General Questions and Answers

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Varicose veins are part of a disease process called chronic venous insufficiency. The disease process will worsen over time. The number of varicose veins and their associated symptoms will increase. How quickly symptoms progress depends on many factors including genetics, occupation (prolonged standing and sitting), pregnancy, body weight, and use of compression stockings. Compression stockings treat the symptoms but do nothing for the underlying cause of varicose veins. The underlying cause of varicose veins is best treated with endovenous laser ablation.

Most insurances cover vein procedures if the patient has symptoms of vein disease such as pain, swelling, heaviness, cramping or restless legs. Most insurances prefer a patient to have a history of trying compression stockings for at least 6 to 12 weeks. We will discuss all of these details with you on your visit. Each new patient will be able to discuss the terms of their specific insurance policy.  You will be responsible for any co-payment, co-insurance, and yearly deductible.

The varicose veins seen on the skin surface are most commonly the result of a malfunction in an underlying vein that can’t be seen. Ultrasound is used to identify the underlying source of the varicose veins and endovenous laser ablation is used to destroy it. The laser fiber is placed within the abnormal vein using ultrasound guidance and laser energy is used to seal the vein shut. The vein that is treated with the laser does not have to be removed from the leg. It is simply absorbed by the body over time. No incisions or stitches are required. Local anesthesia is used to ensure an improved patient experience during the endovenous laser procedure.

Endovenous laser ablation is used to treat the underlying cause of varicose veins. The procedure prevents the formation of subsequent varicose veins within the treatment area. Small varicose veins may disappear following the endovenous laser procedure but large varicose veins will not. They must be removed by micro-phlebectomy, followed by sclerotherapy. The vast majority of varicose vein patients are treated with a combination of endovenous laser ablation, micro-phlebectomy, and sclerotherapy.

The most common cause of varicose veins is a genetic disorder that affects the ability of leg veins to return blood to the heart. Varicose vein disease is a chronic disorder that can recur in another location following successful treatment in a previous location. The most effective treatment is a combination of endovenous laser ablation to treat the underlying cause of varicose veins and micro-phlebectomy to remove the larger varicosities, followed by sclerotherapy to close the smaller varicosities. The recurrence rate within the treated area using this treatment combination is less than 1%. Once the vein is treated, it does not come back.

Varicose veins are abnormal veins that no longer function as they should. Normal leg veins return blood to the heart in an orderly fashion. Varicose veins allow blood to pool in the legs which result in symptoms including leg pain, leg cramps, and leg swelling. Once the varicose veins and their underlying source are treated, the body redirects the blood through healthy veins and the symptoms resolve. We have many miles of veins in each leg that can easily assume the load once the problematic varicose veins are treated.

The risk everybody asks about is the risk of blood clot. This risk is very low, less than 1%. Bruising and redness of the skin along the course of the treated vein are more common. The bruising and redness typically disappear over 1 to 2 weeks. 50% of patients will notice a small amount of skin numbness directly above the course of the treated vein. The numbness is a temporary occurrence and usually completely resolves. Risks are significantly reduced when the procedure is performed by a physician who is highly experienced with endovenous laser ablation. Being compliant with compression stocking after your procedures will significantly reduce any side effects.

The majority of patients will undergo a combination of endovenous laser ablation to treat the source of their varicose veins, micro-phlebectomy to remove the varicose veins themselves, and sclerotherapy to clear associated smaller veins. After endovenous laser ablation or sclerotherapy, patients are able to return to work and full activities usually the same day or the following day. After micro-phlebectomy patients are able to return to work and full activities after two days. Patients wear a compression hose for 1 week on the treated leg after each procedure.

Varicose veins are due to a malfunction in how leg veins transport blood back to the heart. Blood abnormally pools in the leg veins as a result and causes them to significantly distend. The engorged leg veins push against surrounding nerves and leg pain can be the result. Blood is returned to the heart from the legs by the power of muscle contraction. The calf muscle does most of the work. Abnormally engorged leg veins signal the leg muscles to forcefully contract in an attempt to empty the veins and this is often felt as leg cramps.

The most common cause of varicose veins is an inherited disorder that affects the ability of leg veins to return blood to the heart. The chance of developing varicose veins is 90% if both parents have them and 50% if only one parent has them. The chance of developing varicose veins is 27% if neither parent has them. Varicose veins are more common in women due to pregnancy and hormonal factors, however, 40% of people who suffer from varicose veins are men.