Varicose and Spider Treatment Options

Endovenous Laser Ablation Varicose Veins
Under local anesthesia and ultrasound guidance, a small needle is inserted into the damaged leg vein, usually around the inner knee. A laser fiber is then inserted into the vein through a small catheter and passed up to the groin area. Proper placement of the laser fiber is verified with ultrasound. Local anesthesia is again given to surround the damaged vein prior to activating the laser. As the laser fiber is withdrawn, it is activated producing heat bubbles, which damage the vein and cause it to collapse and close. Removal of varicose veins arising from the damaged vein (ambulatory phlebectomy) can be performed at the same sitting after the laser procedure is completed. These procedures are usually performed in the office with oral sedation plus local anesthesia and the patients go home with minimal restrictions.

Ligation & Stripping - Varicose Veins
Varicose vein ligation (damaged veins are tied off) and stripping (removal of veins) is usually performed in the operating room under general or spinal anesthesia as an outpatient procedure. Typically, the main superficial vein (greater saphenous) is removed from the ankle to the groin. This is the most invasive method used to treat varicose veins.

Ambulatory Phlebectomy Varicose Veins
Ambulatory phlebectomy is a surgical technique (usually performed with oral sedation plus local anesthesia) to remove varicose veins arising from the main damaged vein (greater saphenous). After a tiny incision is made next to each varicose vein, the vein is then brought to the skin surface with a small hook and is gently removed. The small incisions heal with minimal scarring. This procedure is usually done in the office in conjunction with the laser procedure.

Sclerotherapy Spider Veins & Small Varicose Veins
Sclerotherapy is performed in the office. Medication is injected into the affected vein using a small needle. The medication damages the inside of the vein, causing it to collapse. The blood in the vein will clot, liquefy, and eventually be absorbed. These are not harmful clots. Patients are usually seen three weeks after the initial sclerotherapy. The clots may need to be removed by nicking the skin and evacuating the clots with a cotton swab. This is done to maximize the cosmetic result. It is important for you to know that cosmetic improvement may not be appreciated for several weeks or even months after the injections.