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If you suffer from varicose and spider veins, you are not alone. It’s estimated that more than 80 million Americans suffer from some form of venous disorder. Some people seek treatment for visual improvement; many seek relief from pain or discomfort.

Varicose veins and spider veins

Veins, unlike arteries, carry blood against the force of gravity. They rely on leg muscle contraction and one-way valves inside the veins to carry blood back toward the heart.

If the valves in the veins fail, gravity keeps blood from flowing back to the heart efficiently. This produces a back-up of blood. As a result, pressure builds up and the diseased veins become enlarged, eventually bulging to the skin’s surface. This process is the same for larger veins that are called varicose veins and smaller veins called spider veins. A visual inspection of your legs and a discussion about your medical history is used to determine the cause and severity of the problem.

Causes of varicose veins and spider veins

Heredity is the number one contributing factor that causes varicose and spider veins. Some predisposing factors include aging, standing occupations, and leg injury or trauma.

It is common for varicose veins to become more prominent during pregnancy and worsen with successive pregnancies.

Symptoms

Varicose veins are known to cause symptoms that may include:

  • leg aching
  • pain
  • heaviness
  • fatigue
  • ankle swelling
  • muscle cramping
  • restlessness
  • itching
  • burning

Symptoms often worsen with prolonged standing. Skin changes may occur. These include brownish discoloration over the veins or near the ankle. A purple discoloration related to congestion of small veins around the foot and ankle may also develop. Varicose veins may also lead to complications such as blood clots, bleeding, rashes, and ulceration.

Benefits of vein treatment

Vein treatment causes abnormal veins to disappear and symptoms to improve. It prevents more extensive vein disease from developing and also helps to keep serious complications from occurring.
There are two general treatment options:

  • conservative measures, such as compression stockings;
  • corrective measures, such as endovenous thermal ablation, chemical ablation, phlebectomy (removal of the vein), sclerotherapy, and light source/laser treatment.

In many cases, a combination of treatment methods works best.

St. Anthony’s Heart Specialty Associates Vein Services offers five treatments for varicose veins: endovenous thermal ablation, ultrasound-guided sclerotherapy and ambulatory phlebectomy, which are medical procedures; along with sclerotherapy and laser treatments, which are cosmetic procedures.

Endovenous thermal ablation

Endovenous thermal ablation is a treatment alternative to surgical stripping of varicose veins. With ultrasound visualization, a small catheter or tube is inserted into the damaged vein, usually through a needle. Thermal energy, or heat, is then delivered inside the vein, which causes the vein to collapse and seal shut. The procedure is done under local anesthesia. After the procedure, a leg wrap or compression stocking is usually placed on the treated leg for 1-2 weeks. Patients are able to walk immediately after the procedure and most individuals are able to return to work the next day.

Ultrasound-guided sclerotheraphy

Ultrasound-guided sclerotheraphy is another treatment alternative to surgical removal of varicose veins. With this procedure, chemical irritant, called a sclerosant, is injected into the vein while the doctor observes the injection process on an ultrasound screen. This allows veins that are below the surface of the skin to be treated, avoiding surgical removal. This technique causes the vein to collapse and seal shut, and may be performed with liquid or foamed sclerosant. This technique is used to accelerate the healing of venous stasis ulcers as well. The terminal interruption of the reflux source (TIRS) procedure reduces venous hypertension at the local level, thus allowing healing to occur. In most cases, the wound will heal in a few weeks.

Performed under local anesthesia, a leg wrap or compression stocking will be placed on the treated leg for 1-2 weeks. Patients are able to walk immediately after the procedure and most patients are able to return to work the next day.

Ambulatory phlebectomy

Ambulatory phlebectomy is a method of surgical removal of varicose veins at the surface of the skin. Small incisions are made next to the vein and sections of vein are removed through these small nicks. This is performed under local anesthesia. Afterwards, a leg wrap or compression stocking is worn for a short period. Generally, normal activities may be resumed after several days.

Sclerotherapy

Sclerotherapy can be used to treat both varicose and spider veins. A tiny needle is used to inject the veins with one of several different kinds of chemical irritant, or sclerosant, that irritates the lining of the vein. In response, the veins collapse, seal shut, and are reabsorbed by the body. The number of sclerotherapy treatments needed is variable, depending on the number, size, and type of veins being treated.

Typically, a patient will receive several injections per treatment session. The procedure is almost always performed in a doctor’s office, and generally, normal activities can be resumed after sclerotherapy. Compression stockings need to be worn for several days after treatment for best results.

Surface laser/light source treatment

A variety of laser/light source treatments are available today. A light beam creates heat inside treated veins that causes them to be sealed off and reabsorbed by the body. By and large, surface laser/light source treatments are used only to treat the smallest of spider veins. Multiple treatments are regularly required. This requires no anesthesia and is usually performed in the doctor’s office. Normal activity can be resumed following treatment. Compression stockings will need to be worn for a few days after treatment.

Treatment results

Technological advances in evaluation and treatment methods allow spider and varicose veins to be treated more effectively and safely than ever before. The success of any treatment method depends of careful assessment of the underlying problem and the skill and experience of the physician and staff providing the treatment.

The most important cause of varicose veins is heredity; thus, even successful treatment does not eliminate the genetic disposition that may cause other veins to fail in the future.

Complications

Generally speaking, complications related to varicose vein treatment are rare. Serious complications, such as life threatening allergy and/or blood clots, may occur with any treatment for large varicose veins. Infection may occur with any procedure, and skin burns may occur with any laser/light source treatment or sclerotherapy. Minor complications may include temporary discomfort, bruising, swelling, discoloration, or reddish blushing of the skin following treatment.

To understand more about the specific expectations of any varicose vein treatment, it is important to discuss these or any other concerns with your treatment provider when considering your procedures. Although these risks are small, no procedure is risk-free.

Schedule an appointment

St. Anthony’s Heart Specialty Associates Vein Services is accredited by the Intersocietal Accreditation Commission (IAC) in venous treatment and management. St. Anthony’s was the first facility that serves patients from Missouri or Illinois to be accredited and was the 20th facility in the country to be accredited.

Vein Services are located at 10012 Kennerly Road, Suite 204, St. Louis, MO 63128. Call 314-880-6622 to schedule a consultation today.