What Are Varicose Veins?
Telangiectasias are small dilated blood vessels near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter. They can develop anywhere on the body but are commonly seen on the face around the nose, cheeks, and chin. They can also develop on the legs, specifically on the upper thigh, below the knee joint, and around the ankles.
Some telangiectasia are due to developmental abnormalities that can closely mimic the behaviour of benign vascular neoplasms. They may be composed of abnormal aggregations of arterioles, capillaries, or venules. Because telangiectasias are vascular lesions, they blanch when tested with diascopy.
What are Varicose & Spider Veins?
The blue vessels under the skin are called varicose veins and are dilated and ropy. Often they are a quarter inch or more in diameter and soft. They can become larger and harder if they develop phlebitis or a blood clot. The small blue and red vessels seen within the skin, usually on the legs, are called spider veins. Sometimes they appear on the face and chest.
What causes Varicose & Spider Veins?
Usually, too much pressure inside the veins (venous hypertension) causes the problem. The main vein which drains the skin circulation is called the Great Saphenous Vein. Veins that branch from this main vein stretch open when too much pressure develops, causing them to become varicose and spider veins. Leg veins contain one way valves which push blood back up to the heart. If these valves become abnormal the blood backs up inside the vein and often flows backwards. This extra pressure generally is the main cause of varicose and spider veins.
Can Varicose Veins cause damage or pain to your legs?
Left untreated, varicose veins can cause permanent damage. Pain is a common occurrence. Contrary to some beliefs, these are not just cosmetic conditions. High vein pressure can cause aching, fatigue, and wormy restless type feelings in the legs. When fluid leaks into and around the tissue in the lower legs, swelling of the leg and the ankle occur. This can lead to black discoloration and inflammation and even ulceration as the problem continues. If not treated, some of these changes can become permanent.
Who should receive vein treatment?
Treatment is suitable for anyone who has varicose or spider veins. If it is determined that the varicose veins have been caused by an incompetent saphenous vein, Doctor Agarwal will recommend an endovenous ablation procedure.
What treatments are available?
Previously, doctors used surgical stripping and ligation methods, which were often painful and had long recovery times. Dr. Agarwal uses newer and innovative techniques to treat incompetent veins utilizing radio frequency waves. State-of-the-art Endovenous Ablation is the modern way to eliminate and incompetent saphenous vein. This new procedure causes little discomfort and can be performed usually without a surgical incision. The long-term results from the procedure are excellent.
Another new technique, developed in Europe, is called Micro-phlebectomy. This method removes bulging varicose veins through tiny openings. Sclerotherapy and laser treatment are also used to eliminate painful and unsightly varicose and spider veins.
How are Spider Veins treated?
Spider veins are reticular veins (the larger feeder veins) are treated using a combination of sclerotherapy (injections of special solutions) and laser. The solutions are injected into the veins with tiny needles. The solutions destroys and dries up the treated veins.
Our vein treatment capabilities include a modern laser unit which is designed to treat sensitive areas with fine spider veins.
Endovenous Ablation using Radio Frequency (The VNUS Closure procedure)
Endovenous radio-frequency using the VNUS Closure procedure is a modern method to remove the abnormal saphenous vein without using stripping or making incisions.
A special catheter is inserted inside the saphenous vein using ultrasound guidance. Using RF energy the inside of the vein is heated and the lining of the vein is destroyed. The deep veins in the legs then spontaneously handle skin blood flow. The VNUS Closure procedure is now approved by Medicare and most major insurance programs.
Advantages to these new procedures
Endovenous ablation is less invasive, less traumatic and causes very little discomfort. Patients are able to return to their normal activities in a much quicker time that with traditional treatments. Of course, each patient will receive specific instructions depending on the treatment chosen.
Risks and Complications
As with any medical and surgical procedures, complications can occur in spite of all the safeguards. Complications have been shown to be between .1% and .2% in the United States. Treatments should be considered very safe. The thick and adherent clot rarely enters the deep vein. A breakdown of the skin can sometimes occur with injection treatments but this is a very rare occurrence.
Other rare side effects such as visual aura and dizziness after injection treatments have been described.
Where are the procedures done?
Endovenous ablation is performed at the Pennsylvania Vein Center on an outpatient basis. Spider vein treatments are also performed here at the Pennsylvania Vein Center.