Sclerotherapy can be used to treat both varicose and spider veins. With minimal to no discomfort reported by most patients, a tiny needle is inserted into the vein and small amounts of sclerosing solution and/or microfoam (Eurofoam-SV®) are injected. The solution causes the vein to close up or 'sclerose'. Typically, these closed veins will gradually be reabsorbed by the body and disappear. The procedure is performed in the office, in sessions that last approximately 30 minutes. The number of sessions required depends on the extent of veins present. Patients experience symptomatic relief such as reduced leg heaviness and the cessation of itching and burning soon after treatment. VLS has developed techniques to avoid side effects such as hyperpigmentation and matted telangiectasias, which frequently occur following sclerotherapy treatment.
An alternate treatment for venous reflux disease is available at Vein and Laser Specialists. It is cost-effective in those situations where the patient has no insurance or his insurance company denies coverage for endovenous laser treatment. The treatment, performed by Dr. Agostini, is a form of sclerotherapy that utilizes real-time sonography to accurately access the greater saphenous vein or connecting veins called perforators, which are not visible through the skin's surface, and inject them with Eurofoam-SV®.
Compression stockings are applied after the procedure and generally worn for about a week. There are no incisions involved and return to normal activities, with the exception of vigorous, aerobic exercise and lifting weights, is immediate. A consultation will determine whether ultrasound-guided sclerotherapy is an appropriate option.
The largest varicose veins associated with extensive valvular dysfunction and multiple points of reflux occasionally require surgical intervention. Fortunately, with the development of an advanced microsurgical technique called ambulatory phlebectomy, this can be performed in a minimally invasive fashion. This is done through tiny incisions that generally do not require stitches, allowing for a very fast recovery and early return to normal activities. It does not require hospitalization.
In the early 2000s, treatment for varicose veins made a quantum leap from a highly invasive, painful surgery, known as vein stripping, to a streamlined, office-based procedure, called Endovenous Laser Treatment (EVLT) also known as Endovenous Laser Ablation (EVLA), which produced superior long-term physical and cosmetic improvement. EVLT or EVLA has become the gold standard for treatment of chronic venous insufficiency and venous reflux disease resulting in varicose veins. Dr. Agostini has performed thousands of EVLT or EVLA procedures with excellent results.
An ultrasound exam done at the time of your initial consultation will confirm the need for EVLT or EVLA. In the event of venous reflux disease, vein valves located along the length of the greater or short saphenous vein, usually at the junction with the corresponding deep vein fail, cause blood to reverse its flow, putting pressure on the connected superficial veins. This results in dilated, visible varicosities. In some people, symptoms are more subtle. No visible veins may be present, but if the person experiences chronic swelling, leg heaviness, and bluish-purple discoloration, particularly around the ankle, he may have chronic venous insufficiency. In both situations, reflux is present and is easily demonstrated by ultrasound. Perforator veins may also be treated with this technology.
The procedure is performed with mild sedation and local, tumescent anesthesia, and takes only about 45 minutes to an hour. A catheter holding a laser fiber is inserted into the vein containing the faulty valve, laser energy is applied and the vein is sealed shut by the laser as the fiber and catheter are withdrawn from the vein. A special compression stocking is worn for about a week to facilitate healing. The majority of patients return to work the next day and a full range of activities in week to 10 days. At VLS, patients experience little to no discomfort, no hospitalization, and an affordable treatment!
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