The most common type of conservative treatment is wearing graduated compression
stockings (tighter at the ankle than the thigh). Although such measures may not
rid your legs of existing varicose and spider veins, symptoms associated with
vein problems can be greatly improved by wearing support stockings. Conservative
treatment is well suited for women who are pregnant or for those who are unable
to undergo medical therapy due to advanced age or illness.
For many people, merely slowing the progression of varicose or spider veins will
not be enough. If you fall into this category, many corrective forms of
treatment are available to improve both the cosmetic appearance of your legs as
well as alleviate associated symptoms.
The first step, and likely the most important, is finding a physician with
experience and expertise in phlebology, which is the field of medicine that
deals with disorders of the venous system. In addition to a focused physical
examination, additional evaluation utilizing a variety of diagnostic instruments
may be necessary when determining the cause, severity and best treatment options
available for your particular problem. These non-invasive diagnostic tests
include doppler, duplex ultrasound and plethysmography.
Sclerotherapy involves a series of injections using a tiny needle to
administer small amounts of a solution into the vein. The sclerosant irritates
the inner lining of the vein causing it to collapse and ultimately disappear.
Sclerotherapy is performed as an in-office procedure and should cause only
minimal discomfort. Following treatment, you can return to your normal daily
activities. Elastic bandages or support stockings may need to be worn during the
daytime for a few days, which will aid in the closure of your veins.
ENDOVENOUS LASER (EVLT)
Recently, a novel technique using laser energy delivered within the vein via a
small laser fiber has been developed for the treatment of varicose veins with
excellent preliminary results. Compared to surgery, the potential advantage of
endovenous laser treatment is a minimally invasive technique performed in the
office with little to no scarring and a shortened recovery period. Compared to
existing minimally invasive techniques, endovenous laser treatment may allow for
more precise control of vein wall damage, resulting in lower recurrence rates
and less potential for adverse side effects.
DUPLEX ULTRASOUND-GUIDED SCLEROTHERAPY
Occasionally, patients with more severe varicose veins will need further
therapeutic intervention. In the past, surgical ligation and stripping was the
only treatment available for these cases. Today, minimally invasive in-office
methods are available and offer good alternatives to surgery for many people.
One such technique is duplex ultrasound-guided sclerotherapy. In experienced
hands, duplex ultrasound-guided sclerotherapy is highly effective, very safe and
SURGICAL LIGATION AND STRIPPING
Surgical removal (also called ligation and stripping) of the greater saphenous
vein (the main superficial vein of the leg) may be necessary in some patients
with large varicose veins. This procedure is usually performed under general
anesthesia, although local or spinal anesthesia may be used. When properly
performed, the greater saphenous vein is removed from the groin to the knee
through small (usually two) incisions using a special instrument.
Ambulatory phlebectomy is a minor surgical procedure that can be used to remove
some large varicose veins. This procedure can be performed in the office using
local anesthesia. The veins are removed in segments through tiny incisions. No
stitches are necessary and scars are barely visible in most cases.
A variety of laser and light source therapies are currently available. Although
many lasers have been highly effective in the treatment of facial spider veins,
laser treatment of spider veins on the legs has proven to be more challenging.
Currently, compression sclerotherapy remains the treatment of choice for
removing most unwanted leg telangiectasia, with lasers offering a complementary
treatment modality in only a select group of people.
THE TREATMENT OF CHOICE
The treatment of choice for the majority of varicose veins and nearly all spider
veins on your legs will be compression sclerotherapy. In some cases, additional
intervention such as surgery, duplex ultrasound-guided sclerotherapy or
endovenous laser treatment will be necessary. Often, a combination of the above
treatments will be most beneficial.
|What is EVLT?
|EVLT stands for EndoVenous Laser
Treatment. It is a treatment alternative for varicose veins.
Make an appointment for a vein consultation to see if EVLT is right