Varicose veins are more than just a cosmetic problem. Having varicose veins puts you at higher risk for leg pain, blood clots, and chronic wounds. That’s why it’s important to have your varicose veins medically evaluated. If your doctor recommends treatment, you have multiple options available to you.
What causes varicose veins?
Varicose veins are caused by a condition called venous insufficiency (aka venous reflux). Inside your veins are tiny, one-way valves that keep blood moving toward your heart. When these valves become weak or damaged (either from age or injury) the blood can reflux (flow backwards) and begin to pool inside the vein. This causes the vein to swell and become twisted and enlarged. Over time, the pooled blood can lead to swelling of the limb, thickened or discolored skin, and leg wounds.
Chronic venous insufficiency isn’t always visible. Sometimes the affected vein is deeper under the skin and you might not know that it’s there unless a doctor examines your leg(s) with an Ultrasound.
Symptoms of varicose veins include:
- A “heavy leg” sensation
- Restless leg syndrome
How are varicose veins treated?
Varicose veins are treated with a minimally invasive procedure called venous closure (aka venous ablation). This procedure closes the vein so your body can naturally redirect blood flow to nearby, healthy veins.
There are several different technologies available to perform venous closure. Two popular options are lasers and vein glue.
Treating varicose veins with laser surgery
Lasers are used to treat varicose veins in a procedure called endovenous laser ablation (ELA). This is very similar to another procedure called radiofrequency ablation (RFA), with the only difference being the type of instrument used.
During this procedure, your doctor will inject a special anesthetic solution along the length of your leg. This numbs your leg and protects the surrounding tissues from the heat of the laser.
Next, your doctor will make a small incision on your lower leg and insert a hollow tube (called a catheter) into your vein. A laser fiber is passed through the catheter to the very top of your vein, near your groin.
Using ultrasound to see inside your vein, your doctor uses the laser to cause targeted damage to the tissues along the length of the vein. This results in the vein collapsing and scarring closed.
How long will laser surgery take?
For endovenous laser ablation, you will likely be at your doctor’s office for about an hour, though the actual treatment will not take that long.
How safe is laser surgery for varicose veins?
Endovenous laser ablation has been used for many years and has proven to be very safe. However, no medical treatment is without risk. Possible complications include infection, pain, bleeding, bruising, nerve damage, redness or swelling of the vein, blood clots, changes in skin color over the vein, and burns.
What to expect after laser surgery for varicose veins?
Immediately after your procedure, you will be encouraged to walk for 30-60 minutes. You’ll be asked to continue walking for 10-20 minutes three times a day for the next three weeks. This encourages blood flow, promotes healing, and helps prevent blood clots.
You’ll also be provided with a pair of compression stockings to wear for 7-10 days after surgery. This will help with swelling and also compresses your veins to prevent additional reflux.
You’ll be asked to keep the incision site dry for at least 48 hours, this may mean you need to sponge bathe for a couple of days.
You may experience bruising, a tight or pulling sensation in the leg, swelling, and/or pain. This should all heal in a matter of weeks. But if the pain is unmanageable, be sure to talk to your doctor about it.
Treating varicose veins with vein glue
Vein glue, also known by the brand name VenaSeal, is an exciting advancement in the treatment of varicose veins. It is a medical-grade adhesive (n-butyl-2-cyanoacrylate) that is safe for use inside the human body.
During your vein glue procedure, your doctor will begin by numbing an area on your calf with a small needle prick. They will then insert a catheter through your numbed skin and into your vein. The flexible catheter will be threaded all the way to the top of your vein, near your groin.
Using ultrasound to see the catheter’s exact position, your doctor will inject a drop of glue into the vein. External pressure will be applied to your leg for about 30 seconds while the glue sets. Your doctor will then repeat this process along the length of your leg until the entire vein is sealed shut.
How long will the VenaSeal procedure take?
For this procedure, you will likely be at your doctor’s office for about an hour, though the actual treatment will not take that long.
How safe is VenaSeal?
VenaSeal is a relatively new technology, but has been rigorously studied and proven to be very safe. However, no medical procedure is without risk. You may experience bruising, tenderness, bleeding or swelling particularly at the injection site. This typically resolves in a few days.
In rare instances (fewer than 1%), patients may develop an allergic reaction to the glue. There is also a small risk of developing a blood clot.
What to expect after VenaSeal Surgery
Immediately after surgery, your injection site will be cleaned and your doctor will apply a small adhesive bandage. You’ll be asked to keep the incision site dry for the next 8 hours.
Vein glue is the only venous closure option that does not require the use of compression stockings after; however, you may choose to wear them if it feels better to you.
You’ll be encouraged to walk for 10-20 minutes three times a day for the next two to three weeks to promote healing and prevent blood clots.
Which varicose vein treatment is better?
Every patient is different, so it’s best to talk to your doctor about which varicose vein treatment is right for you. However, at DeKalb Vein Center, we have generally seen patients who have vein closure using VenaSeal experience less bruising and less discomfort compared to laser surgery. If you’d like to discuss your treatment options please contact us at (404) 501-9377.