Management

Medical Management

Elevation of the legs Raising feet above the level of the heart three or four times daily for about 15 minutes at a time. If prolonged standing or sitting is necessary, flexing (bending) the legs occasionally can help move the blood towards the heart. Patients with mild to moderate varicose veins can experience relief of swelling and discomfort by elevating the legs.

Graduated compression stockings These prescription strength compression stockings compress the veins and help the blood pump up towards the heart. In addition, compression stockings may help with prevention of ulcers.

Sclerotherapy This is a common treatment for spider veins, but oftentimes is not appropriate for large varicose veins. The procedure involves injecting a medication into the small vein that makes the vein disappear and close off. Many insurance companies do not pay for sclerotherapy unless other treatment options have been exhausted.

Surgical Management

Endovenous laser ablation (EVLT) A tiny fiber-optic catheter is inserted into the varicose vein via a small incision. As the catheter is pulled back, a laser is engaged which makes the vein close. Eventually your body absorbs the vein. Scarring is minimal and patients recover in days, rather than weeks

Radiofrequency venous ablation (VNUS) A thin catheter is inserted into the varicose vein and as the catheter is pulled back, heat is engaged which heats the walls of the varicose vein and destroys it. The body eventually absorbs the vein. Scarring is minimal with this procedure, and recovery is short for this procedure as well.

Vein ligation A small incision is made over the varicose vein and it is tied off or disconnected. The disconnected vein is eventually absorbed by the body. Oftentimes this surgery is done in conjunction with other vein procedures.

Vein stripping A number of small incisions are made on the leg and the varicose vein is removed from the body. This is a more invasive procedure and causes bruising and swelling. This procedure is often done in conjunction with other vein procedures.

Stab phlebectomy This procedure involves passing a small hook through a small “stab” incision (the size of a razor nick) and pulling the varicose vein out to tie it off. These incisions are not stitched and usually leave minimal scarring.