Varicose veins are enlarged veins that get that way as a result of faulty valves within the vein that allow the blood to reverse flow so that rather than bringing blood back up to the heart to be recirculated, the malfunctioning valves allow the blood within the veins to reverse flow thereby causing the veins to enlarge. The enlarged veins often lose their straight tubular shape and become tortuous, even appearing in clusters. The varicose veins can become symptomatic with patients often reporting burning, itching, tingling, fatigue, heaviness, cramping, aching, swelling, edema, and restlessness. Left untreated, symptomatic varicose veins can progress to more serious medical conditions including skin inflammation, skin ulcer, venous inflammation, and venous blood clots.

Heredity is the number one factor causing varicose veins. An inherited weakness of the vein wall and vein valves contribute enlargement of normal veins such that they become varicose. Women are more likely to suffer from varicose veins, especially because of pregnancy and hormonal factors. In addition to family history and female gender, other aggravating factors predisposing to development of varicose veins include advancing age, obesity, trauma, intense weight-training exercise, and occupations involving prolonged sitting or standing.

Heredity and advancing age are the predominant risk factors associated with developing varicose veins. An inherited weakness of the vein wall, coupled with the effects of advancing age, contribute to the stretching of veins such that they become varicose. Women are more likely to suffer from varicose veins than men, especially due to pregnancy and hormonal replacement therapy. If others in your family had varicose veins, there’s a greater chance you too will develop varicose veins. Other risk factors for developing varicose veins include obesity, trauma, intense weight-training exercise, and occupations involving prolonged sitting or standing.

A bilateral lower extremity venous insufficiency evaluation performed by one of the expert Vein Specialists at Hogue Vein Institute is a crucial step in the accurate diagnosis of your vein problem. Data obtained through a history and physical examination, as well as venous duplex ultrasound evaluation including vein mapping and venous reflux assessment, allows your Vein Specialist to make an accurate diagnosis with appropriate vein treatment recommendations. As a new patient, you can expect your initial vein consultation at Hogue Vein to take about 90 minutes to complete.

Since varicose veins have abnormal blood flow, the surrounding veins are already being burdened by having to compensate. Treatment of abnormal veins actually removes this burden from the surrounding veins, thereby improving the venous circulation. This improvement in the venous circulation accounts for the improvement in varicose vein symptoms following effective varicose vein treatment. This is because the body redirects the blood flow into stronger, healthier, deeper veins within the legs.

Since your body hasn't used these veins since they became abnormal, there is no reason to keep them.

In assessing symptomatic varicose veins, an expertly performed venous ultrasound evaluation by a Phlebologist plays a critical role. A venous duplex ultrasound evaluation is performed which permits the Phlebologist to see the anatomy and to map out the underlying leg veins. Useful information is gathered to diagnose your specific vein problem. After the Phlebologist makes an accurate diagnosis, an appropriate and effective customized treatment plan can be developed for you.

After applying ultrasound gel to the leg, a handheld device is passed back and forth to evaluate the underlying veins. Sound waves sent into the leg bounce back to the handheld device whereby the attached ultrasound machine displays them as a picture on a monitor. The ultrasound evaluation is painless and usually takes about 45 minutes to complete.

The endovenous laser ablation procedure is performed by a physician vein specialist, also known as a Phlebologist. The EVLA procedure is done in a procedure room at one of our vein clinics and requires only local anesthesia. A very thin bare laser fiber is inserted into a varicose vein within the leg through a tiny skin puncture. Laser energy heats up the vein causing it to shrink and collapse. The venous blood flow is then routed to healthy veins within the leg muscles. Any residual branch veins remaining after the EVLA procedure are effectively treated by the Phlebologist using ultrasound guided sclerotherapy and/or visual sclerotherapy during follow up treatment sessions. Unlike surgical vein stripping where there is significant down time, patients treated with the EVLA procedure and/or with sclerotherapy have no down time, and can resume normal activities immediately.e

Exercise is not only permitted following the EVLA procedure, it is encouraged. Immediately after the EVLA procedure, our patients walk on our clinic treadmill for 20 minutes. We find that patients who use their leg muscles every day after the EVLA procedure have faster healing, less discomfort, and fewer complications. The simplest and most effective form of exercise to optimize leg vein function is walking. We often have our patients abstain from running, jumping, heavy lifting, abdominal straining, swimming and bathing (showering is okay) for 1-2 weeks following the EVLA procedure.

Ambulatory phlebectomy is an outpatient procedure that removes superficial veins through small, slit-like incisions in the skin.

Ambulatory phlebectomy may be used to remove bulging superficial veins from beneath the skin. Typically, treated veins are the larger, bulging (raised) varicose veins.

Patients who are allergic to local anesthesia, who are not able to walk on their own, and who cannot wear medical grade compression stockings or leg compression wraps are not candidates for this procedure. For infection concerns, any active infection or rash in the treatment areas must be resolved before undergoing this procedure.

Ambulatory phlebectomy is performed using tumescent local anesthesia so patients should not feel any pain during stab avulsion or extraction portion of this procedure. Following an AP procedure, discomfort should be minimal, especially if medical grade compression stockings are worn as directed.

Temporary bruising and swelling of the treated area is typical following AP, but is usually minimized with medical grade compression stockings. The tiny incisions heal well without sutures with minimal scarring and pigmentary changes. Although every attempt is made to remove the entire varicose vein, there may be small vein segments that remain beneath the skin. These vein segments may become inflamed and irritated causing a condition known as thrombophlebitis. The residual vein may feel like a hard cord and may be tender. Over-the-counter medications, medical grade compression stockings, and tincture of time usually resolve this condition. Rarely, a sensory nerve may be injured which causes temporary to permanent skin numbness or sensory changes to ensue. The sensory changes usually affect only a small skin area. Movement or leg motor function should not be affected.

Bruising and swelling is normal and temporary following an AP procedure. Patients can walk immediately after an AP procedure and carry on normal daily activities except for exercise and heavy lifting. To maximize your results and recovery, it is important that you follow the activity restrictions and wear the medical grade compression stockings as directed by your Vein Specialist. Your varicose veins are physically removed and therefore should not come back. However, depending on other factors such as family and personal history, new varicose veins may develop over time.

Exercise is not only permitted following the EVLA procedure, it is encouraged. Immediately after the EVLA procedure, our patients walk on our clinic treadmill for 20 minutes. We find that patients who use their leg muscles every day after the EVLA procedure have faster healing, less discomfort, and fewer complications. The simplest and most effective form of exercise to optimize leg vein function is walking. We often have our patients abstain from running, jumping, heavy lifting, abdominal straining, swimming and bathing (showering is okay) for 1-2 weeks following the EVLA procedure.

Call the Hogue Vein Institute at 1-866-356-VEIN to schedule your vein consultation. During this consultation, your legs will be examined and an ultrasound evaluation performed by one of our vascular technologists. Any questions you may have will be answered. You may also discuss your expectations and anticipated results. Since the majority of our patients at Hogue Vein have their therapeutic vein care covered by insurance, it is usually necessary for each patient to first undergo a 3-month trial of physician-supervised conservative vein therapy, provide they have not done so previously. A prescription for medical grade compression stockings is routinely provided at the conclusion of your initial vein consultation if you are diagnosed with varicose veins or chronic venous insufficiency.