Vein & Laser Center Care

Your healthcare provider will ask questions about your medical history, such as:

• Family history of abnormal veins
• Duration and symptoms of the problem
• Your job activities
• Previous treatments
• Medications you are taking
• Current or previous pregnancies

Your doctor will examine your legs during one or more office visits. The abnormal veins may be photographed to map the size and locations. During your exam, a hand-held Doppler scanner may be used to check for signs of reflux. This scanner is used like a stethoscope, to listen to and assess the sounds of blood flow.

Duplex Ultrasound is a noninvasive test that uses sound waves to create pictures. It provides detailed information about the venous system. It also shows blood flow, which helps your doctor determine where reflux is occurring. Duplex ultrasound makes it possible to pinpoint leak points that may be the source of the problem. This test can also help the doctor rule out more serious vein conditions.

During the test, gel is applied to the leg and a probe is moved over the skin. Pictures of the vein can then be viewed on a computer screen.

After your evaluation, you’ll work with your doctor to help develop a treatment plan. This plan is tailored to your individual needs. You may have several treatment options. It is important to learn about each type of treatment and make sure all of your questions are answered.

Making Decisions About Treatment: Your treatment options may include injections, minimally invasive procedures, and surgery. One or more of these may be recommended. All forms of treatment destroy or remove veins. Therefore, the remaining veins take over the workload, carrying the blood where it needs to go. Blood flow then becomes more efficient. Your doctor and his or her staff can make suggestions and offer alternatives. Together, you’ll decide on the plan to meet your needs.

Depending upon the kind of treatment you receive, the aftercare may vary. With most procedures, you will want to resume your normal daily activities as soon as possible to keep the blood flowing strongly in your legs. Other recommendations to aid in recovery include:

• Wear compression stockings or bandages
• Elevate your legs as directed
• Walk each day
• Avoid high-impact activities
• Avoid hot baths, saunas, and whirlpools
• Protect the treated area from sun exposure
• Avoid immediate air travel
• Most importantly, follow the specific instructions provided by the doctor

Varicose veins often develop or worsen during pregnancy. Keep in mind that:

• Self-care, such as wearing compression stockings daily, can relieve symptoms during pregnancy
• Abnormal veins may improve after pregnancy. Your veins can then be reevaluated to see if treatment is needed
• You need not delay treatment with childbearing. In fact, getting treated between pregnancies can reduce vein problems during future pregnancies

Gradient compression stockings fit tightly around your legs, exerting more pressure at the ankle than at the top. This allows blood to move upward and helps keep it from pooling in the legs. These elastic stockings come in different degrees of pressure. Your doctor will prescribe stockings in a safe and effective pressure for you. The stockings come in a variety of styles, lengths, colors, and sizes, including maternity sizes. Compression stockings may be purchased at your doctor’s office, a pharmacy, online, or at a surgical supply store.

To use compression stockings safely and effectively:

• Make sure to wear them correctly. Pull them to the designated height and no further. Avoid letting them bunch up at the top, as this can restrict circulation.
• Replace them when they start to become loose, which is often about 4-6 months.
• Do not sleep in them unless directed.
• Wear the length recommended by your doctor.
• Wear them for the amount of time recommended by your doctor.

This technique involves injecting a problem vein with a chemical. The chemical causes the blood vessel to close up and eventually disappear. Sclerotherapy is the main treatment option for spider veins. It is also performed in a short office visit and is often painless.

Using a very fine needle, your doctor injects a “sclerosing” chemical into the dilated blood vessel. The chemical causes inflammation, which makes the walls of the vessel stick together. As a result, the treated vessel can no longer hold blood. It shrivels and is eventually reabsorbed by the body.

Your doctor may ask you not to use cream or lotion on your legs on the day of the treatments. No other special preparation is needed before this therapy. During your first session, your doctor may perform a few injections to test your response to the chemical. Based on your response, the amount of the chemical may be adjusted. You may then have multiple sessions for different parts of the leg. Many veins can be treated in one session. In most cases, there is little or no pain during treatments, though you may feel a slight burning or stinging sensation.

Right after the procedure, you will most likely feel back to normal. You can return to your normal activities, including work, right away. You may see some bruising, but this is usually not severe. It may take up to 12 weeks for veins to disappear. In rare cases, some veins may need to be injected more than once. Blood may become trapped in some spider veins. If so, your healthcare provider can remove it with a small puncture.

Resume your normal daily activities as soon as possible, but keep in mind the following points:

• Wear compression stockings or bandages
• Elevate your legs as directed
• Walk each day
• Avoid high-impact activities
• Avoid hot baths, saunas, and whirlpools
• Protect the treated area from sun exposure
• Avoid immediate air travel
• Follow any special instructions from your doctor

Risks and potential complications of sclerotherapy are rare. They include: brown discoloration along the treated vessel (usually temporary), allergic reaction to the chemical used in injections, blood clot, scabbing or scarring, small skin ulcers, and formation of new blood vessels around the treated area.

The Sclerotherapy is done while the doctors monitor the vein visually using an ultrasound screen. This procedure allows treatment of unseen veins below the surface of the skin.

Light-based treatment is used to treat small veins. A light beam is pulsed onto the veins in order to seal them and cause them to dissolve. This treatment is a noninvasive way to treat spider veins.

Endovenous Laser Treatment uses heat to treat varicose vein, often a saphenous vein. Closing off a problem vein reduces pressure on smaller varicose veins. The procedure is a less invasive alternative to stripping surgery. Endovenous Ablation involves only needle punctures, not incisions. You can resume normal activities soon after the procedure.

Your doctor punctures the damaged vein with a needle and inserts a catheter. A laser fiber is threaded into the catheter and heats up the blood in the vein. The heat source is then drawn backward, ablating (destroying) the tissue and closing the vein behind it. Over time, the body absorbs the treated vein.

This procedure can occur in our doctor’s office, a hospital, or a surgery center. In most cases, you don’t need to do anything special to prepare. You’ll be awake and be able to talk to your doctor during the procedure. Pain is controlled with local anesthesia. You may also be given a mild sedative to help you relax. When the procedure is complete, pressure or a bandage is applied to the puncture site to stop bleeding. A bandage or compression stocking is then put on the leg.

You’ll be able to go home soon after the procedure. You can resume your normal activities, including work, in 1 to 2 days. You may see some bruising, but little to no swelling. Any pain you have can likely be controlled with over-the-counter medications. Your legs may look and feel better right away, or it may take 1 or 2 weeks after the procedure for you to see improvement.

Risks and complications of this procedure are rare. They may include superficial inflammation, temporary skin numbness, infection, skin burn, blood clot in a deep vein, and blood clot traveling to the lung.

This procedure is an FDA approved treatment alternative to surgical stripping of the greater saphenous vein. A smaller catheter is inserted, usually through a needle stick in the skin, into the damaged vein.

The catheter delivers radiofrequency energy to the vein wall, causing it to heat. As the vein warms, it collapses and seals shut. The procedure is done on an outpatient basis, and is performed under local anesthesia.

After the procedure, the catheter is removed and a compression stocking is placed on the treated leg.

This surgery can be used to remove the great or small saphenous vein. You will receive either local or general anesthesia. During surgery, small incisions are made at the top and bottom. The surgeon then removes (strips) the vein through the lower incision. After surgery, your legs are wrapped in compression bandages to control bleeding and swelling. In 1 to 3 hours, an adult family member or friend can take you home. Pain medication is likely to be prescribed. You can expect to return to work and your normal routine about a week after surgery.

Stab Phlebectomy is an ambulatory procedure that permits removal of incompetent veins below the knee or around the ankle. The varicose veins are identified with an indelible marking pen while the patient is standing. A diluted solution is injected into the tissues in large volumes until the tissues are engorged and distended with the anesthetic. Tiny stab incisions are made. The varicose vein is carefully dissected with the phlebectomy hook. The vein is undermined along its course, all attachments to the vein are freed, and the vein is then grasped with the hook and removed. The entire varicose vein is progressively extracted from one stab incision to the next. Skin closure may be done with steri strips or possibly suturing.