Improved Varicose Vein Treatments Avoid Surgery and Scarring
More than 80 million Americans suffer from some form of vein problem. Varicose veins affect 1 out of 2 people aged 50 and older, and well over half of these are women.
Varicose veins are commonly found on the back of the calves or inside the leg and are usually dark-purple or blue in color. They are often swollen and twisted and usually bulge above the surface of the skin.
Why do they occur? Valves in a normal leg vein prevent the blood from flowing backwards as it moves up the legs back to the heart. Leg veins and their valves have to endure a great deal of pressure because gravity makes it hard to carry blood from the far end of the body back up to the heart. When these valves become weak, blood can leak back into the vein and collect there. Pooled blood enlarges the vein and makes it tortuous and varicose.
Many factors increase a person’s chances of developing varicose veins. These include increasing age, a family history of vein problems, hormonal changes (like pregnancy and estrogen supplements including birth control pills), obesity, leg injury, and prolonged standing.
Varicose veins tend to enlarge and worsen over time. Some common symptoms of varicose veins include: aching pain made worse by standing, easily fatigued legs, and heaviness or swelling of the legs. Severe varicose veins can cause skin changes, rashes, and occasionally numbness of the legs. They may also cause health problems, such as blood clots and infections.
You should consider seeing a doctor about your varicose veins if you have aching pain with prolonged standing, or if there are sores or a rash on your legs near the ankles. After an examination, the physician will take a sound wave picture (ultrasound) of your legs to find the cause and severity of the problem. You should look for a board-certified vascular surgeon or a doctor who specializes in vein diseases to treat your legs. The surgeon will explain the best treatment options for your condition and lifestyle.
Among the treatment options for varicose veins, laser treatment for the deeper varicose veins of the legs (the saphenous veins) has been a huge advance in therapy. It is a relatively new procedure, and has been approved by the Food and Drug Administration for the treatment of varicose veins since 2001. Laser treatment has replaced open surgery for the vast majority of patients with severe varicose veins. The technique is not invasive and can be done in the surgeon’s office. For many patients with varicose veins, the laser treatment is covered by insurance or Medicare.
In the office the surgeon puts a very small tube called a catheter into the vein. Once inside, the catheter sends out laser energy in the form of heat to shrink and close the vein wall. Healthy veins around the closed vein maintain the normal flow of blood up the leg. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink and sometimes disappear completely after treatment. When needed, remaining varicose veins can later be treated with other modes of therapy such as sclerotherapy and mini-vein removal. These procedures are also done in the office.
Laser treatment of varicose veins takes about one and one-half hours to perform. It is done in the office with the patient awake for the procedure. Side effects usually include bruising and swelling along the length of the vein, and maybe some “pulling” pain. These are treated with compression dressings or stockings, an anti-inflammatory pill such as ibuprofen, and a heating pad. Severe side effects, like blood clots in the deeper veins, are extremely rare.
A patient may return to most normal activities after the procedure. Some patients find it helpful to take a day or two off work. The patient is encouraged to walk at least 20 minutes twice daily to promote blood circulation and healing. One should avoid any heavy lifting or any prolonged sitting/standing/squatting for one week after the procedure. Exercising is fine, but one should avoid any gym workouts, aerobic exercises, or weight training for one week.
It is important to remember that venous disease is a chronic disease like diabetes. It can be controlled but never cured. Varicose veins that are treated with the laser will not recur. However, new veins may develop in their place. That is why an annual patient follow-up with your vascular surgeon is recommended following a vein procedure to treat any new vein problems that may develop over time.
In summary, laser treatment of varicose veins is a very new and exciting mode of therapy. It provides excellent relief of symptoms in selected patients, can be done in the office, and in many cases is covered by insurance or Medicare. Contact a board-certified vascular surgeon who is trained in this procedure if you wish to get further information.
Jack Shellito, MD FACS and Robert Vorhies, MD are both board-certified Vascular Surgeons at Wichita Clinic. They are accepting new patients and can be reached at 316-609-4440.
SIDEBAR
The National Women’s Health Information Center at http://www.4woman.gov/faq/varicose.htm has more information about the cause, prevention and treatment of varicose veins.
Improved Varicose Vein Treatments Avoid Surgery and Scarring
Jack Shellito, MD FACS
Robert Vorhies, MD
Originally published in WOMEN’S FOCUS MAGAZINE
Sept/Oct 2006
(Granted permission for reprint).
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