Spider veins (also known as telangiectasias or “sunburst varicosities”) are small, unsightly clusters of red, blue or purple veins usually form on the thighs, calves and ankles. Varicose veins are the blue or purplish enlarged veins appear swollen and raised above the surface of the skin. These thin veins are connected to the venous system, but are not an essential part of it. Spider veins and varicose veins can result from many reasons – heredity, hormonal shifts, weight gain, prolonged sitting or standing, and certain medications. Spider veins sometimes are accompanied by symptoms such as aching, burning, swelling and night cramps.
Spider veins tend to develop in one of 3 patterns:
1) Spider shape – veins radiate outward from a dark central point.
2) Arborizing – resemble tiny branch-like shapes, usually forms on outer thigh.
3) Linear – resemble thin separate lines, usually form on inner thigh.
Listed below are several types of procedures used in spider vein and varicose vein removal:
Sclerotherapy Treatment
Spider veins and smaller varicose veins can be treated by injections of a sclerosing solution. This solution works by irritating the lining of the vein, causing the vein to seals shut and collapse. The vein then fades over time. The injections require no anesthesia as they are relatively painless, and are usually performed in the doctor’s office. Cotton and compression tape is applied to the injection site, and support stockings may be prescribed by the doctor to promote healing. The injection site may be temporarily bruised or discolored for one to two weeks. Two or more sessions are usually required to achieve maximum results, scheduled at least one month apart.
Risks Related to Sclerotherapy Treatment
Risks related to sclerotherapy are very rare, but can include blood clots in the veins, inflammation, allergic reactions to the sclerosing solution and skin injury that could leave scars. In some cases, skin pigmentation irregularity can occur, which will fade over time. Another reaction that can occur is “telangiectatic matting,” where small reddish blood vessels appear around the treated area. This condition is remedied through additional injections.
Endovenous Laser Treatment (“EVLT®”)
Endovenous Laser Treatment “EVLT®” uses laser technology to remove unsightly veins. During EVLT treatment, a thin laser fiber is inserted into the target vein through a small needle hole. Laser energy is applied, which heats up the inside of the vein, and irratates the walls of the vein, causing it to shrink and seal shut. The laser fiber is removed, and a dressing is applied. With no blood flowing through the faulty vein, the bulge is eliminated and the unsightly vein fades from sight.
EVLT treatments are generally done on an outpatient basis using local anesthetic, and takes approximately 30 – 45 minutes. There is no scarring, and minimal discomfort. There may be minor bruising and discoloration, and a little soreness at the treatment site, all which will completely dissappear over time.
Once the vein is sealed, the probe is removed and a small dressing is applied. A compression bandage is prescribed to be worn for about 1 week.
Radiofrequency Occlusion (VNUS®)
Radiofrequency Occlusion (also known as VNUS) uses radiofrequency energy to remove unsightly veins. During VNUS treatment, a thin catheter is inserted into the vein through a small incision. Radiofrequency energy is then applied, which heats up the inside of the vein, causing it to collapse and seal closed.
The procedure is performed on an outpatient basis, in the doctors’ office, surgical center or hospitals. To ensure the patient’s comfort during the treatment, local anesthesia is used.
Ambulatory Phlebectomy
Ambulatory Phlebectomy microextraction is a procedure where a tiny incision is made in the skin to remove unsightly surface varicose veins. This procedure is simple, and done in the office using local anesthesia. The incisions are tiny, stitches are not required, and any resulting scars are imperceptible. The patient will need to wear a compression stocking for about 1 to 2 weeks to minimize swelling or discomfort.
Transilluminated Powered Phlebectomy (“TIPP”)
Transilluminated Powered Phlebectomy or “TIPP” is a vein removal procedure that uses an endoscopic transilluminator. The surgeon inserts the transilluminator is under the skin to illuminate and target the veins that need to be removed. Next, a suction device is positioned through a small incision at the other end of the varicose vein. The surgeon then cuts the vein and removes it using the suction device. Once removed, the surgeon injects a anaesthetic into the area to minimize bruising, and pain. The incisions are then closed with small sutures or tape.
Vein Ligation & Stripping
Vein ligation and stripping are procedures done on large, unhealthy varicose veins that are swollen, have been bleeding, are resulting in ulcers or simply done for cosmetic reasons.
Vein stripping is a procedure involving minor surgery. Veins with valves that are damaged are removed (“stripped”). The surgeon makes an incision above and below the vein and threads a flexible instrument is threaded up the vein to the first incision, and the vein is grasped and removed.
Vein ligation involves a similar procedure. Instead of completely removing the damaged veins, incisions are made over the damaged veins, and the vein is tied off (“ligated”). This cuts off the faulty valves while leaving the healthy parts of the vein in place to continue circulating blood through other veins that still have valves that work well.
Vein ligation and stripping are generally done on an outpatient basis with general anesthesia.