As the largest organization of our kind, conducting more varicose vein and spider vein procedures than any other vein clinic Center for Vein Restoration is built on experience, expertise, and trust. As such, our patients can expect that treatment from CVR will be fast (treatments take less than an hour and patients can immediately return to normal activity with little or no pain), safe (treatments do not require surgical incisions, instead, they are simple office-based outpatient procedures), and reliable (we are extremely proud that our patient satisfaction rate regularly exceeds 95%).
In each of these similar procedures, a catheter is fed through the skin and into the area of the vein requiring treatment. In the case of the radiofrequency treatment, the catheter emits high-frequency radio waves that heat the vein tissue and collapse it. The body then naturally “re-routes” the blood supply around the closed vein, which later is reabsorbed into the body. In the case of laser treatment, the catheter emits light that heats the vein and collapses it. Both of these treatments are used to treat varicose veins but not spider veins.
Catheter Procedures Consist Of Four Principal Steps:
- Mapping the Saphenous Vein
A typical procedure begins with noninvasive ultrasound imaging of the varicose vein to trace its location. This allows our physician to determine the site where the ablation catheter will be inserted and to mark the desired position of the catheter tip to begin treatment.
- Inserting the Closure/Laser Catheter
Our physician then typically injects a volume of diluted anesthetic fluid into the area surrounding the vein. This numbs the leg, helps squeeze blood out of the vein and provides a fluid layer outside the vein to protect surrounding tissue. Then our physician accesses the saphenous vein or the appropriate vein. The Closure or Laser catheter is inserted into the vein and advanced to the uppermost segment of the vein.
- Delivery of Radiofrequency or Laser Energy and Withdrawal of the Catheter
Noninvasive ultrasound is used to confirm the catheter tip position and the physician then activates the RF generator, causing the electrodes at the tip of the catheter to heat the vein wall to a target temperature. As the vein wall is heated, the vein shrinks and the catheter is gradually withdrawn. During catheter pullback, which typically occurs over 1 to 2 minutes, the RF generator adjusts the power level to maintain the target temperature to effectively shrink collagen in the vein wall and close the vein over an extended length. The laser procedure is performed much the same way, using a different type of catheter. After local anesthesia is administered, a laser fiber is inserted through a catheter into the vein. The laser delivers short bursts of energy and the vein collapses around it. The collapsed vein soon shrinks and disappears. This technique rapidly treats the veins and takes 10–20 seconds to perform.
- Follow Up with Ultrasound Study
24–72 hours after your treatment, ultrasound imaging is used to check for a DVT (deep vein thrombosis).
Ambulatory phlebectomy is a minor surgical procedure aimed at removing unsightly and symptomatic superficial varicose veins. This procedure is performed in an office-based, outpatient setting using local anesthesia. Complete surgical removal of varicose veins segments may be achieved in a single session or in separate sessions depending on the location and how extensive the network of veins to be removed. Often, ambulatory phlebectomies are routinely performed at the same time as a laser or radiofrequency ablation. The technique is performed through tiny stab incisions that usually do not require skin sutures to heal. The bulging vein is extracted through these small incisions. The small slit-like incisions heal quickly and after 6-12 months, they are practically imperceptible. Temporary bruising or swelling may occur after the procedure. Recovery time is immediate and ambulation after this surgery is encouraged. A post-operative bandage is kept in place for 24 hours then replaced with daytime compression stockings for 1-2 weeks. The use of compression stockings aids in healing and reduces postoperative pain.
Each of these treatments is administered by syringe. Spider veins are treated by a safe and quick procedure called visual sclerotherapy. A chemical called a sclerosant is injected into the problem vein, filling it and initiating a reaction that results in vein closure. Blood is then naturally re-routed to other healthier veins around the affected area. The body eventually reabsorbs the treated veins.
Ultrasound guided foam sclerotherapy is designed for treatment of varicose veins. The sclerosant foams to fill the veins, which are often larger in diameter than normal veins due to pooling of blood; this is what causes the “ropey” or bumpy look associated with varicose veins. The physician administering the treatment uses ultrasonography—sound waves—to guide the procedure for maximum accuracy and safety. The foam solution has the consistency of shaving cream, which improves treatment in two distinct ways: First, the foam displaces blood within the vein, permitting the full strength of the sclerosing agent to be in direct contact with the vein wall for an extended period of time without any dilution effects. Second, the foam is visible via ultrasound imaging and can be easily tracked and guided to the source of the venous problem.
Visual sclerotherapy is used only for smaller, spider veins. It is administered “visually,” meaning your doctor does not require the use of ultrasound the guide the procedure. Sclerotherapy, or “injection therapy,” is the most common treatment for spider and varicose veins on the legs. During treatment, a mild chemical solution is injected into the incompetent vein or small vessel. The sclerosing agent irritates the walls of the vessel, causing it to collapse. The body then absorbs the vein and blood is re-routed to a healthy vein, restoring proper venous circulation in the area. A single sclerotherapy treatment session involves multiple injections. Patients describe the injections as feeling like a pinprick or mosquito bite. The number of treatment sessions needed will vary from patient to patient, depending on the number of veins treated, healing time, and the level of cosmetic perfection desired. Following injections, a compression stocking needs to be worn to help keep the vein closed. Normal daily activities can commence immediately after treatment.