If you have venous insufficiency, valvular reflux, and signs and symptoms of venous disease, then you would be a possible candidate for a closure procedure. However, a closure procedure will not help your spider veins. These are best treated by sclerotherapy. An option for you would be wearing support hose and just treating your spider veins and then reevaluate your legs after this by a vein specialist.

Published on Jul 11, 2012

Saphenous vein closure by either radiofrequency or laser ablation is very successful at reducing the discomfort associated with chronic venous insufficiency. Large varicose veins may reduce in size to some degree following the procedure in some patients; however, spider veins and the hyperpigmented dark skin does not disappear following vein closure. Sclerotherapy of small spider veins could be done before vein closure. Some people recommend cosmetic IPL (intense pulse light) therapy for reduction of the hyperpigmentation of the skin.

Published on Jul 11, 2012

EVLA by itself is rarely a cosmetic fix to one's vein disease. However, it can be the starting point for one's vein treatment. From there, the doc should address any other internal veins that might be feeding off of the saphenous vein that is also refluxing. Once treated, the doc should then treat any reticular veins, and only then the spider veins. Treating only the saphenous vein and a few isolated spider veins is rarely adequate treatment if you have other venous branches (whether internal or more superficial) that are also refluxing. Proper vein treatment is needed in order to address the circulatory defect that is vein disease. The doc needs to address all parts of a person's vein structure, from the saphenous veins all the way out to the spiders. Failure to treat even the intermediate branches within the venous structure, like the saphenous tributaries and reticular veins, can result in additional treatment-related skin discoloration and potentially localized pain and discomfort.

Published on Jul 11, 2012

EVLA (laser ablation) and VNUS Closure are FDA approved to treat venous insufficiency, not varicose veins, reticular veins or spider veins. However, in 1/3 of patients there is resolution of varicose veins, in another 1/3 there is a reduction in the amount of varicose veins, and in the final 1/3 there is no change at all. In regards to spider veins, there may be some reduction, and the rest can be easily treated with sclerotherapy and/or 1064 Nd YAG laser. Discoloration may imporove, but more importantly, progression to lipodermatosclerosis (C stage C4b of CEAP classification) will slow down. So, get the ablation done if you have venous insufficiency and symptoms as you describe.

Published on Jul 11, 2012

You need a venous ultrasound, and it should be done while standing. It will help determine the size of the vein, as well as the significance and location of any venous reflux. All of this will help determine whether EVLA is right for you.

Published on Jul 11, 2012

I generally do recommend vein ablation when a patient presents with symptoms, skin changes, and documented ultrasound insufficiency. Sometimes spider veins do reduce with the treatment, but usually we follow up with sclerotherapy thereafter for resolution of the spider veins.

Published on Jul 11, 2012