Spider and Varicose Vein Treatment and EVLT
In our office we perform virtually all types of outpatient varicose vein treatments on virtually all types of varicose and spider veins. We also treat swollen legs and skin ulcers using EVLT laser technology.
The key to effectively treating spider and varicose veins is to treat the largest abnormal veins 1st, because these veins are at the root of the problem. Therefore we often start vein treatment with an ultrasound done in our office to map the veins. Often what is seen on the surface is only the tip of the iceberg.
Once the veins have been mapped we systematically eliminate the abnormal veins using a variety of procedures.
If the larger non-visible veins, the greater and lesser saphenous veins, are abnormal, we’ll treat these first using a laser placed inside the vein called EVLT. This routine office procedure is done under local anesthesia and has replaced the older vein stripping.
If large bulging varicose veins are present, we’ll eliminate these using either phlebectomy or sclerotherapy. With Phlebectomy we first numb the skin over the vein, then put a needle hole in the skin , and then actually pull the vein out using a hook that looks like a crochet hook. Alternatively the vein can be injected with a solution of sodium tetradecyl sulfate to kill the vein.
Medium size veins can be removed using the same sclerotherapy approach or can be treated and killed off using an external laser beam using our Cutera Nd-Yag laser.
Blue and red spider veins can also be treated either with injections or with laser. We tend to mix and match the type of treatment to the type of vein and to patient preferences. In most patients we use a combination of laser and injection, because in our experience this combination treatment gives the most rapid response with the fewest number of treatments.
Complications are fairly rare and can include skin darkening, matting (fine vessels that occur after the larger vein has been treated), skin damage, laser burns, and scarring. Most side effects are either temporary or resolve with additional treatment. In our hands we have had no permanent scarring in thousands of vein treatments to date.
Great candidates for vein treatment include any patient with visible veins of any type, as well as patients with leg swelling or venous ulcers. There is typically no downtime other possibly minor bruising, and only a percentage of patients must wear stockings after treatment.
We also treat bulging hand veins.