesia. The patient’s veins are marked while the patient is standing. This allows maximal distention of the bulging veins. The patient is then taken to a treatment room and instructed to lie down. The leg is sterilely prepped, and local anesthesia is injected along the leg, where the veins that are to be removed, in small segments through 2-3mm sized incisions. The incisions are small enough not to require sutures and closed with butterfly strips, a bandage placed on the leg. There is usually little discomfort afterwards and most patients can return to work and normal activity the same day. The patient usually returns to the doctor’s office a day or two after the procedure to have their leg checked, and is advised to wear support stockings for 1-2 weeks after the procedure. The results are quick and cosmetically pleasing. This procedure works better than sclerotherapy for medium to large sized varicose veins.
Sclerotherapy involves injecting solutions into the varicose veins. These solutions create inflammation, which causes the vein wall to constrict with the intended goal to get the vein walls to stick together and close. Utilizing ultrasound can enhance sclerotherapy results. We refer to this as ultrasound guided sclerotherapy. By utilizing the ultrasound, veins are visualized so the needle can be precisely directed inside of the vein and the solution can be directed into the diseased vein intended for treatment.
Compression hose have a place in the treatment of varicose veins. Although there is no convincing evidence that support hose improves or prevents progression of varicose veins, they are usually used as an adjunct to treatment. They will also help to reduce swelling and other symptoms in those patients who are not candidates for procedures.
Please call today to schedule your initial evaluation at one of our offices in Houston or Katy.