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Varicose Veins and Spider Veins Treatment Options

There are several option that you have available for spider vein removal and varicose vein treatment.


Spider veins often are asymptomatic (no symptoms), but sometimes they can cause pain, itching, or a burning sensation. Today, these are treated most successfully by injecting the vein, or cluster of spider veins, with a sclerosing solution. The solution stimulates the body's natural healing processes to close down the bad portion of vein and the veins disappear. The procedure is very safe and comfortable. It is called sclerotherapy.


Varicose veins (the superficial venous system) can be treated by Ultrasound Guided Sclerotherapy. Under the guidance of ultrasound the clinician is able to thread a small catheter into the bad vein and go up to the highest point of leakage. A strong sclerosing agent (usually sodium tetradecyl sulfate) is injected directly into the varicose veins which causes the bad vein to collapse and disappear. The inner surface of the collapsed vein grows together and obliterates the vein. To use the technique successfully, the vein must be collapsed and then compressed with medical compression stockings. After a treatment, the patient can resume walking and exercise immediately. Medical compression stockings are worn constantly for a few days. If this is not done, clotted blood may be trapped within the vein and hold it open. Trapped blood is later absorbed, leaving the varicose vein still present.

Laser Treatments

Laser treatment is sometimes used on spider veins on the surface of the skin. The objective is to heat the blood in the vein, coagulating it to obliterate the vessel. It is not often effective on the these vessels is completely inappropriate for large varicose veins. It can often burn the skin and create severe scarring of the skin along the path of the vein.

Endovenous Laser Treatment (EVLT)

A new laser technique developed out of Cornell University called EVLT (Endovenous Laser Treatment). This innovative new FDA approved technology can be used to close down the absolute worst varicose veins without surgery or sclerotherapy. Radio-frequency Ablation was the first method to be used endovenously (within the vein) to shut down varicose veins. It pioneered the field, but it has been mostly supplanted by laser which is superior in that it is more comfortable, faster and more effective.


EVLT Illustration


The other traditionally used method of removing varicose veins is Surgery. This procedure involves passing a stripper - a flexible rod-like device - through an incision in the vein at the ankle all the way to the groin for the greater saphenous vein. The stripper is sutured to the saphenous vein in the groin. All the branches of the vein are excised or stripped as well. The perforator veins are identified and tied off through small incisions. When all the branches and perforating veins have been removed or tied, the long vein is literally pulled out from the top to the ankle. The leg is bandaged and walking around is allowed the first postoperative day. The bandages may be removed the next day and the patient must then use medical gradient pressure stockings for 10 to 14 days. While this is a tried and true older method of treating varicose veins it is not the ideal choice any more. The risk of the surgery and the anesthesia, the downtime after the surgery, and the fact that 99% of these same veins can now be treated more safely and comfortably by other methods makes stripping nearly obsolete.


Surgical Stripping of Varicose Veins


There used to be considerable disagreement about whether Ultrasound Guided Sclerotherapy, EVLT or stripping should be used. But over 10 years of studies have now shown that EVLT and Sclerotherapy have several advantages over any surgical procedure such as ligation and stripping:

  • Performed as an out patient procedure and does not require hospitalization
  • NO surgical scars
  • Less expensive
  • Less painful
  • Safer with fewer dangerous side effects
  • More than 90% of treated limbs remain reflux free at 2 years
  • Immediate return to normal daily acitivities including work and exercise program