Methods Of Treatment

There are several methods by which varicose veins can be treated. The specific procedure or combination of procedures recommended is based upon the severity of the condition. Some treatment options include the following:

Endovenous Laser

In some cases, underlying vein disease may be treated with an advanced ultrasound guided laser technique through a single puncture or an incision that is less than a quarter of an inch. Sometimes referred to as endovenous laser or "endolaser", this approach allows treatment of vein disease that in the past required stripping through large incisions. Our many years of experience with ultrasound guided vein therapy makes us uniquely qualified to offer this advanced ultrasound guided laser method to our patients. This procedure can be performed in the office. CLICK HERE TO LEARN MORE!!

Conservative Treatment

When a patient has mild varicose veins with mild symptoms, then oral medications and special compression stocking may be useful in treatment to relieve symptoms. However, one must be aware that varicose veins is a progressive condition, and therefore in spite of using medications and stockings, the disease condition can increase in severity. Therefore regular follow up with your physician is important.

a) Medications:

Various medicines are advocated which have varying degree of effect. One of the commonest used is extract of the Horse chestnut tree bark, available over the counter. This is reported to decrease the burning symptoms in cases of spider veins, and help in ankle swelling.

The most extensively studied drug is MPFF ( Micronised purified Flavenoid Fraction), available as Daflon. In many randomized trials it has been shown to help in symptoms of fatigue and leg pain, decrease the ankle edema, and help in earlier healing of Varicose ulcers. However, it needs a doctors prescription, who will suggest this drug if he determines you may benefit from it.

b) Graduated Compression Stockings:

Stockings are the mainstay of treatment of early varicose veins. They not only help to relieve the symptoms of leg pain and cramps, but also help to decrease the rate of progression of varicose vein severity.

c) Regular Exercise:

Regular walking or running activates the calf pump, and helps in emptying the blood from the veins and returning to the heart.
1. Reduces symptoms such as aching & pain
2. Reduces ulcer recurrence
3. Speeds resolution of superficial phlebities & DVT
4. 30 Minutes daily is Best
5. Lower extremity is helpful(Stay away from heavy weight lifting or other strenuous activity)

SCLEROTHERAPY

This is technique whereby small amounts of medications are injected directly in to the varicose veins. The acidic nature of the sclerosant medication acts on the inner vein valve, causing spasm of the vein and subsequent closure of the vein. The sclerosant medicine can be used in various concentrations depending on the diameter of the treated vein. It can be injected either in the liquid form, or by preparing a foam preparation using air or carbon dioxide. It is injected via tiny needles into the veins, either by direct visualization, or under the guidance of ultrasound in cases of deeper veins.
The commonly used drugs are Sodium Tetradecyl Sulphate or Polidocanol.

Foam Sclerotherapy

Instead of using a sclerosing agent in its liquid form, this technique involves a foam sclerosing solution. The principle behind foam sclerotherapy is the same one that makes shaving cream so effective: foam has a greater surface area than liquid, which increases the likelihood that it will cling to its target surface. Foam sclerotherapy irritates the vein and causes it to shrink more quickly than liquid sclerotherapy.

Surgical Ligation and Stripping

Surgical stripping is reserved for only the most severe 10% of varicose vein cases. It is usually used to remove the main superficial vein (the long saphenous vein), which runs from the groin to the ankle. This collects blood only from the skin. Removing the veins will not affect the circulation of blood in the leg because veins deeper in the leg take care of the larger volumes of blood. Vein stripping" is the oldest method for treatment of varicose veins. The first surgery was first performed 100 years ago. Incisions are made to dissect down into the leg and locate underlying diseased veins. Long "strippers" of various designs are passed through these deeper veins and then the stripper and vein are pulled out of the leg together. This is almost always performed using general anesthesia (with the patient completely unconscious and connected to a ventilator) due to the tissue trauma involved. The need for general anesthesia requires that the surgery be performed in a hospital or equivalent surgical facility. Surface vessels are commonly removed at the same time through several incisions measuring 1 to 4 inches each. Recovery times vary widely, but are typically about two to four weeks.

The 2 main types of surgery for varicose veins are

1. Mini-phlebectomy
2. Ambulatory surgery
Mini-phlebectomy is an in-office surgical procedure performed under local anesthesia to remove the faulty area of a vein through minute incisions. Ambulatory surgery is performed in the hospital to remove the long saphenous vein through two small incisions at the groin and at the ankle or knee.

Side Effects of Surgery

Surgery can leave permanent scars.
Serious side effects are uncommon
However, with general anesthesia, there always is a risk of cardiac and respiratory complications.
Bleeding and congestion of blood can be a problem, but the collected blood usually settles on its own and does not require any further treating.
Wound infection, inflammation, swelling and redness can occur.
A very common complication is the damage of nerve fibres around the veins which can lead to pain.

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