Varicose veins and venous reflux disease cannot be completely prevented. However, it is well-proven that conservative steps to improve your circulation and muscle tone can reduce the risk of developing varicose veins or getting additional varicose veins. Some basic recommendations:
Get your legs moving. This augments your calf muscle pump and thereby improves both you arterial and venous circulation. Charlottesville and Central Virginia residents are fortunate to have a variety of opportunities to enjoy low-impact exercise both outdoors and indoors all year round.
Losing excess weight removes unnecessary pressure on the veins in your legs, where varicose veins and venous insufficiency are likely to occur.
Avoid high heels. Low-healed shoes work calf muscles more, which is better for your leg veins. Don’t wear tight clothes around your calves or groin. Tight panty-leg girdles, for instance, can restrict circulation.
To improve venous circulation attempt to elevate your legs every three to four hours for 15 minutes to assist gravity and thereby your circulation. Although crossing your legs has long been thought to aggravate circulatory problems, this has never been clearly proven.
Make a point of changing your position frequently to use your calf muscles and encourage venous blood flow.
One of the most proven and beneficial conservative therapies in treating leg swelling and symptoms associated with varicose veins is compression therapies (see below).
Self-help efforts such as leg elevation, compression and the other listed preventive measures can help ease the pain and discomfort of varicose veins and may slow the progression. But if you are concerned about the appearance and symptoms associated with your veins and the self- care measures have not improved your venous condition from getting worse, see your physician.
Endovenous Laser ablation is an alternative to traditional surgical excision or “stripping” of specific underlying veins that are the source of varicose veins and venous insufficiency.
Endovenous laser treatment, also known as Venacure® (AngioDynamics, Inc., Queensbury, N.Y.) has become a widely accepted procedure with an excellent success and low complication rate. It is performed in an “office” setting under local anesthesia and works by heating the inside of the valve-incompetent vein, which causes it to seal shut and disappear. You will be in the office for approximately 1½–2 hours.
During this technique a very thin laser fiber is inserted into the damaged underlying vein with incompetent valves. The fiber is then advanced under duplex ultrasound guidance to the upper end of the abnormal vein. Local anesthesia is then delivered to the entire vein and the fiber with an 810 or 980 wavelength diode laser heats the inside of the vein as it is slowly withdrawn back down the vein. The only visible site on the surface of the skin is a small puncture site about the size of an IV catheter.
After endovenous laser treatment, the venous blood re-routes through the remaining normal (valve-competent) veins to more efficiently circulate blood back to the heart and reduce the abnormal high venous pressure in the legs. Because they are no longer under high sustained pressure, patients quickly experience significant improvement in their leg discomfort and varicose veins generally decompress and disappear spontaneously. Any prominent veins that persist can easily be treated by minimally invasive microphlebectomy or sclerotherapy. Possible side effects of endovenous laser treatments include skin numbness, blood clots and phlebitis and vein inflammation.
Microphlebectomy is a minimally invasive technique to remove abnormal, prominent varicosities through a tiny incision or incisions. The procedure is performed in an office-setting using a special set of instruments. Recovery is rapid, and most patients do not need to interrupt regular activity after microphlebectomy.
The TriVex® System (Smith & Nephew, Andover, MA) also known as Transilluminated Powered Phlebectomy is a minimally invasive technique to directly remove varicose veins. This outpatient procedure has become a widely accepted method used as an alternative to the traditional microphlebectomy approaches. The TriVex System uses two small cannulas inserted through a minimal number of 1-2mm puncture sites to localize and directly visualize varicosities and assist in their complete removal. Tri-Vex is a useful technique for patients who are not candidates for endovenous catheter therapies because of venous anatomy or varicose veins recurrence.
Cosmetic sclerotherapy is the most effective treatment for eliminating spider veins. This is an out-patient procedure in which your vascular specialist will inject a sclerosing solution into the spider vein. This injection is very well tolerated by all patients because the needles used are the size of a human hair. Special magnifying lenses and polarized light are used so the doctor can see the veins in question. The chemical causes the vein to collapse. Your body absorbs the vein and it eventually disappears with fading of the visual appearance of the treated vein. Healthy veins take over for the ‘old vein’ and your circulation improves. Sclerotherapy can enhance your appearance and your self confidence. The agent we use at CVC is Asclera which FDA approved and is also known as Polidocanol. Asclera is the most affective treatment presently available for the treatment of spider and reticular veins.
Tumescent Enhanced Sclerotherapy (TES) is a newly developed and clinically tested office procedure that takes traditional sclerotherapy a step further by applying tumescent (meaning making the tissue “tight”) anesthetic solution with a small pump designed for the procedure. In order to make the sclerosing solution that is injected in the veins work better, another solution made up of saline, lidocaine and adrenalin is used to compress the veins being treated. This has the effect of isolating the solution in the veins causing compression which can lead to better results. Usually, fewer injections and fewer treatments are needed. Less concentrated solutions are required as compared to conventional sclerotherapy.
For the best cosmetic outcome, you may need at least two to three sclerotherapy sessions. Your doctor may also recommend that you wear special wraps around the treated area and elevate your legs.
Other post-procedure recommendations include:
You can also avoid skin discoloration in the affected area by:
Side effects of sclerotherapy may include:
You may also experience a blood clot when your vein shuts down during
the injection therapy. Rest assured that these blood clots are not
dangerous at all since your body absorbs the vein. They are not the
same as dangerous blood clots which can occur for other reasons in
the deeper veins inside your legs.
Sclerotherapy is generally a very safe and effective procedure.
Occasionally, though, it can result in complications such as:
If you experience any of these side effects or complications,
our team of experienced vascular specialists will work with you
to address and resolve them.
Once we treat your spider veins, they are gone forever and will not reappear. It is possible to develop new spider veins in other areas or even in areas that were previously treated.
Most insurance companies consider injection therapy cosmetic and do not provide coverage or reimbursement for it. We will tell you how much the procedure will cost before we schedule it so you can budget accordingly.
To make an appointment, call us at: (434) 654-1700
Many people have problematic veins that are too twisted to be treated with the laser fiber or too small and numerous to be removed with microphlebectomy. The physicians at the Charlottesville Vein Center may rely on their ultrasound expertise to inject a solution precisely into the problem veins in a technique called ultrasound-guided sclerotherapy. The solution irritates the vein lining, causing them to shrink and close.