Frequently Asked Questions about Varicose Veins
Via the “American College of Phlebology” at Phlebology.org
What can I expect at my initial office evaluation?
Prior to or at your initial office visit, you will have an ultrasound scan of the veins in your legs performed. This allows the vein specialist to know what your underlying problem is and saves you an office visit later on. During your initial office visit you will meet the physician or certified RN who will discuss your symptoms and examine your legs. They will review the results of your ultrasound with you. Together, you and your vein specialist will then discuss a treatment plan that addresses your particular situation and needs.
What is superficial phlebitis and is it dangerous?
Superficial phlebitis is inflammation in a superficial vein caused by a small clot. Patients develop localized redness, swelling, discomfort, and hardness along the vein. Treatment usually consists of NSAIDS, ibuprofen and warm compresses. Unlike a deep vein thrombosis it is not dangerous.
Will my varicose veins disappear after the laser procedure?
In 60% of the cases, varicose veins will disappear following the laser vein procedure. In the other 40% of the cases, you will need further vein treatments to help the varicose veins disappear.
Will I need more than one vein treatment for my veins to disappear?
The number of procedures that an individual patient will need is dependent upon the severity of their problem. Patients with more advanced venous disease require more procedures. Many patients with unsightly veins may only require one venous procedure to relieve their symptoms. However, the number of venous procedures needed generally cannot be determined ahead of time and is dependent upon the desired cosmetic result of the patient.
What if I need to undergo heart bypass surgery and I no longer have my greater saphenous veins?
Varicose veins are thin walled and cannot be used for bypasses because they cannot handle the high arterial pressure. Their use is not recommended for bypass. Everyone has many other veins, many of which are usable for heart bypass procedures. Nowadays the internal mammary artery and the radial arteries are being used with increasing frequency before a vein is used for bypass.
What causes varicose veins?
Varicose veins are usually caused by an underlying venous reflux disease. This results in increased pressure against the wall of the vein causing the vein to stretch and elongate. They become tortuous and unsightly. They can rupture, bleed spontaneously or develop clots known as superficial phlebitis. They are caused by heredity, prolonged sitting or standing, pregnancy, trauma, and obesity. Increasing age also make venous reflux disease more likely.
What are the chances of getting a deep vein thrombosis (DVT) from foam sclerotherapy?
The chances of developing a deep vein thrombosis (DVT) from foam sclerotherapy are rare. Although unusual, when a DVT occurs it is usually in a small vein and resolves rapidly with medicine.
How are spider veins treated?
Spider veins may be caused by underlying venous reflux. If there is reflux in the feeding veins this will need to be treated first. The spider veins may then disappear with time. Any remaining spider veins can be easily treated with sclerotherapy.
Is endovenous laser ablation as effective as vein stripping?
Yes, endovenous laser ablation (EVLA) has been proven to be as effective in treating venous reflux disease as vein stripping. In fact, EVLA is non-invasive while vein stripping requires multiple incisions. Vein stripping is performed under general anesthesia in the operating room while endovenous laser ablations are performed under local anesthetic in an office or vein center. Vein stripping is more painful and requires a longer recovery time. EVLA usually causes minimal discomfort both during and after the vein procedure. After EVLA you can leave and drive home if you want to.
Does the loss of the vein cause a problem in the leg circulatory system?
No, varicose veins are actually working against you and making it more difficult for the normal veins to function properly. Your venous circulation actually improves after you eliminate malfunctioning, refluxing veins. Eliminating the varicose veins reduces the venous pressure in the legs and helps the blood to return to the heart better. There are many veins in the legs and the blood will be re routed to the heart through a different healthy vein after eliminating the malfunctioning vein.
Who is not recommended to undergo a vein procedure?
Individuals who have undergone surgery within the past three months or women who are pregnant or who have been pregnant within the past three months should discuss the timing of their vein procedure with their vein care specialist. Patients with a recent deep vein thromboses (DVT) should not be treated for varicose vein disease during the active phase of treatment. Venous procedures are generally not recommended for patients who cannot walk , unless their venous disease is in an advanced stage.
What can I expect after the vein procedures and what is the recovery like?
Following the vein procedures, patients are required to wear medical grade support stockings. You may experience minimal discomfort that is easily treated with Tylenol or Ibuprofen. You may feel a tightening or pulling sensation in the area that the vein procedure was performed. Some bruising may occur, especially after microphlebectomies. Patients are able to walk out of the office and drive themselves home. Depending on which procedure you undergo vigorous activity such as aerobics, running, swimming and a gym workout should be avoided for up to one week. We request that patients walk for about 10-15 minutes every hour the day of the vein procedure and should avoid sitting or standing for prolonged periods of time.
What are the complications of this procedure?
Complications associated with our vein procedures are rare. However, there is always a potential for complications to occur with any medical procedure. Potential complications include numbness, tingling, skin burns, blood clots, cellulitis, and temporary tenderness or tightness in the treated leg. The vast majority of problems following vein procedures are minor and resolve quickly.
Will I need to take time off of work following the vein procedures?
Following the vein procedures you will be able to resume normal activities. You may return to work unless your job requires heavy lifting. Following the laser procedure, you will not be able to lift greater than ten pounds for one week. Following the microphlebectomy and foam sclerotherapy procedures you will not be able to lift greater than ten pounds for two days. We also do not recommend prolonged sitting or standing the day of the procedure. If your job requires any of the above, you will be given a written excuse with restrictions for your employer.
Are the procedures painful and how much pain will I have after the procedures?
Every patient has a different pain tolerance, but generally all of the procedures cause minimal to no discomfort. We recommend Tylenol or Ibuprofen for the discomfort.
What is the Greater Saphenous Vein (GSV)?
It is the longest superficial vein in the leg. It runs on the inside of the legs from the ankle to the groin area.
How long do the vein procedures take?
Generally, all of the procedures take less than an hour. Immediately after completion of the procedures, patients are up and walking and may drive if they are comfortable doing so.
When will I be allowed to travel long distances after my vein procedure?
Both long distance air and car travel is restricted until your follow up vein scan one week after the procedure. Be sure to ask your vein specialist about any travel plans before undergoing your vein procedure.
No, all of the vein procedures are performed in our office in the outpatient setting. If you feel comfortable you may drive to and from the vein procedure. If your work does not require lifting you may even return to work.
How long do I wear compression stockings on my legs following a vein procedure?
Following the laser and microphlebectomy procedures, you will be required to wear compression for four days following the procedure. Following the foam sclerotherapy procedure you will be required to wear compression for three days. You will be required to sleep in the compression stockings the first night and then after the first night the compression stockings may be removed at night and reapplied in the morning. This helps to insure the best possible result. If you suffered from swelling before the vein procedure you will need to wear knee high compression stockings for a longer period of time.