Venous Disease Procedures
There are many ways to treat venous disease. The physician will usually recommend a combination of endovenous ablation, sclerotherapy, and ambulatory phlebectomy based on your unique symptoms and situation. Below is brief overview of each procedure. Click on a link to read more.
• Endovenous Ablation
• Sclerotherapy
• Ambulatory Phlebectomy
• Venography and Embolization
Endovenous Ablation
Ablation procedures are performed with heat generated by a safe laser or radio frequency. The procedure is performed under local anesthesia. When compared with traditional "vein stripping" techniques, endovenous ablation is more effective and is associated with much less pain during recovery. There are virtually no scars because catheter placement requires skin openings of only a few millimeters.
At the start of the procedure, the skin is numbed and a small needle is inserted into the refluxing vein using ultrasound guidance. A thin catheter is then introduced to deliver the heat energy to close the vein. Closure of a faulty vein does not adversely affect circulation because other veins assume responsibility for blood return back to the heart. The diseased vein shrinks after treatment. Successfully ablated veins are unlikely to reopen to cause later problems.
The procedure usually take one to two hours. After the treatment, the patient wears a compression stocking as instructed by the physician while resuming daily activities.
Sclerotherapy
Sclerotherapy is used for the management of large varicose veins and venous malformations. The procedure is performed in our office by using ultrasound guidance to inject a solution directly into the vein. The solution irritates the lining of the blood vessel, causing it to swell and stick together and the blood to clot. Over time, the vessel turns into scar tissue diverting blood flow to healthy veins.
 A safe medication is inserted to close the faulty vein. |
Many injected veins may be eliminated with each session. A few people who have sclerotherapy on their varicose veins do not respond to the injections. In these instances a different method, such as laser therapy, may be tried. In general, spider veins respond to treatment in 3 to 6 weeks, and larger veins respond in 3 to 4 months. If the veins respond to the treatment, they will not reappear. However, new veins may appear over time. If needed, the patient may return for more injections.
The procedure usually takes one to two hours. After the treatment, the patient wears a compression stocking for a time while resuming daily activities.
Ambulatory Phlebectomy
 Tiny incisions are used to take out the
varicose veins. |
The procedure is performed in our clinic using local anesthesia. Diseased veins are removed through very small incisions or punctures. Because veins are collapsible, even very large veins may be removed through a tiny incision. After the procedure, steri-strips are applied and then covered with a compression dressing. Typically, the incisions require no stitches and leave nearly imperceptible scars.
Similar to ablation and sclerotherapy, ambulatory phlebectomy usually takes one to two hours. Again, doctors will recommend wearing a compression stocking for a time while the patient resumes daily activities.
Venography and Embolization
The causes of chronic pelvic pain are varied but are often associated with the presence of ovarian and pelvic varicose veins. Pelvic congestion syndrome is similar to varicose veins in the legs. In both cases, the valves in the veins that help return blood to the heart against gravity become weakened and don't close properly. This allows blood to flow backwards and pool in the vein, causing pressure and bulging veins. In the pelvis, varicose veins can cause pain and affect the uterus, ovaries, and vulva.
Embolization is a minimally invasive procedure performed by interventional radiologists using ultrasound imaging techniques for guidance. During the outpatient procedure, the specialist inserts a thin catheter, about the size of a strand of spaghetti, into the femoral vein in the groin and guides it to the affected vein. To seal the faulty, enlarged vein and to relieve painful pressure, the physician inserts tiny coils often accompanied by a medication (the same type of material used to treat varicose veins) to close the vein. After treatment, patients can return to normal activities immediately.
