Varicose veins have been around since Hippocrates, the father of modern medicine, recommended using tight bandages to compress the swollen veins. Although compression (with special elastic stockings these days) is still one of the treatments for varicose veins, today there are other options, such as those offered by Dr. Charles Dietzik, of the Vein and Vascular Institute of New Jersey.
Varicose Veins – Background
With each heartbeat, blood circulates through your arteries and veins. There’s plenty of pressure to move the blood through the arteries, but veins need help. The first “helper” is contractions of the leg muscles, which help pump blood back up against the force of gravity. But the muscles can’t stay contracted all the time, so as the pressure in the vein drops tiny flaps of tissue called valves close, keeping blood from flowing backwards. As you grow older, these valves can become less effective or fail completely, allowing blood to pool in and distend the veins.
Varicose Veins – Surgery
At one time, surgery was the only option for varicose veins. Patients would be admitted to the hospital and given a general anesthetic. The surgeon would make incisions at the top and bottom of the vein – usually the large saphenous vein – and pull or “strip” the vein out of the tissue. Smaller veins would often also come out during the stripping process, and the surgeons would also tie (or ligate) other veins. Veins that had not been removed would take over the tasks performed by the stripped veins. Patients would spend several days in the hospital. Today, this procedure is much more likely to be done as an outpatient operation, and a similar but less invasive procedure called an ambulatory phlebectomy may also be used for larger varicose veins.
Less Invasive Treatments
Since varicose veins can often be treated without surgery today, these procedures may be performed by a surgeon, but are just as likely to be done by interventional radiologists, interventional cardiologists or even family practice doctors who have had special training. The less invasive procedures can be performed in a physician’s office or outpatient clinic under local anesthesia. With the exception of strenuous exercise, most patients can resume their normal activity within a day or so. Today’s techniques include endovenous laser ablation (EVLA), microphlebectomy and sclerotherapy.
- EVLA – a tiny laser is inserted into the vein. The laser heats the vein wall, causing it to swell and collapse.
- Sclerotherapy – similar to EVLA, except a special irritant solution is injected into the vein instead of using a laser.
- Microphlebectomy – The doctor makes several small cuts on the surface of a large, bulging varicose vein, grasps one end of the cut vein and pulls it out, then moves on to the next cut and repeats the procedure.
Varicose vein treatment has come a long from Hippocrates. If you have questions or want treatment for varicose or spider veins, please contact us. We can schedule an appointment with Dr. Dietzik for an assessment.