What we do
Vein Care
Frequently Asked Questions
What are varicose veins?
Varicose veins are abnormally enlarged veins. In most patients, they are caused by faulty valves which allow blood to "leak" back down into the leg. This causes increased pressure within the veins of the leg causing them to enlarge. As the veins enlarge, they can be seen under the skin as tortuous ropes. Varicose veins cause are variety of symptoms such as burning, itching, tingling, fatigue, heaviness, cramping, aching, swelling, edema, and restlessness. Left untreated, symptomatic varicose veins can progress to more serious medical conditions including skin inflammation, skin ulcer, venous inflammation, and venous blood clots.
What are spider veins?
Spider veins are smaller, colored veins that look like the legs of a spider. Spider veins are often considered to be unsightly and can cause leg pain and/or a feeling of heaviness. There is not always a correlation between amount of discomfort felt and the number of spider veins present; e.g. a person may have only a few spider veins and feel a fair amount of pain. Conversely, a person may have many spider veins and feel little or no pain. Just like larger varicose veins, spider veins are a result of increased pressure in the veins.
What causes varicose veins?
Varicose veins result from increased pressure in the venous system of the leg. The most common cause is failure of the valves in the veins. Less commonly, the veins of the leg can become blocked. The veins then enlarge as the pressure inside them increases. Patients see these as blue ropes under the skin. A common cause of varicose veins in the legs is reflux in the great saphenous vein.
What is venous insufficiency?
Venous insufficiency is a common condition that occurs when valves inside the veins do not function normally. This allows blood to flow backward ("reflux") down into the leg causing increase pressure inside the veins.
What symptoms does venous insufficiency cause?
The symptoms caused by venous insufficiency and varicose veins include aching pain, burning, tired and heavy legs, all of which worsen as the day goes on. In many patients, leg elevation relieves these symptoms. In more severe cases, venous insufficiency and reflux can cause changes in skin color and eventually wounds in the skin. People who have venous insufficiency can have symptoms even without visible varicose veins.
What are the risk factors for varicose veins?
Heredity is the number one factor causing varicose veins. This is due to a weakness of the vein wall and vein valves. Women are more likely to suffer from varicose veins, because of pregnancy and hormonal factors. Other risk factors include advancing age, obesity, trauma, intense weight training exercise, and occupations involving prolonged sitting or standing.
Are varicose veins a common problem?
Approximately 30% of the U.S. population has venous disease. It is more common in females and elderly patients.
Why would I need an Ultrasound study?
Ultrasound is the most useful tool for evaluating the function of the veins in the leg and plays a critical role in determining the location and cause of the varicose veins. The ultrasound evaluation is usually takes between 30 and 45 minutes per leg to complete. It is completely painless.
What is Endovenous Laser Ablation?
Endovenous laser ablation (EVLA) is procedure used to close abnormally functioning veins. EVLA is an outpatient procedure done under local analgesia. The laser is placed inside the abnormal vein through a tiny incision in the skin. The laser energy heats up the vein causing it to shrink and collapse. The procedure takes approximately 1 hour and you can return normal activities almost immediately.
What is Sclerotherapy?
For varicose veins, sclerotherapy is a very useful method to close down veins that cannot be treated with EVLA. This procedure is often performed under ultrasound guidance using a foam solution of a drug called Sotradecal.
Spider veins are readily treated with sclerotherapy. Using a special light, a small needle is placed in the tiny vein and a drug is injected to close down the vein. In most patients, several sessions of sclerotherapy over a 3 month period will be required. Most patients will see an improved 90% of the time. Often, an ultrasound study will be performed prior to sclerotherapy to ensure the other veins in the leg are functioning normally.
What is Ambulatory Phlebectomy?
Ambulatory phlebectomy is surgical procedure used to remove varicose veins. Under a local anesthetic, tiny incisions are made over the abnormal veins and they are removed.
Don’t I need all my veins?
The veins that are treated are abnormal and the body does not need them. In fact, by removing the abnormally functioning veins improves circulation in the remaining veins in the leg.
How do I know if I could benefit from these procedures?
If you have visible varicose or spider veins. Varicose veins are large, blue, bulging veins. Spider veins are small, thin red or purple veins that lay close to the skin surface.
If you have been told that you have venous reflux or venous insufficiency.
If you have symptoms of venous insufficiency. Symptoms may include one or more of the following:
- Leg pain, aching or cramping
- Burning or itching of the skin
- Leg or ankle swelling
- Heavy feeling legs
- Skin discolorations (at the ankle)
Do varicose veins get worse over time?
Yes. In many patients, the disease progresses with time. Discoloration of the skin in the ankle area occurs not infrequently. Painful venous ulcers can develop in the calf. Superficial thrombophlebitis (a condition in which a vein near the surface of the skin becomes inflamed and develops clot) may also occur.
What about pregnancy?
Many women first experience vein problems during pregnancy and these can be treated with compression stockings. Normally, within 3 months of delivery, improvement in varicose veins can be seen but veins remaining after this time likely will not improve. Patients should not undergo any of these procedures while pregnant but can be treated if they are planning future pregnancies.
Are these procedures covered by insurance?
Many insurance carriers cover venous insufficiency treatments, based on medical necessity for symptom relief.