Treatment of varicose veins
Thomas Bryant, MD, is a surgeon who practices at East Morgan County Hospital in Brush, Colo.
Question: I think I have varicose veins. What can I do to get rid of them?
Answer: Varicose veins are enlarged veins which often appear in the legs. Normal veins have a series of valves which prevents the pooling of blood in the lower leg. In varicose veins the valves are defective and the veins stretch out. Gravity pulls down on the blood in leg veins.
They are caused by several factors: genetics, being female, pregnancy, standing for protracted periods and high-heeled shoes. Some people with no known risk factors still develop varicose veins.
It is estimated that about 20 percent of the adult population has some degree of vein disorder. The figure is higher above the age of fifty.
Varicose veins cause pain and other unpleasant symptoms. They may also cause blood clots and inflammation. The treatment of such veins is considered a medical procedure.
We currently use endovenous laser therapy to treat varicose veins. This is a procedure to seal the major varicose vein shut without removing it.
A small laser fiber is threaded up the abnormal vein beginning near the level of the knee. The laser is activated and slowly removed from the vein. This results in a closure of the vein. In addition, side veins can be removed through extremely tiny incisions through a procedure known as mini phlebectomy. These procedures are done at the same session as an office procedure using local anesthesia.
The veins which cause the symptoms are part of the superficial venous system which carries only 10 percent of a leg’s blood back to the heart. Abnormal veins carry even less. There is also a deep venous system which carries the other 90 percent. The deep system is not disturbed in the procedure. Prior to recommending a vein procedure, both vein systems are tested to make sure that the deep system is functioning and to confirm the diagnosis of an abnormal superficial system.
We evaluate patients with a non-invasive test known as a duplex study. This study combines an ultrasound with a dopler study. This allows a comparison between vein size and blood flow.
For the first two weeks, it is necessary to wear elastic compression stockings. This compresses the treated veins as they heal in a closed position. There may be some bruising which slowly resolves. Patients are encouraged to be up and about beginning the day following the procedure.