Most problems underlying the various vein conditions like spider veins, varicose veins and the later stages of skin changes in venous insufficiency result from an inability of the veins to return blood effectively from the feet to the heart. In fact, veins must work hard against gravity to return the blood to your heart. Normally, veins have strong valves that direct the flow towards the heart. If the valves in the veins become weakened and incompetent, blood starts refluxing backwards down the leg (venous reflux). This backward blood flow is what causes these veins to become engorged and enlarged leading to a persistently elevated pressure in the veins of the legs.
Therefore, the primary goal in the treatment of venous disease is to eliminate the point of venous reflux in the legs and shut down enlarged and malfunctioning veins to divert the blood into the healthier veins. It is also important to recognize that in10-15% of patients, the point of reflux starts higher up in the pelvis. In those patients, in addition to treating the leg veins,we may have to address and treat the pelvic veins as well (see: PCS).
Depending on the size, location of the refluxing varicose veins in your legs, different treatment methods are used…
- Initial treatment: When you are first diagnosed with VV, our vascular experts may recommend an initial period of three months of what is known as conservative therapy to include Exercise of the ankles, Elevation of the legs and Elastic stockings (easily remembered as the 3 E’s). During that time, you will undergo testing of the leg and the malfunctioning veins will be identified.
Exercise: flex and extend your ankle ten times every two hours
Elevation of the legs above your heart for short period of times to relieve the pressure
Elastic compression stockings
After the period of the initial treatment, our expert may recommend one of the following methods to complete the treatment of your legs:
- Endovenous ablation: During this in-office procedure, our specialists first administer a local anesthetic and then insert a small catheter into the vein that drains the varicosities. Through a special catheter, they are able to treat your vein with radio frequency (RF) energy, causing it to collapse. Then your body naturally disposes of the collapsed vein. Closing the refluxing veins reduces the venous pressure in the leg and is safely done in the office. Commonly treated veins are the greater saphenous vein (on the inner thigh and leg) and the short saphenous veins (on the back of the calf).
- Varithena®: is a minimally invasive procedure to treat varicose veins. Our vein specialist injects a special foamy solution directly into your vein under ultrasound guidance. This solution irritates the lining of your vein, causing it to shrink and collapse, which blocks the flow of blood. The vein will eventually become scar tissue and disappear. Your body will redirect blood flow to other veins (link to video). It is particularly effective in treating very tortuous veins.
- Vein Removal: also called ambulatory or stab phlebectomy, is performed in the office under local anesthesia. This can be done in select patients with branch varicose veins and eliminates the need to go to the hospital. Using micro incisions, the veins can be removed leaving very minimal scars, and resulting in quicker recovery.
All three treatments are minimally invasive, and there is little downtime associated with them.
You will be given detailed aftercare instructions (link to pre and post instructions), which typically include:
- Compressing the leg with medical stockings
- Resuming normal activities to encourage blood flow
- Taking over-the-counter pain relievers for any soreness
At South Charlotte General and Vascular Surgery, we are committed to help you preserve your legs to protect your lifestyle.
To learn more about how you can get rid of unsightly and uncomfortable varicose veins, call South Charlotte General and Vascular Surgery or book an appointment online with our varicose vein specialists.