New treatments available – painless

Easy, state-of-the-art treatments available for varicose veins

Bulging, ropey, varicose veins aren’t simply unsightly, they are a serious health concern, causing anything from discomfort to debilitating pain and blood clots. In the not-so-long-ago “old” days, vein stripping was the only real option for treating varicose veins. The procedure was as invasive and unpleasant as the name implies. Thankfully, breakthroughs in technology have moved us into a kinder, gentler era of varicose vein treatment. With today’s new minimally invasive and nearly painless treatments, there’s no need to live with the pain of varicose veins, or with self-consciousness over the way they look. Veins, which carry blood back to the heart for recirculation, are equipped with one-way valves. A varicosity is caused when the valve in a vein fails, allowing blood to flow backward and pool in that vein. This is why varicose veins get so big and push above the surface of the skin. Valves can’t be repaired, so the only option is to literally take the affected vein out of circulation and let blood reroute itself through healthy veins. Stripping was the old way of removing the vein—a procedure done in the hospital under general anesthesia, in which the offending vein was pulled out of the leg with a stripper tool. The new procedures available today are a vast improvement.

The two new state-of-the-art procedures— Endovenous Laser therapy (EVLT®) and Closure®—are very similar in how they work, how they’re performed, and also in the experience and results patients can expect. Both use heat to close affected veins. Once the problem vein is closed, blood naturally reroutes through other healthy veins. Even though one or more veins have been taken out of service, overall circulation is actually improved because the sluggish pooling caused by the varicose vein is gone. The closed vein simply is reabsorbed by the body over time.
Both EVLT® and Closure® are usually done on an outpatient basis in a doctor’s office or dedicated vein clinic with a simple local anesthesia. Treatment typically takes less than an hour. A tiny tube, or catheter, is inserted through a small puncture or incision in the thigh and guided by ultrasound to the affected vein.

Once in place, heat is delivered to the catheter, which is then slowly withdrawn, shrinking and sealing the vein behind it.

Patients walk out ready and able to resume normal life. After treatment, a compression stocking is usually applied on the treated leg. Patients are instructed avoid heavy lifting for about two weeks—but regular exercise is not only allowed immediately afterward, it’s recommended. Bruising or scarring is minimal to nonexistent, and patients experience noticeable improvement in their symptoms within the first week or two as healthy veins restore the normal flow of blood. Published data on both procedures suggest a success rate of at least 90 percent—and nearly 100 percent of patients would recommend the procedures to others.

About half of all Americans over the age of 50 have varicose veins, with women accounting for about three-quarters of cases. You can manage your risk of getting varicose veins by staying active and managing your weight, but other risk factors, including age, gender, and genetics, are out of your control.

Left untreated, varicose veins will likely get worse. If your veins have recently become more swollen, or tender and warm to the touch, or if you have sores or a rash on your leg, it’s important to see a doctor right away. Other symptoms that are commonly seen with vein disease include: leg cramps, itching, aching and fatigue with prolonged standing or sitting, swelling and restless legs. Even in the absence of these most severe symptoms, if you’re concerned about varicose veins, or about smaller and less pronounced (and less medically significant) “spider veins,” make an appointment with your regular doctor or with a doctor who specializes in vein care. He or she can evaluate your situation and recommend appropriate measures. With the new, virtually painless technologies, it hurts more to wait.

Dr. James (Bo) Johnson, MD, FACS is Medical Director of Rocky Mountain Vein Clinics, PC of Billings, MT and Cody, WY.

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