Varicose veins are, put simply, abnormally enlarged veins. They are usually caused by damaged valves in the veins which transport blood from our legs back to the heart. Normally, these valves act to prevent blood from flowing backwards (towards the feet), as the muscles in our legs squeeze the veins causing blood to flow forward (towards the heart). When the valves are faulty, blood flowing backwards fills and inflates these veins like a balloon. These become the unsightly veins many people are familiar with. The underlying abnormal blood flow is known as "venous insufficiency".
Aside from being unattractive, varicose veins can cause an aching pain, a sensation of heaviness or fatigue of the legs. Venous insufficiency, the underlying problem, can also lead to ulcer formation in the shin area and to dark blotchy areas of discoloration.
Varicose veins can usually be diagnosed by simple physical examination. However, the underlying cause, venous insufficiency, is best evaluated with Doppler ultrasound. This is a pain-free way of determining the exact pattern of abnormal blood flow and determining which valves are abnormal. This information can then be used by the physicians at Valley Endovascular to tailor a treatment plan.
In the past, varicose veins were often treated by a surgical procedure known as "vein stripping". This is an often painful procedure whereby a long vein (the greater saphenous vein) is removed from the leg through small incisions. The procedure typically requires a two week recovery time before returning to normal activities. At Valley Endovascular Associates a new minimally invasive option is available.
EVLT is a procedure performed in our office, with no incisions and no hospital stay required. After local anesthesia is given, a laser fiber is inserted through a small needle-hole in the skin into a vein that runs along the inner thigh (the greater saphenous vein). This is the vein which contains the abnormal valves that cause most varicose veins. The vein is then heated with the laser, causing it to collapse and shrink so that it can no longer carry blood backwards into a patient's varicose veins. This portion of the procedure usually takes a few minutes and is painless. Patients can return to their normal activities immediately following the procedure.
Patients may experience some soreness after the procedure which can be treated with over-the-counter pain relievers. Once the abnormal reverse blood flow has been stopped with EVLT, the enlarged varicose veins typically shrink in size and symptoms resolve or are greatly improved. After a few months of observation, any residual enlargement of veins can be treated with sclerotherapy or ambulatory phlebectomy, minimally invasive procedures also offered in our office.
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