Patients who have problems with their veins may have chronic venous insufficiency (CVI). Typical symptoms of CVI include leg pain, leg swelling, varicose veins, skin discoloration and itching, open leg ulcers and painful blood clots (phlebitis). Most patients with vein problems have varicose veins. Varicose veins can be as small as spider veins or appear like serpentine swellings. Depending on your symptoms, your vascular doctor will recommend various treatments.
For patients with cosmetically unsightly veins, sclerotherapy is a good option. Although very effective, most insurance companies consider spider veins to be a cosmetic problem and will not reimburse expenses. Sclerotherapy is an office procedure at our Center that involves the injection of a chemical into the vein which causes it to shrivel up and disappear. The best results are in small spider veins but larger veins can be treated as well.
Patients with advanced disease complain of pain due to swelling. These symptoms can be treated very well with medical stockings prescribed by your vascular physician. These stockings can only be obtained with a doctor’s prescription. They come in various colors, sizes, and tightness strengths. Compression therapy is very effective but requires patients to use these stocking for life. Many patients don’t want to wear their stockings forever and often opt for removal of their veins.
Patients with large veins can have them taken care of in several different ways. Currently the treatment options include compression therapy, vein stripping, or endovenous ablation.
Open vein stripping is the traditional surgical option. An incision in the groin and several small incisions in the leg are made and the varicosed veins are removed. Although this procedure is associated with post operative leg pain, bruising, blood clots under the skin and unsightly incisions sometimes; this is the only option in advanced disease.
Endovenous ablation is a new technology. A catheter is placed inside the vein and using either radio waves or a laser the vein is burned from the inside. Although the vein is left in the leg it is no longer functional. Endovenous ablation has less pain than traditional surgery, can be done as an office procedure, and is associated with few if any scars. Complications include bruising and blood clots in the large vein in the groin.