From the Doctor's Desk: Varicose Veins

Modern medicine has come a long way, but it's not always easy to determine what courses of treatment are right for you. Dr. Peter Caravella is here to help you understand your options and break down some of the more puzzling aspects of the medical industry. Today he's going to shed some light on a common problem: varicose veins. 

Varicose veins, also called “varicosities,” are painful, cosmetically disfiguring, enlarged veins of the legs. Frequently, they cause loss of strength secondary to swelling, heaviness, and cramping of the lower extremities. More serious cases can lead to leg ulcers or external bleeding; minor cases are often unsightly.

Varicose veins affect 30% of both men and women. Conditions and habits that may put you at risk are pregnancy, obesity, smoking, and heredity; some individuals are just genetically predisposed to varicose veins. 

The condition typically arises from “venous insufficiency” or “valvular incompetence.” In layman’s terms, the venous blood – blood without oxygen in it – instead of flowing up the leg and back to the heart, turns around and travels backwards. This results in enlargement of the veins and in varicosities. 

Standard non-operative treatments include leg elevation and compression stockings. “Vein stripping,” an older, less effective and more invasive surgical procedure, has been replaced by laser vein ablation (endovenous laser ablation) EVLA. The latest techniques have a 97% success rate, and very few complications.

Laser ablation is an in-office procedure done under local anesthetic. In skilled hands, it takes less than ten minutes and can return patients to work in twenty-four hours. The technique is done under ultrasound guidance and entails placing a catheter into the diseased feeding vein (typically the greater saphenous vein), inserting a laser into the catheter, and ablating the vein using laser energy. This will close the vein and prevent “refluxing” (backward flowing blood), and the eventual varicosities will shrivel and disappear over the next six to twelve weeks. 

If you have varicose veins, your best bet is to seek treatment from a doctor who is trained in the latest techniques. Low downtime and minimal invasiveness mean suffering from this condition is no longer necessary.