Dr. Bruce R. Hoyle, M.D.
Specialist in the Treatment of Varicose Veins
Ultra-sound
Guided Sclerotherapy
Sclerotherapy can be used to treat both varicose and spider veins. A tiny needle is used to inject the veins with a medication that irritates the lining of the vein. In response, the veins collapse and are reabsorbed. The surface veins are no longer visible. Sclerotherapy relieves symptoms due to varicose and spider veins in most patients. With this procedure, veins can be dealt with at an early stage, helping to prevent further complications.
You may need anywhere from one to several sclerotherapy sessions for any vein region. Depending on the type and number of veins being treated you may have one to many injections per session. Generally, normal activities can be resumed after sclerotherapy. Medically prescribed support hose and/or bandages may need to be worn for several days to several weeks to assist in resolution of the veins. The procedure, performed in the doctor's office, usually causes only minimal discomfort. Bruising and pigmentation may occur after sclerotherapy. Bruising typically disappears within 1-2 weeks. Although pigmentation almost always fades, it can last for several months. Scarring and other complications are rare.
Ultrasound-Guided Sclerotherapy
This is an in-office treatment alternative to surgical stripping. With this technique, sclerotherapy is done while the doctor visually monitors the vein on an ultrasound screen. This enables treatment of veins that can't be seen because they are below the surface of the skin and would otherwise require surgical removal.
LES-Vein© (Laser Endovenous Saphenous Vein) Procedure is a treatment alternative to surgical stripping of the greater saphenous vein. A small laser fiber is inserted, usually through a needle stick in the skin, into the damaged vein. Pulses of laser light are delivered inside the vein, which causes the vein to collapse and seal shut. The procedure is done in-office under local anesthesia. Following the procedure a bandage or compression hose is placed on the treated leg. LES-Vein© treatment performed with a Dornier laser is FDA-approved for the treatment of the greater saphenous vein.
Radiofrequency Occlusion (Closure Procedure)
The Radiofrequency Occlusion closure procedure is a treatment alternative to surgical stripping of the greater saphenous vein. A small catheter is inserted, usually through a needle stick in the skin, into the damaged vein. The catheter delivers radiofrequency energy to the vein wall, causing it to heat. As the vein warms, it collapses and seals shut. The procedure is generally done in an outpatient or in-office setting. It may be done under local anesthesia. Following the procedure, the catheter is removed and a bandage or compression stocking is placed on the treated leg. The closure procedure is FDA approved for the treatment of the greater saphenous vein.
Surgical techniques to treat varicose veins include ligation (tying off of a vein), stripping (removal of a long segment of vein by pulling it out with a special instrument), and ambulatory phlebectomy (removal of veins through tiny incisions, SEE SECTION BELOW). Surgery may be performed using local, spinal or general anesthesia. Most patients return home the same day as the procedure. Surgery is generally used to treat large varicose veins.
Ambulatory phlebectomy is a method of surgical removal of surface varicose veins. This is usually done in the office using local anesthesia. Incisions are tiny (stitches are generally not necessary) and typically leave nearly imperceptible puncture mark scars. After the vein has been removed by phlebectomy, a bandage and/or compression stocking is worn for a short period.
A variety of laser/light source treatments are available today. A light beam is pulsed onto the veins in order to seal them off and cause them to dissolve. Light-based treatment is generally used only to treat small veins. Treatments may be combined with sclerotherapy. Multiple treatments are usually required.
What Results Can You Expect From Vein Treatment?
With the evaluation and treatment methods available today, spider and varicose veins can be treated at a level of effectiveness and safety previously unattainable. Regardless which treatment method is used, its success depends in part on careful assessment of the problem by a knowledgeable phlebologist.