What Are the Treatment Options for Varicose Veins?

If you have been diagnosed with varicose veins, your physician may refer you to an interventional radiologist or vascular specialist for treatment. Treatment options for varicose veins that are performed by these specialists include endovascular venous laser treatment (ELVT), sclerotherapy, vein stripping, or bypass surgery.

An interventional radiologist, a physician trained to use x rays and other imaging techniques to see inside the body, may perform some of these procedures. Interventional radiologists use long, flexible, thin tubes called catheters and other microtools to treat conditions without surgery.

Varicose veins is a progressive disorder that worsens if it is not treated. The primary goals of treatment are stopping the backflow of blood, improving the circulation of blood through your veins, and improving the appearance of your legs.

Treatment Options for Varicose Veins

Endovascular Laser Venous Treatment (ELVT)

ELVT, or laser treatment, is a relatively new, minimally invasive, painless procedure that is becoming a more popular treatment for varicose veins. The procedure, which has shown excellent long-term results, is performed in an outpatient setting, often in a physician's treatment office, and usually takes between 45 minutes and 1 hour. Prior to the procedure, a local anesthetic is applied to the area of the leg being treated. During the procedure, an interventional radiologist inserts a tiny fiber-optic probe into a varicose vein through a catheter. This probe transmits laser energy to the affected vein. The laser energy kills the diseased tissue in the varicose vein, causing the vein to close and eventually be reabsorbed by the body. Once complete, the probe is removed from the vein. With a 98 percent success rate, the long-term results of EVLT are equal to or better than results for surgery (such as vein stripping), sclerotherapy, and radiofrequency ablation.

Sclerotherapy

Sclerotherapy is a minimally invasive procedure used to treat diseased or cosmetically undesirable surface veins. It is performed in the physician's office and does not require a hospital stay. The physician injects a liquid called a sclerosing (hardening) solution into a diseased vein, which causes an inflammatory reaction on the walls of the vein. As a result, the vein closes, blood reroutes to healthy veins, and the diseased vein eventually disappears.

Vein stripping

Vein stripping removes varicose veins and their tributaries (branches) through small incisions. Variations on this procedure have been performed for more than 100 years.

Also known as saphenectomy, vein stripping is typically performed as an outpatient procedure in the operating room. You may receive general or, occasionally, spinal anesthesia. The procedure removes your greater saphenous vein (GSV), the largest superficial vein in your leg, as well as any varicose tributary veins. The GSV runs along the inside of your leg from the top of your ankle to just below your groin, where it connects with the femoral vein, the major deep vein in your leg. When the GSV is removed, the deep vein pathways in your leg continue to return the majority of blood to the heart.

Bypass surgery

Surgical bypass is a procedure that can improve blood flow by rerouting blood around a diseased vein. In bypass surgery, surgeons connect a fabric tube called a vein graft or a piece of a saphenous vein taken from a healthy leg to your diseased vein to help blood drain from your affected leg. Most vein surgery can be performed with imaging techniques that allow procedures to be conducted through tiny incisions.

Posted by Columbia Endovascular Associates/Interventional Radiololgy on 1/8/2013

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