Varicose Veins

What are varicose veins?

Varicose veins are enlarged veins that look like twisted cords. They often bulge above the skin’s surface and may appear flesh-colored, red, or blue. While any veins can become varicose, they usually form in the legs and feet.

What causes varicose veins?

Varicose veins take shape when the valves in the veins no longer function properly, causing blood to pool. Aging can contribute to their formation because veins lose elasticity, stretch, and weaken over time, making it harder for blood to flow back to the heart. Pregnancy can also lead to varicose veins by increasing the blood volume in your body. Family history of varicose veins, obesity, and spending lengthy amounts of time on your feet also increase your risk.

How are varicose veins treated?

Lifestyle Changes

Good skin hygiene, leg elevation, diet and exercise with weight loss are simple and helpful modifications. Low salt diet reduces water retention and swelling.

Compression Stockings

Wearing prescription, medical-grade, properly fitting support stockings is the most conservative approach, especially when the veins are causing uncomfortable symptoms or pain or when non-healing wounds/ulcers ensue. These can be purchased from a pharmacy or a medical supply store. They come in various sizes such as below-the-knee, thigh-high and pantyhose style.

Non-Surgical Treatments

Watch the videos below for demonstrations on the VenaSeal™ closure system and Covidien ClosureFast™ venous treatments.

Sclerotherapy Injections

Since the 1930s, injections of concentrated saline (salt) solution or a detergent injected into the veins make them harder initially and disappear eventually in 3-6 weeks. We use FDA-approved medication, Sotradecol®, with or without ultrasonic guidance, to treat spiders and smaller sized varicose veins.

Laser and Intense Pulse Light (IPL) Therapy

These devices use heat energy, with minor discomfort, to damage or destroy the abnormal vessels. Discoloration, staining and blister formation are their potential side effects. Lasers and IPL devices may be useful in treating these veins particularly on the face.

Vein ligation (tying off a vein) and venous stripping (removal of a long segment of the vein) are the most commonly used surgical modalities. Others include ambulatory phlebectomy and endoscopic surgery.

Endo-venous Ablation

Dr. Bokhari, Board Certified in Endovascular Medicine, specialize in minimally-invasive endovenous ablation therapy using various modalities including, but not limited to, laser, radiofrequency, clarivein and/or venseal to treat the symptomatic, chronic venous insufficiency caused by significant venous reflux. It is an outpatient, office-based, approximately a 45 minute procedure with no need for hospitalization or general anesthesia and minimal to no downtime that results in immediate recovery but long lasting results.

What’s chronic venous insufficiency?

While varicose veins aren’t always problematic from a health standpoint, they can progress or derive from chronic venous insufficiency (CVI). This condition happens when vein walls or valves stop working effectively, interfering with blood flow and causing pooling of blood known as stasis.

CVI symptoms may include:

• Aching or tiredness in the legs
• Flaky or itchy skin on the legs or feet
• Leathery-looking skin on the legs
• New varicose veins
• Swelling in the lower legs and ankles, especially after standing for long periods of time
• Stasis ulcers

How’s CVI treated?

Your doctor can diagnose CVI through a physical exam and noninvasive duplex ultrasound imaging. Treatment may involve venous stripping, which is a highly invasive surgical therapy, or endovascular ablation, which is a minimally invasive in-office procedure. Endovascular ablation takes only 45 minutes and brings immediate recovery, so there’s no need for downtime.

How can I prevent CVI?

Lifestyle shifts, such as a healthy diet, regular exercise, and maintaining a healthy body weight, can go a long way toward preventing CVI. Leg elevation, painkillers, compression stockings, and laser and Sclerotherapy injections may also help manage symptoms.