Services Provided

There are many options for the treatment of varicose veins. Appropriate treatment recommendations are based on the underlying cause of the problem, the symptoms and the goals of the patient.

Often a patient requires a combination of different treatments to achieve satisfaction and a complete resolution of varicose vein symptoms.

For example, laser or RF ablation of the saphenous vein may be required to treat the underlying source of the problem. This may be performed along with Microphlebectomy to remove bulging varicose veins.

The initial treatment may be followed by sclerotherapy or surface laser treatment to treat small, unsightly varicose veins.

Treatment Options

Non-Surgical Laser Vein Ablation for minimally invasive treatment of saphenous vein incompetence in the setting of symptomatic varicose veins.

Minimally Invasive Surgical Excision for patients with mild venous reflux and medium to large sized varicose veins.

Saphenous Vein Stripping is used to treat greater saphenous vein incompetence when a laser vein treatment is a poor choice.

Sclerotherapy for small reticular varicose veins in the 1 to 3 millimeter size range.

VeinGogh Spider Vein Thermocoagulation Treatment of spider veins is a newer, minimally invasive treatment to effectively eliminate spider veins.

Skin Laser Vein Treatment is best used in red spider veins within the skin, those that are less than 1 millimeter.

Conservative treatment involves wearing firm compression stockings daily and the avoidance of prolonged standing or sitting. Walking and weight loss are also encouraged.

Saphenous Vein Ablation Treatment

Non-surgical vein ablation treatments for varicose veins are used to treat the underlying problem of saphenous vein incompetence (failed, stretched out vein valves) instead of a traditional saphenous vein stripping procedure.

At St. Luke’s VeinCare, we are able to offer our patients ablation treatment with Laser fibers or Radiofrequency (RF) catheters.

Ablation or elimination of the failed saphenous vein is accomplished by inserting a thin catheter into the vein under ultrasound guidance, insulating the vein with a column of anesthetic fluid and then heating the inside of the vein with laser energy. This forces the vein to scar together, sealing the inside of the vein so that it no longer is part of the body's circulation.

The benefits of this method include an early return to normal activity, avoidance of general anesthesia and prevention of surgical scarring since there are no surgical incisions.

Most people can return to work the day after the procedure. The procedure is performed in our office in under an hour using local anesthesia. Your doctor may recommend removing visible, bulging varicose veins at the same time.

Minimally Invasive Surgical Excision

Minimally Invasive Surgical Excision of varicose veins is known by several names, including, Micro-Phlebectomy or Stab Avulsion Phlebectomy (SAP). It involves making very small surgical incisions to permanently remove offending varicose veins.

These treatments are used for patients with mild venous reflux and medium to large sized varicose veins. It is often performed at the same time as a saphenous vein stripping procedure or a saphenous vein ablation procedure. The benefits of these methods are that they are very effective and durable. The scars related to the micro-incisions are minimal.

Additional minimally invasive procedures include saphenous vein ligation without stripping. This involves a small incision, 3 to 4 cm long, in the bikini line to identify the failed saphenous vein connection and ligate or disconnect it from the surrounding veins.

Saphenous Vein Stripping

Saphenous vein stripping is the gold standard procedure for the elimination of greater saphenous vein incompetence. It has been performed safely for many years. The techniques however, have improved greatly over the last five to ten years. It is now possible to use very small incisions and patients experience a two to three day recovery and usually are back to normal activity within a week.

The benefits of a stripping procedure are that it is a definitive operation in that it is the most direct form of eliminating failed veins. It has the lowest rate of recurrence and has a very low rate of subsequent follow-up procedures such as sclerotherapy.

The downsides are that it requires a general anesthetic and additional hospital expenses. Bruising in the thigh typically lasts for 2-3 weeks and there is a moderate amount of thigh discomfort that lasts one to four days. Most people require a recovery period away from work for a week, but after two to three weeks they feel great.

Sclerotherapy

Sclerotherapy involves the injection of a solution into varicose veins followed by the application of pressure over the veins. This damages the inside of the vein forcing it to close off.

Multiple treatment sessions may be required to achieve the desired results of varicose vein elimination and it is not a "cure" but more of an ongoing process.

Sclerotherapy works well on small varicose veins or reticular veins ("feeder veins") that are in the 1 to 3 millimeter size range. It can be used on larger veins, but the success rate is lower.

Sclerotherapy is a very effective treatment if the underlying, major veins are normal or have been removed by an ablation or stripping procedure.

The discomfort is minimal and the recovery involves keeping the injected areas wrapped with compression bandages or stockings for one to three days.

VeinGoghtm Thermocoagulation of Spider Veins
Thermocoagulation of spider veins is a newer, minimally invasive technique to treat spider veins using a tiny needle that pierces the skin surface and uses radiofrequency energy to heat and destroy the damaged veins.

Thermocoagulation works best on small spider veins and sclerotherapy may still be required to treat underlying feeder veins.

The benefits are that it is a relatively painless procedure that provides instant results without the need for compression and without the risks of skin pigmentation. Compared to sclerotherapy, results are more predictable and fewer treatment sessions are required with VeinGogh to achieve the desired result.

VeinGogh is the name of the device that we use at St. Luke's VeinCare. VeinGogh is a registered trademark and is distributed by RefineUSA, LLC.

Skin Laser Therapy

Surface Laser Treatment is best used in red spider veins within the skin. These are very small, abnormal veins that are typically less than 1 millimeter in size.

Spider Vein treatment with a laser is strictly a cosmetic procedure for individuals without a failure of the underlying veins.

Skin Laser Therapy can also be used to treat hemangiomas, which are vascular lesions within the skin.

Summary of Services Provided

Our goal is to provide comprehensive care for individuals with varicose vein disorders. Treatment will be custom designed for an individual, utilizing the complete spectrum of currently available and effective treatment options.

Treatments offered include conservative therapy with compression stockings, thermocoagulation for spider veins, sclerotherapy for small varicose veins, and minimally invasive excision or phlebectomy for larger varicose veins

We are also able to perform saphenous vein stripping, laser vein ablation or radiofrequency (RF) ablation for underlying venous incompetence or failed vein valves.

You can find all of these treatments available at various other centers, but no other location can provide ALL of these treatment modalities. At other vein centers, if they perform only one or two of these treatments, then that is what they are likely to offer their patients.

The psychologist Abraham Maslow said: "If you only have a hammer, you tend to see every problem as a nail."

Our vascular specialists are able to recommend the most appropriate treatment for each person on an individualized basis.

We believe that Board Certified Vascular Surgeons provide the best possible care for simple varicose vein problems and complex venous disorders.