What Are Varicose Veins?
Varicose veins are veins that have become enlarged and tortuous. The term commonly refers to the veins on the leg, although varicose veins can occur elsewhere. Veins have leaflet valves to prevent blood from flowing backwards (retrograde). Leg muscles pump the veins to return blood to the heart, against the effects of gravity. When veins become varicose, the leaflets of the valves no longer meet properly, and the valves do not work. This allows blood to flow backwards and they enlarge even more. Varicose veins are most common in the superficial veins of the legs, which are subject to high pressure when standing. Besides cosmetic problems, varicose veins are often painful, especially when standing or walking. They often itch, and scratching them can cause ulcers. Serious complications are rare. Non-surgical treatments include sclerotherapy, elastic stockings, elevating the legs, and exercise.
The traditional surgical treatment has been vein stripping to remove the affected veins. Newer, less invasive treatments, such as ultrasound-guided foam sclerotherapy, radiofrequency ablation and endovenous laser treatment, are slowly replacing traditional surgical treatments. Because most of the blood in the legs is returned by the deep veins, the superficial veins, which return only about 10 per cent of the total blood of the legs, can usually be removed or ablated without serious harm. Varicose veins are distinguished from reticular veins (blue veins) and telangiectasias (spider veins), which also involve valvular insufficiency, by the size and location of the veins. Many patients who suffer with varicose veins seek out the assistance of physicians who specialize in vein care. These physicians are called phlebologists.
Left untreated, venous insufficiency of the leg can cause permanent harm. Pain and leg fatigue is commonly caused by vein problems. Dr. Argawal specializes in vein disorders, and as a surgeon, brings years of experience toward the diagnosis and treatment offered at The Vein Center of PA.
The practice’s expertise in ultrasonography is an important component in the proper diagnosis and treatment of all vein problems. The treatments offered use the latest technology that offers less invasive techniques and quicker recovery when treating varicose veins and spider veins.
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.