Varicose Vein Treatment

How it works: Endovenous thermal ablation is a minimally invasive, nonsurgical new technology that allows physicians to direct laser or radiofrequency energy through a thin tube called a catheter to seal shut the varicose vein. Patients are given a local, rather than general, anesthetic.

Benefits: Recovery is quick with minimal discomfort. Other benefits: no scars, minimal risk of infection, high success rate, minimal recurrence rate, excellent long-term effectiveness, and reduced risk of complications. Because this procedure closes targeted veins but leaves them in place, there is less bleeding, bruising, and pain and a faster return to normal activity.

Recovery: A typical thermal ablation (outpatient) procedure takes just 45 minutes. You can walk immediately afterwards. The small incision can be covered with a Band-Aid. Any post-procedural pain is usually relieved with ibuprofen or acetaminophen. A graduated compression stocking must be worn for at least two weeks. Walking is strongly encouraged as part of the recovery regimen. A small minority of patients may have residual varicose veins that require additional treatment with ambulatory phlebectomy or sclerotherapy.

How it works: Your doctor injects a chemical solution into small- or medium-sized varicose veins. The solution shrinks those veins until they close. Your leg is then compressed with either stockings or bandages that must be worn for one week after treatment. In a few weeks, the treated veins dissolve and disappear as the body naturally absorbs them. Patients sometimes need two or more treatments - separated by several weeks - to significantly improve the appearance of their leg veins.

Benefits: While the same vein may need to be injected more than once, sclerotherapy is generally quite effective and doesn't require anesthesia. Sclerotherapy is preferred over laser or radiofrequency therapy for eliminating larger spider veins, smaller varicose leg veins, and veins that are too twisted for insertion of a thermal ablation catheter. Unlike ablation, the chemical solution used in this approach also closes the "feeder veins" under the skin that are causing the spider veins to form, thereby making a recurrence of spider veins in the treated area less likely.

How it works: Ambulatory phlebectomy is a micro-extraction procedure that removes large varicose veins near the skin’s surface through tiny skin punctures that require no stitches. Removal of these veins is often necessary to prevent the varicosity from reoccurring.

Benefits: Unlike traditional vein stripping, the incisions are small and bruising is minimal. The radiologist will make micro-incisions (2-3 millimeters) in your leg then use a special instrument to easily extract even large varicose veins. Scarring is generally minimal.

Recovery: You can walk immediately following the procedure. Intravenous sedation (fentanyl and versed) is used during this procedure. Patients return the following day for a dressing change, and a compression stocking is applied for the following week.