Treatment of Various Vein Diseases
Vein disease of the legs is one of the most common medical conditions. Approximately half of the population has some form of vein disease. Varicose veins affect between 15%-25% of all adults, and approximately 50% of people over the age of 50. Women have a higher incidence of vein disease than men. Varicose veins are blood vessels just beneath the skin that have widened and stretched. In abnormal circumstances, these veins become exposed to a high volume or pressure of blood, leading to the stretching and bulging. This becomes visible as the swelling intensifies and can lead to stretching of surrounding nerves, leading to pain or discomfort.
Depending on the type and stage of the vein disease, there are many different treatment options available to you. Most often, an ultrasound of the legs is necessary to determine the appropriate form of treatment. The goal is to eliminate the varicose veins and to correct the underlying physiology of the leg to prevent recurrence. Treatment options can include:
· Compression Stockings: Compression stockings help to relieve pain and discomfort associated with varicose veins, but cannot aesthetically improve the appearance of the vein. By compressing the dilated veins, compression stockings create a gentle squeeze at the ankles, calves, and thighs to get your blood moving up the leg and to temporarily eliminate reflux. This can reduce the achy, tired, heavy tingling/burning, and numb sensation in the legs and feet, but requires persistent use to be completely effective.
· Endovenous Laser Therapy: The most modern advance in the treatment of varicose vein disease, Endovenous Laser Therapy (EVLT) was developed approximately seven years ago as a ‘minimally invasive’ alternative to the old-fashioned ’stripping’ procedure. Using laser technology, the veins that are ‘refluxing’ are shut down permanently through a needle-stick near the knee, often resulting in complete resolution of the varicose veins and the associated discomfort, without any other procedure. The procedure itself is performed under local anesthesia, takes approximately 30 minutes to do, involves no incision, and allows one to return to normal activities the day of the procedure. Aside from the cosmetic and patient satisfaction benefits that EVLT has over its predecessor (stripping), EVLT has an improved success rate in preventing recurrence of varicose veins, which can be as high as 10% in patients undergoing stripping.
· Sclerotherapy: Sclerotherapy is commonly used to treat spider veins by injecting a small volume of a liquid into the diseased vein. The sclerosing liquid acts upon the lining of the vein to cause it to seal shut, eliminating the vein completely. Sclerotherapy is not suitable for large varicose veins, varicose veins extending up to the groin, or people who are obese.
· Surgical Stripping: This is an ‘old-fashioned’ procedure rarely performed in a modern vascular practice. However, there are few instances when this may be necessary, such as in an individual who is not a candidate for EVLT. This procedure requires the placement of two incision in the leg (one near the ankle and one near the groin) through which a large vein that is refluxing is removed from the leg. Stripping is performed under general anesthesia and often requires a couple days to return to normal activities. It is highly effective in patients whom are deemed appropriate candidates.
Dr. Weiswasser, M.D., F.A.C.S.
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