Many varicose vein sufferers delay treatment because they believe the only cure for the painful condition is extensive surgery. While surgery may have been the only option decades ago, today’s minimally invasive varicose vein treatments require little or no anesthesia, are virtually painless, and allow patients to quickly return to their normal activities.
Twenty years ago, the primary medical intervention for varicose veins was vein stripping or ligation (the surgical tying off of the vein). Typically performed in a hospital under general anesthesia, the affected vein was either tied off to prevent the blood from pooling in the vein (the main cause of varicose veins), or “stripped” (removed) through a small incision.
Today, vein stripping is rarely advised except in cases of superficial venous thrombosis (a blood clot in the leg) or phlebitis, an inflammation in the vein sometimes caused by a blood clot. In the past, even patients without those conditions had to undergo vein stripping, which forced them to endure a long, sometimes painful recovery period. As a result, the procedure has been replaced by newer, less invasive methods that eliminate varicose veins with less discomfort and downtime for the patient.
Modern Varicose Vein Therapies
Thanks to state-of-the-art surgical techniques, varicose vein patients dodge a major operation and lengthy recovery time. Current varicose vein treatments are performed on an outpatient basis and result in fewer side effects. However, which method is ultimately used depends upon the size of an individual’s varicose veins. Here’s a rundown of procedures frequently used to treat varicose veins.
Sclerotherapy. Reserved for small varicose and spider veins, sclerotherapy uses extremely thin needles to inject a sclerosing solution into the vein. Because the needle is so small, patients don’t feel any pain and don’t require anesthesia. The substance irritates the vein, causing it to collapse and be absorbed into the body. The appearance of varicose or spider veins gradually diminishes within several weeks. An offshoot of sclerotherapy is ultrasound-guided sclerotherapy. In that procedure, ultrasound imaging guides the surgeon to the damaged vein, and the vein is then injected with the sclerosing agent.
Endovenous Laser Therapy. Endovenous laser therapy (EVLT) has replaced vein stripping as the standard treatment for varicose veins. For this procedure, the surgeon applies local anesthesia in the area of the damaged vein. A laser probe inserted into the vein pulsates heat that shrinks and collapses the vein wall. Blood is then re-routed to healthier veins. After EVLT, patients may notice slight bruising and tightness in the leg, but those symptoms dissipate after a few days. Patients can also return to their normal activities the same day as the procedure, although exercise and heavy lifting are not recommended.
Microphlebectomy. In cases where sclerotherapy cannot address large varicose veins or the veins are too small for laser ablation, microphlebectomy becomes the next option. Like EVLT, this minimally invasive procedure begins with a local anesthetic. Inserted through a small incision, an instrument pulls out the vein. Due to the small size of the incision, no sutures are needed. Patients are left with virtually no scarring and can resume their daily activities within a day.
Following treatment, it’s recommended that patients wear compression stockings. These elastic garments aid the healing process by supporting circulation from the legs to the heart. Over-the-counter pain medications can relieve any mild discomfort from the procedure.
As with any surgical procedure, varicose vein treatments pose some risks, although complications are rare. A doctor will discuss those risks, which may include infection, numbness, deep vein thrombosis, or phlebitis.
Is it Time to Treat Your Varicose Veins?
Varicose vein patients no longer face the prospect of major surgery and weeks of recovery to treat the painful, swollen veins on their legs. At the Vein & Vascular Institute, we offer the minimally invasive therapies detailed here, among others. Make an appointment today and our expert staff will discuss how to eliminate your varicose veins with one of several nearly pain-free procedures.