A common condition, varicose veins can cause leg pain, swelling, aching, feelings of heaviness, itching, and more. But does one have to get a medical procedure to stop discomfort? Read on to find out.
Enlarged, distorted varicose veins, usually occurring in the legs, are caused by weak or damaged vein walls and valves. The disorder can cause blood to pool in the lower legs or flow backward, creating a variety of uncomfortable symptoms.
We spoke to vein expert Soohyun Kim, MD, RVT, lead physician at Center for Vein Restoration's vein clinics in Phoenix, Arizona, and Mesa, Arizona, about the risks of varicose veins and if vein treatment is necessary to restore proper blood flow.
Can varicose veins resolve without intervention?
In short, "no," says Dr. Kim. "Varicose veins cannot be resolved without intervention." She explains that varicose veins result from venous reflux disease, which causes dysfunction in the leg valves. Varicose veins form because of this structural deformity, triggered by various risk factors, including obesity, hormones and pregnancy, advanced age, and genetics.
"Therefore, varicose veins will not resolve themselves unless we intervene on the structural deformity," adds Dr. Kim.
Are varicose veins dangerous?
"Varicose veins could be dangerous if they rupture and are not properly cared for," says Dr. Kim. She adds that one could bleed significantly if the leg is not quickly elevated or proper pressure is not applied. Sometimes the person requires a suture ligation of the bleeding veins or even a transfusion. Untreated varicose veins are at higher risk of bleeding. However, she emphasizes that varicose veins are not generally considered life-threatening.
When should I seek treatment for varicose veins?
Dr. Kim says a person should seek treatment when varicose veins become symptomatic. She cautions that symptoms often go unnoticed because they develop gradually, and the person learns to adapt and accept the warning signs as normal. "Symptoms such as heaviness, throbbing, restless leg, itchiness, burning, swelling at the end of the day, and crawling sensations are not normal," she emphasizes. When these symptoms arise, the person must seek evaluation by a medical professional.
"Over 30 million Americans have vein disease, but only 1.9 million seek treatment annually. Of that, only 447,000 get treatment for their vein disease."– Dr. Soohyun Kim
What are the best treatments for varicose veins?
"There is no one best treatment for all people," says Dr. Kim. Just as everyone is different, treatment choice depends on which vein is refluxing and the vein's location. The vein specialist will use this information to develop a customized treatment plan for the individual. Common treatment modalities include:
Tumescent-based thermal ablation
EVLT System (uses laser energy to destroy the diseased vein, redirecting blood flow to healthy veins)
ClosureFast Catheter (uses radiofrequency energy or heat to close the diseased vein, redirecting blood flow to healthy veins)
Why would a physician remove a problem vein instead of treating it?
Dr. Kim believes that some older surgeons are not trained in the newer, minimally invasive techniques and therefore rely on surgical removal. That said, a technique such as ambulatory phlebectomy, which uses tiny incisions that require nothing more than a band-aid to cover, is well-suited in conjunction with other modern minimally invasive modalities.
She adds, "more than 95 percent of my patients are successfully treated without surgical intervention using only minimally invasive procedures."
How does ambulatory phlebectomy differ from vein stripping?
Traditional vein stripping is the more intrusive procedure that involves the removal of the entire length of the great saphenous vein (GSV). The GSV is the largest vein in the body, running from the ankle to the top of the thigh. Removal of the GSV requires multiple incisions along the length of the leg through which the vein is pulled out (stripped) from the body. The procedure requires general anesthesia, can be uncomfortable, and requires a 2-4 week recovery period.
On the other hand, ambulatory phlebectomy is minimally invasive, performed in an office setting, requires only local numbing, and takes less than an hour to complete. Patients are encouraged to walk immediately and resume regular activity immediately, with few restrictions.
Dr. Kim calls ambulatory phlebectomy "a nice procedure in addition to other minimally invasive procedures, such as endovenous laser ablation or radiofrequency ablation, when the veins are too big and may need to be interrupted and manually manipulated."
How to schedule with the nation's leader in vein care
To book an appointment with Dr. Kim or any of the other experienced CVR physicians at the 100+ locations across the country, call 800-FIX-LEGS. You may also schedule online HERE.
carriers, including Medicare and Medicaid, cover vein care procedures.