FAQ
Q. What are the symptoms of Venous Insufficiency aka Venous Reflux?- Heavy, tired, burning or aching legs especially at the end of the day
- Cramping in the calves (Charley horse)
- Restless legs especially at night
- Swelling in the ankles that goes away in the morning
- Numbness or tingling in the lower legs and feet
- Itching or irritated rash in the lower legs
- Thickening and darkening of the skin around the ankles that progresses upward
- Tiny blood vessels around the ankle that burst open and bleed spontaneously
- Open ulcers that do not heal for long periods of time
- All of the symptoms typically progress and worsen throughout the day, making it difficult to stand or sit for long periods, and cause poor sleep
Q. What are Varicose Veins?
A. Veins are vessels that return blood from the legs back up to the heart. Healthy veins work against the force of gravity using one-way valves that allow upward blood flow, but not downward flow. Varicose veins develop due to loss of valve function that allows blood to flow back down the leg. Over time, they continue to dilate and become visibly enlarged, bulging, and twisted. Varicose veins are more than just a cosmetic nuisance. They are a visible symptom of a progressive, underlying condition called venous insufficiency.
Q. What causes varicose veins?
A. Heredity is a primary factor in over 85% of the cases of varicose and spider veins. Women are more likely to suffer from abnormal leg veins due to hormonal factors and multiple pregnancies. Other contributing factors include occupations requiring prolonged standing or sitting, obesity, a previous leg injury or leg surgery.
Q. What are spider veins?
A. Spider veins also called telangiectasias are tiny red or purplish veins located at the surface skin layers. Spider veins cannot be felt. Veins larger than spider veins are called reticular veins and these are the blue veins seen under the skin.
Q. What is Endovenous Laser Ablation (EVLA)?
A. It is a minimally invasive laser treatment for venous insufficiency also known as superficial venous reflux. A thin laser fiber is inserted through a small catheter that is placed in the vein through a tiny opening. The laser fiber delivers heat to the vein wall, causing it to collapse and seal shut.
Q. How long does the laser procedure take?
A. The actual laser portion of the procedure takes approximately 15 to 30 minutes, though patients normally spend 1 1/2 to 2 hours at the clinic due to normal pre- and post-treatment prepping.
Q. Is this procedure painful?
A. Patients report feeling little, if any, pain during and after the procedure. The physician will give you a mild sedative and use a local anesthetic to numb the treatment area prior to the procedure.
Q. Will the procedure require any anesthesia?
A. The procedure is performed using only local anesthetic that numbs the skin.
Q. How quickly can I resume normal activity?
A. Patients are walking immediately following the procedure, and typcially, resume normal activities within one day and may drive the following day. For a few weeks after treatment, we recommend wearing compression stockings and staying active with a walking regimen to avoid any complications.
Q. How soon will my symptoms improve?
A. Many patients notice an immediate relief of symptoms such as pain, heaviness and fatigue. The full benefits of the procedure may take 1 - 2 weeks.
Q. Is there any bruising, swelling, or scarring after the procedure?
A. Patients report minimal to no bruising, scarring or swelling following their laser procedure.
Q. Are there any potential risks and complications associated with the procedure?
A. As with any medical intervention, potential risks and complications exist. The physician will review your medical history and potential complications at the consultation prior to the procedure and send a letter to your primary care physician. Complications can include, phlebitis, which is an inflamed vein, bruising, numbness or tingling, and rarely, deep vein thrombosis.
Q. Is the endovenous laser procedure suitable for everyone?
A.The physician will determine if the procedure is a good option for you based on your medical history. However, those persons that have an acute blood clot, are currently pregnant, or immediately post-partum may have to wait until the physician gives the ok to undergo the procedure.
Q. How effective is the endovenous laser procedure?
A. Over 90% of treated veins remain closed 1-year post-treatment.
Q. What happens to the treated vein left behind in the leg?
A. The vein simply becomes fibrous tissue and will gradually be absorbed. Your body naturally reroutes the blood through the remaining healthy veins.
Q. What happens to the blood flow if you close off my vein?
A. The vein being treated is already not working and is making other healthy veins take up the extra burden. Once the diseased vein is closed, these healthy veins can work more efficiently and will essentially improve your circulation.
Q. What if I need the vein for bypass surgery in the future?
A. Enlarged diseased veins are not appropriate for bypass surgery. Physicians will use healthy, much smaller veins from other areas of your body.
Q. Is this procedure covered by insurance?
A. Most insurance companies will cover vein procedures and you are responsible for any co-pays, deductibles and / or co-insurance, if applicable. We can give you an estimate before your first treatment.
Q. How does venous disease progress if it is not treated?
| A. | Stage 2 | - Simple varicose veins |
| Stage 3 | - Ankle oedema of venous origin (not foot oedema) | |
| Stage 4 & 5 | - Skin changes and healed venous ulcer | |
| Stage 6 | - An open venous ulcer |
Q. What is sclerotherapy and what is it used for?
A. Sclerotherapy is the injection of a sclerosing solution into an abnormal vein. The solution that is injected destroys the vein wall which causes the vein to collapse and shut down. Sclerotherapy is a form of chemical ablation, while laser treatment is a form of thermal (heat) ablation. Sclerotherapy is typically performed on very curvy varicose veins, bluish reticular veins, and reddish-purple spider veins.
Q. Can varicose and spider veins return after treatment?
A. Current treatments for varicose veins and spider veins have very high success rates. Once the vein is treated, that vein will not come back. However, because venous disease is typically inherited, you will always be predisposed to developing spider and / or varicose veins over time.
