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Sclerotherapy
What is sclerotherapy?
Sclerotherapy is used to treat both spider veins and certain types of varicose veins. Sclerotherapy involves the injection of a special medication into the diseased vein which causes it to close off. Here at Vein Center of Lake Norman, we use FDA-approved drugs called Polidocanol and Sotradecol. These drugs are not as painful as saline injections, which are used by many other offices.
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Will it hurt?
Most patients describe minimal itching and burning for 5-15 minutes following sclerotherapy, but you will leave the office free of discomfort. You will feel the prick of the needle being inserted into the skin. However, we use the tiniest of needles possible to reduce the discomfort felt by our patients. A day or so after treatment, you may have tenderness in the area of the vessel we treat. However, the discomfort will be temporary.
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Is this treatment permanent?
Most people who have spider veins also have diseased veins which “feed” the spider veins. At our office, we make every effort to treat the underlying problem, as well as the spider veins. By treating the underlying veins, the chances of recurrence are much lower.
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How many treatments will I need?
It depends on the severity of your problem. If we are able to treat the “feeder” veins effectively, you may only require one or two treatments. However, if you have a more severe problem, such as numerous spider veins over a larger area, we may require 3-5 sessions to take care of your veins.
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Will I need to take time off of work?
No. You will need to wear compression hose for at least 24 hours, but you can resume some normal activities immediately after the treatment. The only restrictions will be from high impact aerobic activity and weight-lifting with the affected limb.
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What is the cost?
This will vary depending on the number/length of session(s) you require, and whether you are treating spider veins or varicosities. We charge per session.
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Endovenous Laser Treatment
What is EVLT?
EVLT stands for Endovenous Laser Treatment. This is a relatively new technique that is replacing the traditional vein stripping in practices across the nation. It is primarily used to treat varicose veins. EVLT involves threading a laser fiber into the diseased vein and firing it inside the length of the vein. This effectively “closes” the vein, preventing backward blood flow and the increased pressure associated with varicosities. Local anesthetic (numbing medication) is used, and all EVLT procedures are done here at our office.
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Is the procedure painful?
As mentioned, the procedure is carried out under local anesthesia. A dilute solution called “tumescent” is used. You will feel the prick of the needle used to inject the anesthetic, but you should be completely numb for the remaining part of the procedure. Many people describe a feeling of pressure as the anesthetic is injected into the tissue, but this only lasts a few seconds until the medication takes effect. Since the entire area around the vein is numb, you will feel nothing as the laser is fired. After the procedure, the anesthetic lasts a few hours. You will take medication at regular intervals for at least 10 days to decrease pain and inflammation. Most people find the pain-relief we recommend to be more than sufficient. Very rarely will patients require a stronger pain-reliever, but if they do, we are happy to prescribe something.
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How effective is the ELT treatment?
The EVLT procedure is about 98% effective in closing the vein. When a vein is stripped in the traditional method there is only about a 50% likelihood that the surgery will be successful. Also, there is a good chance new veins will grow and would require treatment. With EVLT, new veins are unlikely to grow thus greatly decreasing the likelihood that you will require additional treatment in the future. In short, EVLT is considered not only more effective at treating varicosities than traditional stripping, but also safer since general anesthesia in not necessary.
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Can all varicose veins be treated with ELT?
Unfortunately, no. If the vein is greater than 2cm in diameter, then the laser will not be effective. Also, if the vein is very tortuous or “winding”, then it may be impossible to insert the laser fiber far enough into the vein to be helpful. If the vein is located very close to the surface, EVLT is not appropriate. In these cases, an alternative treatment will be recommended by the surgeon.
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MICRO-INCISION PHLEBECTOMY
What is a micro-incision phlebectomy?
A microphlebectomy is used to treat certain types of varicose veins. The word “phlebectomy” literally means removing the vein. The day of the procedure, the doctor or nurse will mark your leg where the veins bulge out. Then, a special local anesthetic (numbing medication) called “tumescent” is injected into the area surrounding your vein. The doctor will make tiny incisions of about 2-3mm, the size of a ballpoint pen tip, and then use a crochet-type hook to “grab” the vein and remove it. This interrupts the vein, causing any remaining portions of the vein to “clot off”, and get rid of those unsightly bulgy areas!
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But don’t I NEED those veins?! What if I need bypass
surgery later?
NO! With the advances in technology regarding heart and vascular surgery, it is no longer necessary to use leg veins in the heart. Since the veins in the legs are dilated and not working properly, they are actually doing more harm than good.
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Does it HURT?
Most patients say that the procedure does not hurt at all. You will feel the pin prick of the needle as we inject the anesthetic, but then the quickly becomes numb. You will not feel any of the incisions. You should not feel pain from the veins being removed. We will give you some prescription-strength ibuprofen to help you for the first day or two, but the vast majority of patients require only extra-strength Tylenol or Motrin to keep them comfortable. Rarely will patients require a stronger pain-killer post-operatively.
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What about scarring?
The incisions are so tiny, that any scarring is not usually seen. Most patients can barely see their incisions four to six weeks following surgery. Compared to the “railroad tracks” associated with traditional vein stripping, the scars are practically non-existent.
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What is the “down” time for a stab phlebectomy?
The “down” time for this procedure is negligible. You will need to take it easy for the first 24 hours, but walking is encouraged to promote healing—you will walk out of the office! After the first day, normal activities are resumed, except for high impact aerobic activity, weight-lifting with the affected limb, swimming and taking tub-baths. After that, it is business as usual.
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Laser Treatment for Spider Veins
What happens during the procedure?
During the procedure, the doctor or nurse will take a device that looks like a large pen with a wire attached and place the tip directly on the skin over the vein. He/she will then fire the laser several times along the length of the vein. You will hear clicking and beeping sounds as the laser fires and will feel a tingling sensation. The laser shrinks and closes the vein so that blood can no longer flow through it. This decreases or completely gets rid of those purple/red veins.
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Is it painful?
Most patients describe the tingling sensation mentioned above. Others describe the feeling as “tiny pinches” or “bee stings”. Either way, the feeling is fleeting, lasting less than a second. Once the firing is complete, the discomfort disappears.
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When is laser used?
Laser is used on the tiny reddish or purple veins that are less that 1mm in diameter. Laser can also be used when veins are located on the face. It is also used in combination with injections or sclerotherapy. The laser helps shrink the veins so that the sclero medicine is more effective.
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Is it dangerous?
Without special safety precautions, the laser can be dangerous. However, we ensure patient as well as health care worker safety by 1.) providing safety glasses for everyone in the room and 2.) using the lowest effective setting possible. At the very low energy settings we use to treat spider veins, the danger is minimal.
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