What's Newer in Vein Treatments

There was a time when treatments for varicose and spider veins required surgical removal of the faulty vein, which was both invasive and had a longer recovery time. There are newer vein treatments available now that are a non-invasive alternative to surgery.

Reasons for Vein Treatments

Spider and varicose veins are not only unsightly, they can also be the symptom of a condition called venous insufficiency. The veins have very thin walls, as compared to the arteries, and they rely on a series of valves to keep blood flowing in the same direction – back to the heart. If those valves are weakened, blood does not flow as efficiently, which causes the veins to expand. If this happens in veins close to the surface of the skin, it may appear as a bluish or bulging varicose vein or a discolored, web-like grouping of spider veins.

Venous insufficiency can cause other problems as well, including:

  • Leg pain and leg cramps
  • A heavy feeling and weakness in your legs
  • Swelling in your legs and ankles
  • Discoloration of the skin around your ankles
  • Leg ulcers

Types of Vein Treatments


Sclerotherapy injects foam into the vein which causes scar tissue. The scar tissue prevents blood from flowing through that vein, which causes the varicose or spider vein to disappear and also relieves some of the symptoms of venous insufficiency. There is a relatively new injectable foam sclerosant available that was approved by the Food and Drug Administration in late 2013, and will be available in mid-2014 for use in sclerotherapy in the U.S. Varithena™ (formerly known as Varisolve) is a comprehensive therapy that improves both symptoms and appearance for a wide range of varicose veins, including incompetent GSV, accessory saphenous veins and visible varicosities of the GSV system. Treatment involves a non-surgical procedure with guided ultrasound, and doesn’t require sedation.

Considerations of sclerotherapy treatment include:

  • Sclerotherapy is minimally invasive
  • Sclerotherapy works best in conjunction with other therapies, such as laser therapy
  • Sclerotherapy is best suited for small veins
  • Veins treated with sclerotherapy fade over time
  • The procedure is performed in the doctor’s office with local anesthetics
  • Sclerotherapy usually requires at least two procedures to successfully treat each problem vein

Endovenous Laser Therapy

Endovenous laser therapy (endovenous thermal ablation) uses a laser attached to the end of a catheter to treat the inside walls of the vein. The heat from the laser causes the treated vein to shrink, which closes off blood flow. Endovenous thermal ablation, also referred to as Endovenous saphenous vein obliteration, can also be done using radiofrequency (Endovenous RF ablation).

As with sclerotherapy, endovenous laser therapy can reduce the appearance of varicose veins and relieve some of the symptoms of venous insufficiency.

Considerations of endovenous laser treatment include:

  • Laser therapy works best on larger veins
  • Veins treated with laser therapy fade almost immediately
  • The procedure is performed in the doctor’s office with local anesthetics
  • Laser therapy usually requires just one procedure to successfully treat each problem vein

Vein Surgery

Generally, the combination of laser therapy and sclerotherapy are effective enough that most patients don’t need surgery. However, some insurance plans may not cover these newer therapies. You can pay out of pocket for your sclerotherapy or endovenous laser therapy, but if you need to rely on insurance, surgery may be the only covered treatment option.

If the damaged veins are extremely large, or deep within the tissue, the doctor might also recommend surgery over the newer treatments. With surgery, your doctor would actually remove the damaged vein in a process called vein stripping. Vein stripping is fairly invasive, requires general anesthesia, and requires a longer recovery time than the newer procedures. If you have varicose or spider veins and you are interested in your options for vein therapy, consult your physician about your options.

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