Definition
Varicose veins are swollen, twisted, painful veins that have filled with blood.
Alternative names
Sclerotherapy? Laser treatment – varicose veins? Radiofrequency vein ablation? Intravenous thermal ablation? Ambulatory phlebectomy? Postluminous power phlebotomy? Intravenous laser ablation? Treatment of varicose veins
Varicose veins most often develop in the legs. They often protrude and are blue in color.
- Normally, the valves in your veins keep your blood flowing up toward the heart so that the blood doesn’t pool in one place.
- The valves in the varicose veins are either damaged or missing. This causes the veins to fill with blood, especially when you are standing.
The following treatments for varicose veins can be done in a healthcare provider’s office or clinic. You will receive a local anesthetic to numb your leg. You will be awake, but not in pain.
Sclerotherapy works best for spider veins. These are small varicose veins.
- Saline (saline) or a chemical solution is injected into the vein.
- The vein will harden and then disappear.
Laser treatment can be used on the surface of the skin. Small bursts of light make small varicose veins disappear.
Phlebectomy treats superficial varicose veins. Very small incisions are made near the damaged vein. The vein is then removed. One method uses a light under the skin to guide the treatment.
This can be done along with other procedures such as removal.
Excision uses intense heat to treat the vein. There are two methods. One uses radio frequency energy and the other uses laser energy. During these procedures:
- Your doctor will puncture the vein.
- Your doctor will pass a flexible tube (catheter) through the vein.
- The catheter will send intense heat into the vein. The heat will close and destroy the vein and the vein will disappear over time.
Why is the process running?
You may have varicose veins treatment to treat:
- Varicose veins that cause problems with blood flow
- Leg pain and feeling of heaviness
- Skin changes or skin sores caused by excessive pressure on the veins
- Blood clots or swelling in the veins
- Undesirable appearance of the foot
Risks
These treatments are generally safe. Ask your provider about specific problems you may have.
The risks for any anesthesia and surgery are:
The risks of treating varicose veins are:
- Blood clots
- Nerve damage
- Failure to close the vein
- Opening of the treated vein
- Irritation of the veins
- Bruises or scars
- Recurrence of varicocele over time
Before the Process
Always tell your provider:
- If you are or could be pregnant.
- About any medicines you take. This includes medicines, supplements or herbs bought without a prescription.
You may need to stop taking aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and other drugs that make it harder for your blood to clot.
After the Process
Your legs will be wrapped in bandages to control swelling and bleeding for 2 to 3 days after your treatment.
You should be able to resume normal activities within 1 to 2 days after treatment. You will need to wear compression stockings during the day for 1 week after treatment.
Your leg may be checked with an ultrasound a few days after treatment to make sure the vein is sealed.
Outlook
These treatments reduce pain and improve the appearance of the foot. Most of the time, they cause very minor scarring, bruising or swelling.
Wearing compression stockings will help prevent the problem from returning.
bibliographical references
Goldman MP, Guex JJ. Mechanism of action of sclerotherapy. In: Goldman MP, Weiss RA, eds. Sclerotherapy. 6th ed.Philadelphia, PA: Elsevier; 2017: chapter 7.
Goldman MP, Weiss RA. Venology and treatment of leg veins. In: Bologna JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed.Philadelphia, PA: Elsevier; 2018: chapter 155.
Sadek M, Kabnick LS. Varicose veins: intravenous ablation and sclerotherapy. In: Sidawy AN, Perler BA, eds. Rutherford’s Vascular Surgery and Endovascular Therapy. 9th ed.Philadelphia, PA: Elsevier; 2019: chapter 155.
