Articles

Treatments

What are my treatment options?

At Soffer Vein, our philosophy and preference is to take a comprehensive minimally invasive approach that includes all or some of the following:

  • Endovenous Laser Treatment (EVL)-Endovenous Laser Treatment is a newer breakthrough technology used to treat varicose veins which involves heating the inside of the vein, causing it to seal shut and disappear. During EVL, a very thin laser fiber is inserted into the damaged vein. It is largely painless and can be performed on an outpatient basis, allowing patients to go back to work the very same day. In capable, experienced hands, this technology has been extremely successful and has largely eliminated the need for the more invasive vein-stripping surgery. Most EVL patients will require some sclerotherapy in conjunction with EVL to treat their varicose and smaller veins to ensure satisfactory long term results.The result is often a complete resolution of symptoms and a vast improvement in aesthetic appearance.

  • Sclerotherapy- Sclerotherapy is an injection treatment used to eliminate small to medium size varicose veins and spider veins. Sclerotherapy is affordable, does not require anesthetic, and there is no downtime associated with this simple procedure. Sclerotherapy utilizes a very fine needle to inject a solution, sclerosant, into the varicose or "spider vein". Most patients compare the discomfort of the needle to an ant bite. The location of the vein determines if this procedure is done with or without ultrasound guidance. Different solutions are used, depending on the type of the vein and different strengths of the solutions are used based on the size of the vessel. Once injected, the cells that line the vein wall (endothelium) will become irritated, inflamed and damaged. External pressure is applied using cotton balls, tape and support hose. The compression causes the vein walls to seal together, sealing the vein off from the rest of the vein network in your leg, and the vein can no longer transport blood. Your body will then breakdown and absorb the damaged vein and naturally redirect the blood flow to healthy veins. Upon the completion of healing, the vein is no longer visible. It should be noted that the same vein may have to be treated more than once during your sclerotherapy sessions. The process is very similar to how your body heals a bad bruise. "Spider" veins do not have any known useful function and eliminating them will not affect your circulation. Reducing or eliminating varicose veins can improve your circulation and symptoms of heaviness, aching and fatigue.
  • Ultrasound-guided Sclerotherapy
    Ultrasound-guided Sclerotherapy is used for larger and deeper varicose veins that cannot be treated with the laser for varying reasons, including their visibility, location and morphology. The ultrasound offers your physician the ability to precisely target the exact location to optimize treatment results.  Ultrasound guided sclerotherapy is similar to traditional Sclerotherapy. The only difference is that the doctor uses ultrasound technology to see the veins beneath the skin. Using the ultrasound image as a guide, the doctor can place sclerosing foam directly into the abnormal vein thereby redirecting blood flow to healthy veins.  The treated vein closes and over weeks or months becomes an imperceptible thread beneath the skin.
  • Foam Sclerotherapy - Foam Sclerotherapy is a painless procedure that uses a vein light to make your veins appear fluorescent in color, after which they are injected with a special foam sclerosant.
  • Conservative Treatment- The objective of the conservative approach in treating varicose veins is to help support the venous circulation of the legs in order to slow the development of new veins and to minimize symptoms. These treatment methods will not cure or eliminate existing vein problems, however, they will help slow the progression of the disease and alleviate symptoms such as swelling, aching, and cramping. As a result, conservative treatment is most suitable for people who are sick, elderly, or pregnant. Some of the more popular conservative treatments are:
    • Wearing Compression Stockings
Support compression stockings provide external graduated counter-pressure to aid in venous blood flow to the heart. They reduce pooling and pressure in the veins and may also reduce the risk of forming a deep vein blood clot. Consider wearing them during long plane or car rides.
  • Making Lifestyle Changes- including losing weight and increasing activity and exercise.
  • Preventative Measures- There is no known scientific method for preventing varicose veins, but there are ways of improving your circulation and muscle tone, thereby reducing the risk of developing varicose veins or getting additional ones.  Some of the more popular preventive measures are:
    • Elevating Your Legs.  Elevate your legs when possible by keeping your feet positioned higher than your heart level to reduce pooling and pressure on your legs.
    • Exercising Daily.  Walking, climbing stairs, cycling and swimming keep your calf muscles in motion to activate the calf muscle pump. This reduces pooling and pressure in the veins.
    • Maintaining a Healthy Body Weight.Maintaining your ideal body weight will reduce excess pressure on your legs.
    • Actively Moving.  On long car or plane trips, activate your calf muscle pump by flexing your ankles periodically to pump the blood out of your legs (simulating walking).  During periods of prolonged sitting or standing, flex your ankles 10 times and repeat this every 10 minutes.  You should also consider stopping for short walks every few hours.
    • Avoiding Sitting Extensively.Try to avoid sitting for extended periods throughout your day.
    • Avoiding Excessive Heat.  Try to avoid excess heat on your legs, such as hot tubs and hot baths.  Heat tends to increase vein distention and lead to more pooling of blood.
  • Nutraceutical Treatment:
    • Horse Chestnut/Escin.One of the most widely used nutraceutical approaches for varicose veins is horse chestnut seed extract (Aesculushippocastanum).  Horse chestnut seed extract is widely used in Europe for chronic venous insufficiency.  Horse chestnut seed extract demonstrates impressive efficacy in relieving the symptoms of chronic venous insufficiency, effectively reducing leg volume, alleviating leg pain, improving edema, and averting itching.  The active ingredient in horse chestnut seeds is a chemical called escin, which in clinical studies has been reported to increase blood circulation.  Studies suggest that twice-daily horse chestnut extract containing 50 mg escin is as effective as standard therapy with compression stockings in the early stages of chronic venous insufficiency. Escin works by increasing the tone in the walls of the veins, preventing blood from pooling there.  Its ability to support healthy blood circulation has made horse chestnut a popular treatment for varicose veins.  More recent studies indicate that escin may also possess anti-inflammatory properties useful in reducing edema, swelling, and hemorrhoids.  Although horse chestnut extract has been recommended for a variety of medical conditions, such as inflammation and arthritis, varicose veins and chronic venous insufficiency are the only conditions for which there is strong supportive scientific evidence.  For optimal effects, the therapeutic dose of horse chestnut extract is 250 mg twice daily (standardized at 20% escin), which provides an equivalent dose of escin shown to be beneficial in clinical studies.

While there are a number of different treatment options available for varicose and spider veins, in our experience, we have found that a treatment consisting of a combination of the treatments above have proven to be most effective in the treatment of varicose and spider veins, and related symptoms.  Our refined use of sclerotherapy, combined with EVL, allows us to uniquely address the needs of our patients by treating the smallest spider vein to the largest ropelike varicose vein.  The great news is that none of the treatments requires hospitalization or surgery.  All procedures are done in our office. The patient can be back on their feet doing their normal routine that very same day.

mod_google_tr