Ronald L. Nath, MD
This procedure involves the removal or destruction of
that are just under the skin.
There are different methods to remove veins, such as:
Veins have one-way valves to channel blood back to the heart. Varicose veins develop when the valves of the veins become damaged. This causes blood to pool in the veins, enlarging them, and often making the veins just beneath the skin visible. The skin can also turn dark purple or brown because of increased pressure.
Treatment may be done for cosmetic and health reasons. In some cases, the areas of discolored skin may break down and form open sores, called stasis ulcers. Clots can also form in the pooled blood. When the valves are functioning poorly, your leg may burn, ache, or throb.
Treatment for this condition can involve either destroying or removing the damaged veins.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Smoking may increase the risk of complications
Your doctor will:
Leading up to the procedure, you may be advised to:
The anesthesia depends on the type of procedure that you are having. Anesthesia may be:
With this procedure, a chemical will be injected into each of the damaged veins. This chemical will scar the vein so that it will no longer be able to carry blood. This will be a short, simple office procedure.
A catheter is inserted into the damaged vein. An ultrasound is used to view the placement of the catheter. An adhesive is injected into the catheter to seal the vein.
This is done on one of the largest superficial veins, called the great saphenous vein. The vein will be viewed using an ultrasound. Then, the vein will be punctured near the knee. A catheter will be threaded up to the groin. The space between the vein and the skin will be filled with a special solution. This solution will provide local anesthesia. The catheter will then be attached to a radiofrequency generator or a laser. Heat or light energy will seal the vein closed so that there is no longer any backflow of blood.
The veins will be removed by threading a long wire into them. Each vein will be tied to this wire and then stripped out. This will leave the smaller side branches broken off and in place. This procedure is usually not used on the saphenous vein.
This surgery is used to remove larger veins that cannot be injected. Many small incisions will be made to access each varicose vein. The vein will either be tied off or removed.
If vein stripping is done, you will have many loose vein ends in your leg. Your leg will be tightly wrapped. This is to prevent blood from leaking out of the veins.
You will have pain and discomfort with the procedure. Stripping is more painful. Ask your doctor about pain medication.
When you return home, be sure to follow your doctor's instructions. You may need to have another ultrasound done.
After arriving home, contact your doctor if any of the following occurs:
If you think you have an emergency, call for emergency medical services right away.
American College of Phlebology
American Society of Plastic Surgeons
Canadian Society for Aesthetic Plastic Surgery
Canadian Society for Vascular Surgery
Merchant RF, Pichot O, Closure Study Group. Long-term outcomes of endovenous radiofrequency obliteration of saphenous reflux as a treatment for superficial venous insufficiency.
J Vasc Surg. 2005; 42(3):502-509.
Varicose veins. VascularWeb website. Available at:
http://www.vascularweb.org/vascularhealth/pages/varicose-veins.aspx. Accessed June 13, 2016.
Varicose veins and spider veins fact sheet. US Office on Women's Health. Available at:
http://womenshealth.gov/publications/our-publications/fact-sheet/varicose-spider-veins.html. Updated July 16, 2012. Accessed June 13, 2016.
6/2/2011 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed.com: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
3/16/2015 DynaMed Plus Systematic Literature Surveillance
http://www.dynamed.com: US Food and Drug Administration. FDA approves closure system to permanently treat varicose veins. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm435082.htm. Published February 20, 2015. Accessed June 13, 2016.
Last reviewed June 2016 by Michael J. Fucci, DO
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