Varicose Vein Treatments
Modern treatment innovations like endovenous laser treatment (EVLT®), radiofrequency ablation (ClosureFastTM), VenaSealTM, ultrasound guided foam sclerotherapy and contemporary surface sclerotherapy have made varicose vein treatment with surgery almost obsolete. The non-surgical methods that Vein Specialists of Northern California employ for varicose vein treatment leave no scars and involve no down time. There are no incisions, no general anesthesia and no time spent in a hospital. After out-patient treatment with endovenous laser or foam sclerotherapy you can return to work, exercise and your normal daily routine immediately. Below you’ll find a more in-depth account of the varicose vein removal methods and procedures that will get you on track to healthier, younger looking legs.
What are Varicose Veins?
Abnormally dilated and bulging veins, otherwise known as varicose veins, affect a surprisingly high percentage of adults at some time in their lives. Associated symptoms of varicose and spider veins can include aching, throbbing, excessive fatigue, itching, burning, restless legs syndrome and cramping. Unaware that any non-surgical remedy is available, many vein disease sufferers resign themselves to their discomfort and altered lifestyle.
Causes of Varicose Veins
Both spider veins and larger varicose veins are caused by abnormally high pressure within the affected vein. In most cases the cause of this high pressure is hereditary. Larger varicose veins have abnormal valves that fail to keep blood flowing toward the heart. Blood flowing downward instead of upward in the legs causes high pressure that makes the vein walls stretch out until the vein bulges from the skin surface.
Treatments for Varicose Veins
Elastic stockings, otherwise known as graduated compression hose, provide external support to failing varicose veins, giving temporary relief of symptoms and, to some extent, correcting the direction of flow. For many people, this simple remedy may be all that’s needed. Though many insurance companies currently demand a supervised trial of prescription strength elastic stockings before other treatments are considered, it is important to understand that the corrective effect of graduated compression hose lasts only as long as the stockings are worn. There is no evidence in the medical literature that these stockings will eliminate varicose veins or have any long term curative effect.
Duplex-Guided Sclerotherapy and Foam Sclerotherapy
In the case of large varicose veins in which the sources of abnormal flow are out of sight below the skin surface (and therefore in the past only treatable by surgery), duplex ultrasound is used to identify these sources and to enable the physician to guide the tip of the injecting needle directly to these sites. After treatment the vein gradually disintegrates within the body. Similar treatment without ultrasound guidance is extremely effective for spider vein removal.
At Vein Specialists of Northern California, the solution used for treatment is sodium tetradecyl sulfate, “STS” or Sotradecol®. Vein Specialists of Northern California prefers this solution to hypertonic saline (concentrated salt water, used by many dermatologists), which is more painful and less effective on larger veins. A recent innovation in sclerotherapy for varicose veins is the use of foam STS. Foam becomes less diluted than liquid when injected into the vein allowing more high-strength solution to come into contact with the vein wall. The result is that less solution has to be injected in order to get the same effect, and the long term success rate is higher.
An extremely fine needle is used for all injections making anesthetic unnecessary. Even people with needle phobia find foam sclerotherapy surprisingly painless and easy.
Endovenous Laser Treatment
Endovenous laser treatment is called different names (EVLT®, EVL®) by different laser companies. EVLT® was approved by the FDA in 2001 and is an office-based procedure that takes about 30 minutes from beginning to end. Endovenous laser treatment uses laser energy delivered through a thin fiber-optic fiber to treat the underlying cause of the varicose veins. Endovenous laser treatment is performed under ultrasound guidance with local anesthesia allowing a more gentle, minimally-invasive approach to the treatment of varicose veins. There is minimal to no pain and virtually no scarring. During the procedure, the area of the leg affected is locally anesthetized and a thin laser fiber is inserted into the abnormal vein, delivering the laser energy. This laser energy closes off the vein to any future abnormal blood flow. Your body will continue to use other healthy veins to return blood to the heart. Patients often see and feel immediate improvement and can resume normal activity the next day.
Most patients will wear elastic stockings for two weeks after treatment, depending on the size of the vein treated. Vein Specialists of Northern California was one of four offices in the country involved in the original FDA trials of endovenous laser treatment in 2000 and is therefore one of the most experienced offices in which this relatively new treatment is available. We have a longer period of experience with this procedure than anyone else west of the Mississippi and have served as a teaching site for other physicians learning to do endovenous laser treatment.
Radiofrequency Ablation (ClosureFastTM)
Like endovenous laser treatment, radiofrequency ablation (ClosureFastTM) uses a thin fiber inserted through a needle under ultrasound guidance to apply heat to the internal surface of an abnormal vein. Utilizing local anesthesia, radiofrequency ablation (ClosureFastTM) is a come-and-go out-patient procedure that takes only 30 minutes. Because the heat is more controlled than in the endovenous laser procedure, many patients find that they have less soreness the following day. We have been using this procedure since 1998 and have seen wonderful results, especially since the introduction of the newest generation of radiofrequency catheters.
Vein Specialists of Northern California would proudly like to announce that we were chosen to be the first office in the Bay Area to treat patients suffering from venous reflux disease with the VenaSeal™ closure system. This new, minimally invasive procedure uses an advanced medical adhesive to coapt (close) the diseased vein in patients with symptomatic venous reflux disease. The VenaSeal™ closure system is the only procedure to use adhesive to coapt and close the vein with high closure rates across three clinical trials. Patients treated with the VenaSeal™ closure system usually have minimal to no bruising, and are able to quickly resume normal daily activities. Unlike other heat based treatments, VenaSeal™ does not require the use of injected tumescent anesthesia, and eliminates the risk of nerve injury associated with thermal based procedures. In most cases, patients do not need to use compression stockings post procedure. The VenaSeal™ closure system is the only non-thermal, non-tumescent, non-sclerosant procedure approved for use in the U.S. that uses an advanced medical adhesive that closes the diseased vein. This procedure is office based and done in under an hour.
How Do You Decide Which Treatment Is Right for You?
Dr. Isaacs feels strongly that an educated and informed patient achieves the most satisfactory outcome. As our patient, you are a member of the treating team and understanding your own condition is essential for getting the best results.
Before any treatment is recommended or any estimate of cost is made, we ask you to visit us for an initial evaluation. At that time you will receive educational material, have a full history taken by Dr. Isaacs, undergo a complete examination of your veins and have a duplex ultrasound evaluation of the circulation in your deep and superficial veins. After this examination has been completed and the results explained, you will have a complete understanding of the nature of your vein condition and the options for treatment. If our treatment is not appropriate for you, alternative recommendations will be made. We do not believe in “selling” you on our treatment; the final decision is always yours.
Questions about our services? Please see our FAQ page.
If you would like any further information or wish to schedule a consultation, please call (925) 945-8656.