Varicose Veins & Treatments

Veins are blood ves­sels that car­ry blood back to the heart. To keep blood mov­ing toward the heart, veins have one way valves. When the valves break­down, blood does not flow well and can cause Chron­ic Venous Insuf­fi­cien­cy (CVI) and vari­cose veins. The abnor­mal flow of blood is typ­i­cal­ly referred to as reflux’ since the blood moves back­wards and for­wards. Venous reflux occurs most often in veins clos­est to the skin (super­fi­cial veins) and vari­cose veins can be blue, red, or flesh-col­ored. They typ­i­cal­ly look like cords under the skin and can be twist­ed or bulging. Spi­der veins are like vari­cose veins, but much small­er. The look like small tree branch­es on the sur­face of the skin.

Chron­ic venous insuf­fi­cien­cy and vari­cose veins can cause symp­toms in 50% of adults. Fac­tors that can increase a per­son­’s risk of CVI and vari­cose veins is fam­i­ly his­to­ry, increas­ing age, stand­ing occu­pa­tions, lack of move­ment, obe­si­ty, injury and preg­nan­cy. The most com­mon symp­tom is ankle swelling that pro­gress­es up the foot. Oth­er symp­toms can be dull aching pain, heav­i­ness” of the leg, fatigue, rest­less legs, night time cramp­ing, itch­ing or burn­ing of the skin. Many patients need to sit down in the after­noon and ele­vate their legs to relieve symptoms.

In more advanced cas­es, break­down of the skin may cause ulcers. Venous ulcers occur in 1% of the pop­u­la­tion and 70% of all leg ulcers have a venous com­po­nent. Venous ulcers occur due to the dilat­ed veins, their asso­ci­at­ed inflam­ma­tion, and some­times minor trau­ma. Small injuries can grow into large wounds in the pres­ence of chron­ic venous insuf­fi­cien­cy. Venous ulcers can heal and then re-occur and per­sist for long peri­ods of time if not prop­er­ly treated.

The great saphe­nous vein is the largest super­fi­cial vein in the leg and goes from the top of the foot to the groin. When the saphe­nous vein valves break down and cause reflux, the dis­eased saphe­nous vein is often the main cause of chron­ic venous insuf­fi­cien­cy and vari­cose veins. The tra­di­tion­al oper­a­tion was saphe­nous vein strip­ping’. This pro­ce­dure required large inci­sions, had a painful recov­ery, and often had to be done in the hos­pi­tal or out­pa­tient sur­gi­cal center.

A less inva­sive pro­ce­dure is now per­formed in the office. Endove­nous Laser Treat­ment (EVLT) is a min­i­mal­ly inva­sive and clin­i­cal­ly proven pro­ce­dure. Under local anes­the­sia, a laser fiber is insert­ed into the vein using ultra­sound guid­ance. After prop­er­ly numb­ing the leg, the laser fiber is acti­vat­ed and the vein walls scar and shrink so blood can no longer flow though the vein. With the saphe­nous vein treat­ed, blood then flows into healthy veins toward the heart. 

Watch a video on endove­nous laser treatment.