The Cause of Spider Veins

Spider veins are clusters of small surface veins that are typically red, blue, or purple and have developed from weakened or damaged valves in the tiny vessels. Spider veins are much smaller than varicose veins but do not often cause pain or symptoms. Below are some causes of spider veins and ways of prevention:

  1. Genetics- There is a strong familial component for developing spider veins. Often times, patients will report multiple family members with pesky spider veins.  
  2. Pregnancy- Hormonal changes and abdominal pressure during pregnancy can cause spider veins to form or become more prominent.
  3. Excessive Standing or Sitting- Long periods of standing or sitting can increase pressure in the veins, causing them to dilate and damage the valves, leading to prominent veins on the skin. Try to take short breaks when sitting or standing for long periods of time or do a brief walk. Compression stockings may also help reduce some of the pressure on the veins when standing or sitting for extended periods.
  4. Sedentary lifestyle and increased BMI (Body Mass Index) – Exercise and maintaining a healthy weight can help decrease the risk of spider veins.
  5. Trauma or injury- Some people will notice spider vein formation after a focal trauma to their leg.

Spider veins can be easily treated in the office setting using sclerotherapy injections. This is where the small clusters of spider veins are injected using a medication, called a sclerosant. Over time, the spider veins close off and fade away.

If you are interested in learning more about spider veins and treatment, contact the Vein Institute to set up an appointment!

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12 Symptoms of Varicose Veins

When most people think varicose veins, they think about bulging veins. Unfortunately, the signs of varicose veins can be vague and nonspecific, which the untrained eye has a hard time distinguishing. Many patients don’t realize that you don’t need to see bulging veins to have varicose veins. Some patients suffer severe cases of certain symptoms of varicose veins, but don’t even have any visible bulging varicose veins. Patients do not need to have bulging varicose veins to have the underlying disease (chronic venous insufficiency) or experience the symptoms.

We compiled the 12 most common symptoms of varicose veins based on what patients subjectively feel or see. We also considered the signs of varicose veins – what vein doctors see and observe during an examination.

1.Dull, Throbbing

Do your legs constantly throb and ache? Do they feel dull and painful, causing you to constantly want to rub or elevate them? Patients often describe this symptom as a background annoying pain, pressure, or cramping/tingling-type feeling that is tolerable during the day when you’re too busy to dwell on it. But at the end of the day when they try to relax, the pain can be debilitating. Many patients experience this symptom the more they are on their feet and at the end of the day.

2. Heaviness

Do your legs feel heavier at times throughout the day, usually getting worse toward the end of the day? The feeling is pronounced once you are stationary, such as during a movie or a long flight. Patients with more severe symptoms say it feels like they have “lead” in their shoes or socks.

3. Fatigue

Do you usually feel like your legs are tired and lethargic? Many people experience fatigue in the legs but assume they just had a long day at work.

4. Swelling

Chronic Venous Insufficiency usually causes the feet and ankles to swell; the swelling gets progressively worse as the day goes on. Once you take off your shoes, you’ll likely notice a “sock line.” Swelling can happen for many other reasons, such as heart disease, but younger patients who have no history of other causative factors should schedule a vein appointment. A vein doctor is trained to see if chronic venous insufficiency is the cause or if it can be ruled out.

5. Itching

Superficial veins that cause chronic venous insufficiency drain blood away from the skin on the leg. Since incompetent varicose veins cause poor blood circulation, your skin can become very dry and scaly, especially on the shins, calves, and ankles. Many patients use excessive lotion and moisturize (many even claim to use up to one bottle of lotion each day!) to constantly keep their legs from being so dry. Obviously, dry skin may be caused by dermatologic issues, but check with a vein doctor to make sure you’re not suffering from CVI.

6. Burning, prickly feeling

Patients have trouble describing this symptom, but many relate it to heat or a burning feeling. You may feel a prickly feeling, with some even describing “creepy crawlers” underneath the skin in their legs. Once a vein doctor investigates, he or she often finds a bulging varicose vein close to where the patient feels the burning sensation.

7. Restless Leg Syndrome

Restless Leg Syndrome (RLS) is manifested as a constant need to move or shake your legs and it occurs most often at night. Traditionally, RLS has been considered a neurological issue. However, many patients with chronic venous insufficiency say they also experience restless legs as well. Patients say they “just can’t get their legs comfortable” in any position, so they constantly shift their legs, put a pillow between their legs, or elevate their legs on a pillow. Patients who have varicose veins and are treated nearly always also get relief from their restless leg symptoms.

8. Charley horses or leg cramping

Similar to RLS at night, many patients experiencing the symptoms of varicose veins report that they often wake up in the middle of the night with severe cramps or Charley horses. They usually have to jump out of bed and move to stop the pain and cramping.

9. Bruising

Do your legs bruise easily? Even minimal injuries or bumps leave bruises, which tend to last longer than other bumps or bruises on the body. This is because people with varicose veins have an increased number of dilated veins near the skin’s surface.

10. Skin darkening and/or hardening

Have you noticed the skin on your legs darken and harden and you don’t know why? Usually over the shin and calf region, the symptom starts as darker spots and progresses to a reddish brown skin discoloration, oftentimes accompanied by hardening of the skin in the same region. Sometimes, this area will stop swelling and the swelling only occurs above this in the upper calf and knee region.

11. Bleeding

Women often report that while they were shaving their leg over a small bulging vein, they experienced severe bleeding, often in the shower and creating a terrifying scene. Men describe excessive bleeding after a small bump or scrape over a bulging vein. Varicose veins bleed because they are under pressure. They can take significant time and pressure to ultimately stop bleeding.

12. Skin breakdown/ulcer

An ulcer is one of the most severe symptoms of varicose veins. Ulcers usually occur after decades of poor venous skin circulation from venous insufficiency. The patient usually experiences many of the previous signs and symptoms of varicose veins before developing an ulcer, especially the dark skin discoloration and hardening previously described. An ulcer refers to an open wound or sore in the leg. The diseased varicose vein is located underneath the skin and the ulcer. The patient needs more than wound care since covering it and applying topical medicine only treats the problem superficially; you need to have the underlying vein problem professionally treated to have this symptom cured.

If you have any questions about the symptoms of varicose veins, contact us and we’d be happy to help. We can readily see abnormal veins underneath the skin with a quick and easy ultrasound exam. If one or more of these symptoms sound familiar to you, schedule a free vein screening at your earliest convenience to find out if you’re suffering from varicose veins.

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What Are The Safest Varicose Vein Removal Procedures?

Varicose veins, which arise due to chronic venous insufficiency, are not simply unsightly; they can also cause pain and discomfort. Symptoms may even arise even without any bulging veins.

Years ago, patients underwent a surgery known as vein stripping for varicose vein removal. This has been largely replaced by safer and less invasive varicose vein removal treatments that require no significant amount of downtime for recovery. We want our patients to understand their options and help them choose the procedure that is best for their situation.

Radiofrequency Ablation for Varicose Vein Removal

Radiofrequency ablation destroys the vein through the use of heat. The practitioner uses ultrasound to find the vein and place a catheter (small tube) in the right location. The catheter then generates heat to close down the problematic vein. Most patients experience promising results in a short period of time.

Endovenous Laser Ablation Therapy

Endovenous laser ablation therapy works similarly to radiofrequency ablation in that it utilizes an ultrasound to guide the catheter. In this instance, it uses a laser rather than radiofrequency to generate the heat. Once in position, the laser closes down the abnormal vein.

Ultrasound-guided Foam Sclerotherapy

With ultrasound-guided foam sclerotherapy, the vein doctor also utilizes an ultrasound to guide the procedure. After finding the abnormal vein, the doctor injects a special solution known as sclerosant into the problem vein. The foam solution incorporated in this type of sclerotherapy closes problematic smaller veins.


VenaSeal, one of the newest varicose vein removal treatments available, is a proprietary adhesive used to close troublesome superficial veins. It is FDA-approved medical grade product designed to be gentle and minimizes the lidocaine numbing injections when compared to the ablation procedures. In the VenaSeal closure system procedure, the vein doctor uses a catheter to inject the adhesive into the incompetent veins to prevent the blood flowing backward into the vein. The procedure is guided by ultrasound.  


Microphlebectomy is used to remove large bulging veins by using tiny incisions after the skin and vein are numb with lidocaine. The incisions are so small that generally they do not require stitches and rarely leave any visible scars. Microphlebectomy is usually done in conjunction with an ablation procedure.


The above procedures provide some of the safest and minimally-invasive varicose vein removal options. Generally, they require little to no downtime, and you often can leave the doctor’s office on the same day and go back to your daily life. Ready to move forward in treating your varicose veins? Sign up for a free vein screening.

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Vein Center Versus Hospital: What Does it Take to Be a Vein Center?

When you have a certain health problem, the best practitioner to see is a specialist in that specific area of medicine. By the same logic, when you experience vein issues, the best place to go is a vein center. The criteria for this designation are strict, ensuring that the doctors and staff members have the knowledge and expertise to assist you.

What Are the Qualifications to be a Vein Center?

As the name suggests, this type of facility focuses on treatments for problems with the veins, such as chronic venous insufficiency and varicose veins. Facilities offering vein procedures can choose to become accredited by the Intersocietal Accreditation Commission (IAC) for special designation as a location offering these procedures. Additionally, facilities can also choose to meet rigorous standards from the American College of Radiology (ACR) to become accredited in Vascular Ultrasound as well.

To do so, facilities must offer at least two out of four procedures associated with vein treatment:

  • Saphenous vein ablation (such as surgical or ultrasound-guided chemical ablation)
  • Ambulatory or powered phlebectomy
  • Sclerotherapy
  • Non-operative management of chronic venous insufficiency with ulceration (i.e. wound care such as compression therapy and debridement)

The center must undertake a rigorous evaluation process by an external committee to ensure it adheres to the strict standards of the IAC in every facet. These include items such as the training and experience of the medical staff, the type of equipment, the physical space, and the type and volume of the medical procedures. Then, the IAC reviews the application and determines whether the facility meets the criteria. Only the top vein practices in America get accredited.

How Is A Vein Center Different Than Hospitals or Other Healthcare Facilities?

Although hospitals generally have highly-skilled staff members specializing in many areas of medicine, the facilities – and often the doctors – deal with a variety of issues on a daily basis. Many healthcare facilities also provide a multitude of services, although some might focus on one specialty, such as ambulatory surgical centers. In order to be able to offer and treat so many different procedures, they cannot have expertise in all.

In contrast, a focused vein practice concentrates only on vein issues and handles only these treatments. The doctors and staff can become experts as that is all that they treat. The medical staff must undergo continuing education, which ensures they regularly review the latest knowledge of the field and bring it back to their center to the benefit of the patients.

What Are the Benefits of Seeing a Vein Doctor?

The biggest benefit of seeing a vein doctor at a specialty vein center such as The Vein Institute is that you get expert care with the latest treatments. Because the only patients they see have chronic vein insufficiency and similar health problems, they can fully focus on becoming experts in the field. Choosing an IAC-accredited center and ACR-accredited Vascular Ultrasound practice further ensures that you visit a facility with the best equipment, procedures, and patient care for these particular treatments who have met or surpassed a rigorous testing process for excellence.


Interested in getting rid of your varicose veins or other vein problems from vein experts? Sign up for a free screening to learn how we can help.

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What is Cosmetic Sclerotherapy and Is It Right For Me?

Spider veins, also known as telangiectasias, often get confused with varicose veins, but there is a difference. By definition, varicose veins are bigger than spider veins, which are surface veins smaller than 1 mm. While varicose veins bulge out of the skin and cause swelling and pain, spider veins generally are simply a cosmetic issue. About 40 percent of women and 25 percent of men experience spider veins at some point. The most common – and best – treatment is known as cosmetic sclerotherapy.

What Is Cosmetic Sclerotherapy?

Cosmetic sclerotherapy is a minimally-invasive therapy in which a doctor such as an interventional radiologist or a trained physician assistant injects a special solution called a sclerosant into these spider veins. The veins seal shut, impeding blood flow to those particular veins. Instead, the blood moves to healthier veins in the same area of the body. Because there is no blood flow to the unsightly veins, the visibility reduces, and the vein ultimately disappears.

When Do You Need Treatment?

Spider veins occur for various reasons, some of which are unknown. Genetics, injuries, small repetitive trauma, varicose veins, and hormones can contribute to their development. The symptoms include visible purple, red, or blue veins which usually occur in a pattern similar to tree branching out or like a spider, hence the name. They can cause mild itching but are often present without any pain or swelling.

Although treatment is not medically necessary for most patients, many still prefer to do it for aesthetic reasons. Anyone with spider veins and general good health is a candidate for the procedure. Unsuitable candidates include those who are pregnant, have an allergy to the solution, or have certain conditions which your doctor will screen for.

What Is the Treatment Procedure?

The procedure takes place in a comfortable office setting at the doctor’s office. After an examination, the doctor identifies the troublesome veins, which might require the use of an ultrasound or specialized flashlights in some instances. The doctor or physician assistant injects the medication carefully into both the spider veins and the veins that lead to them using a tiny needle, one which is much smaller than the typical one used to draw blood.

All the spider veins that can be safely treated are addressed at the appointment. However, you might need to have more than one treatment with a six to twelve-week gap in between. The number of treatments varies for different patients and is based on the number of spider veins, the expectations of the patients, and whether new spider veins form. Although there is a high success rate, spider veins do tend to recur in many patients.

What Is the Recovery Time?

Sclerotherapy is a minimally-invasive treatment with little to no down time. There is no anesthesia, so you do not have to worry about any potential complications of that. The typical side effects are minimal, such as itching, swelling, and discolored skin. You might experience bruising in the area in which the doctor made the injection. Generally, there is no need for stockings afterward and most people return to normal daily activities immediately.

Because spider veins are not medically necessary to treat, sclerotherapy is considered a cosmetic procedure. As such, most insurance companies do not cover it and payment is out-of-pocket.

Contact us if you have any questions and we’d be happy to help you learn more!

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Varicose Vein Treatment: What Is An Interventional Radiologist (IR)?

Before you undergo any vascular treatments, you should fully research the procedure and any language you might hear from your vein specialist. Several key terms associated with varicose vein treatment may confuse patients. The following definitions should help you understand the important words for a more informed discussion with your doctor and/or vein specialist.  

Interventional Radiologists

An interventional radiologist, or IR, is a physician who specializes in utilizing imaging guidance to diagnose and then treat using minimally invasive procedures. They treat diseases in nearly every organ system in the body, especially in arteries and veins.

Interventional radiologists use several types of imaging including ultrasound, x-ray fluoroscopy, CT scans, and MRI. One of the unifying themes of all interventional radiologists is performing procedures using minimally-invasive techniques.

Minimally-Invasive Treatment

You probably hear the term minimally invasive treatment, procedure, or surgery said a lot, but you might not know what it actually means. A minimally invasive approach involves the least possible damage to the body, typically requiring only a small incision or nick not much bigger than a needle. Advantages of using minimally invasive techniques abound – less risk of bleeding, lower chance of infection, less painful procedures requiring minimal if any sedation, smaller incisions leading to smaller scars, often no sutures required, and less overall risk of the procedures.  

Thermal vein ablation is an example of a minimally-invasive treatment. Generally speaking, minimally invasive procedures such as ablations are strongly preferred by nearly all patients and have made more invasive surgeries obsolete.   

Chronic Venous Insufficiency

Chronic venous insufficiency is the condition associated with varicose veins. Veins carry blood to your heart from the rest of the body. Blood valves in the legs prevent the blood from refluxing, or going back, down towards the feet instead of to the heart. With venous insufficiency, the blood cannot properly flow to the heart, so it pools in the veins and can cause bulging, painful varicose veins.

Varicose Vein Treatment

Patients have several options for varicose vein treatment. For most patients, varicose vein surgery is unnecessary and has been nearly rendered obsolete; instead, they can undergo minimally invasive procedures. Some of the most common treatment options include:

  • Vein Ablation: Also known as radiofrequency ablation (RFA) or endovenous laser ablation (EVLT), this procedure uses radiofrequency heat or laser heat to close the varicose veins.  
  • Venaseal: The latest vein treatment is actually a vein adhesive or medical grade glue. Venaseal works by gluing the veins closed instead of heating them; eventually, the varicose veins will fibrose and disappear.
  • Microphlebectomy: Microphlebectomy or ambulatory phlebectomy uses small punctures in the skin to remove varicose veins. It is used on smaller veins and produces minimal scarring.
  • Sclerotherapy: This procedure involves directly injecting a medicine called a sclerosant into troublesome veins to close them down. Ultrasound is often used to guide the therapy, which is known as ultrasound-guided foam sclerotherapy.

If you have any questions, we’d be happy to discuss vein treatment further. You can also contact us to schedule a consultation

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What You Need to Know About Venous Insufficiency

Chronic Venous Insufficiency (CVI) is a medical condition in which the veins in the legs have trouble getting blood back to the heart. CVI is especially pronounced in the legs because veins in the legs are furthest from the heart and must work against gravity to get blood back to the chest.

This condition is usually caused by failure of the valves in these veins. Valves function by preventing the backward flow of blood, and when they do not work, they allow blood to pool in the leg veins, causing bulging veins and a number of different symptoms.

relaxing Venous Insufficiency

What is venous insufficiency?

Symptoms of Venous Insufficiency

Initially, venous insufficiency may not have any symptoms at all save the appearance of pronounced or even bulging veins in the legs. However, if the condition worsens, it can cause pain or discomfort, as well as an assortment of other symptoms. Some of these include:

  • Leg heaviness and fatigue
  • Swelling of the ankles and calves
  • Itching of the skin around the veins
  • Muscle cramps/Charlie horses
  • Restless legs at night
  • Skin discoloration or breakdown

Treatments for CVI

Elevating the legs, exercising, and wearing compression stockings may provide some relief from minor cases of venous insufficiency. You can also alleviate the pain somewhat by avoiding sitting or standing in one position for a long time to help prevent blood from pooling in the legs.

More serious chronic venous insufficiency may require medical intervention. Vein doctors prescribe several different treatment methods depending on the severity of the condition:

  1. Conservative treatment
  2. Medical grade compression stockings
  3. A minimally-invasive procedure to effectively eliminate diseased veins and improve venous circulation of the legs

Are Other Treatment Options Available? →

Is This a Serious Medical Issue?

About 40% of the US population is affected by venous insufficiency to some degree. When diagnosed and treated early, venous insufficiency rarely results in serious complications. Even long-standing chronic venous insufficiency can be reversed with prompt treatment.

If you are worried about varicose veins or other vein issues, talk with your vein doctor or sign up for a free vein screening to find out if you need treatment.

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Is Restless Leg Syndrome (RLS) a Symptom of Varicose Veins?

Varicose veins are usually recognized by their unsightly appearance – large bulging veins, either green or bluish purple – most commonly found on the legs, although they can appear anywhere on the body. But these relatively small veins are actually a medical issue (covered by insurance) rather than cosmetic (not covered by insurance) and can cause moderate to severe health problems.

The symptoms of varicose veins may seem minor at first but may indicate serious conditions that can escalate quickly if the veins are left untreated.

Many patients are surprised to learn that one of the most common symptoms of varicose veins is Restless Leg Syndrome (RLS) – the irresistible feeling to move your legs, especially at night while trying to sleep. How can the two different conditions be related?

We’re first going to discuss the causes and symptoms of varicose veins a little more in-depth, then explain how RLS is connected to varicose veins, and last, what patients can do to find relief.

Causes of Varicose Veins

Varicose veins are caused when valves in leg veins malfunction and lose the ability to maintain proper blood flow. Eventually, blood starts to pool in the leg veins, causing them to bulge out. This condition is generally more pronounced in the legs where the veins are furthest from the heart and must work against gravity to return blood to the chest cavity.

Many people connect varicose veins with pregnant women, but varicose veins can happen to anyone of any demographic. Yes, pregnant women often develop varicose veins because of hormonal changes increasing the volume of blood in the body. While these changes protect the growing fetus, they can have adverse consequences. In reality, any adult can suffer from varicose veins – and may not even know it!

Symptoms of Varicose Veins

Especially in the early stages, symptoms of varicose veins are not particularly pronounced. Many people don’t even have bulging veins at all. However, many common issues may develop the longer the veins persist, including:

  • Swollen ankles
  • Itchiness around the shin region
  • Dull, aching pain that worsens as the day progresses
  • Legs always feeling tired and heavy
  • Muscle cramps, usually at night
  • Inflammation or reddening of the skin
  • Restless legs when trying to sleep at night

Varicose veins can become severely uncomfortable so patients are encouraged to find early treatment.

Check if you have the symptoms of varicose veins →

Varicose Veins and Restless Leg Syndrome

Although not everyone understands the symptoms of varicose veins, many do know the telltale signs of RLS. The sensations associated with this condition include:

  • Throbbing
  • Itching
  • Pulling Sensation
  • Aching
  • Creeping (prickly feeling)

Restless leg syndrome affects about 10-15% of Americans, though not all of these cases are caused by varicose veins. However, varicose veins do appear in many RLS patients. If you suspect you have RLS, it’s possible that varicose veins are causing them. Treating varicose veins leads to an improvement in RLS most of the time.

Find Treatment

If you are concerned about how the symptoms of varicose veins and RLS are affecting you, visit your doctor or vein clinic for a diagnosis. We offer free vein screenings to help educate patients on what varicose veins are. If you have any questions or concerns, please call 585.200.5363 for more information and we’d happy to help in any way we can.

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Why Do Spider Veins Need Multiple Treatments?

Many patients ask why they need several treatments for spider veins (technically known as telangiectasia). Cosmetic sclerotherapy, a minimally-invasive procedure designed to improve the appearance of spider veins, generally requires multiple treatments. Why can’t treatment be complete in only one session?

To help you understand spider vein treatment, let’s first talk about what spider veins truly are.

What Are Spider Veins?

Spider veins are characterized by a web of dilated veins most often found in the legs, though they can appear anywhere on the body. They resemble a spider web or thin tree branches that are either red, purple, or blue.

Spider veins are commonly found with varicose veins, which are blood vessels that have filled with pooled blood, but can be isolated as well. Although similar in appearance, spider veins and varicose veins are not the same. Spider veins are smaller (less than 1 mm) and are generally asymptomatic and only a nuisance aesthetically, although they can occasionally cause itching, burning, or stinging. However, unlike varicose veins, treatment for spider veins is typically considered cosmetic and is not usually covered by insurance.

What Causes Spider Veins?

Spider veins are thought to be hereditary and occur more often in women than in men. They are frequently caused by various life conditions such as puberty/growth spurts, pregnancy, occupations that require frequent standing, a history of blood clots, menopause, and weight gain. Spider veins occur most often around ages 30-50 but increase with age.

Cosmetic sclerotherapy has proven to be the most effective solution to treat spider veins, known as the medical gold standard, even earning an 88% Worth It rating within the last 24 months.

Cosmetic Sclerotherapy: Treatment for Spider Veins

During cosmetic sclerotherapy, a specialized solution called a sclerosing solution is injected directly into the problematic spider vein via a very tiny needle. The solution irritates the vein lining, causing fibrosis, and thereby closing the vein. The vein typically disappears in 2-6 weeks.

The number of treatments necessary to clear spider veins depends on each individual. In most cases, patients need 2-5 treatments to completely eliminate the appearance of spider veins. If the spider veins are bigger and more prevalent, additional treatments may be necessary. If new spider veins appear, patients will have to revisit their vein doctor. Always discuss with your vein specialist before beginning the procedure.

Spider veins require a slightly different treatment than varicose veins. Vein doctors generally treat underlying venous reflux and perforator venous reflux that contributes to the cause of the spider veins prior to actually performing cosmetic sclerotherapy. This will help prevent spider veins from coming back after treatment and potentially lessen the number of treatment sessions.

Ask Your Doctor

If you’re still not sure if cosmetic sclerotherapy will benefit you and how many treatments you’ll need, set up a consultation with your vein doctor. A professional vein specialist will be able to tell you if cosmetic sclerotherapy is a good option for you.

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Does Minimally Invasive Treatment for Varicose Veins Really Work?

Vein Stripping vs. Ablation Treatment for Varicose Veins

treatment for varicose veins

Do you think you might be suffering from varicose veins? You’ll know by taking a look at the various symptoms of this disease. The most obvious signs of varicose veins are:

  • Visibly bulging veins anywhere on the legs
  • Veins have a dark blue, purplish color
  • Dull, aching, and/or throbbing leg pain that gets worse as the day goes on
  • Your legs are heavier and more tired after extended periods of standing
  • Nighttime cramping or charlie horses
  • Restlessness at night, just can’t get your legs in a comfortable position
  • Swelling around the ankles (“cankles”)
  • Skin discoloration around the shins with open ulcers

Fortunately, patients with chronic vein insufficiency (CVI) do have hope – there are multiple treatment options available for varicose veins. How do you know which procedure is right for you? We will discuss the older method of vein stripping and compare it to modern, minimally invasive methods of varicose vein treatment.

Vein Stripping

Surgical vein stripping is generally performed in a hospital under anesthesia. During the procedure, the patient undergoes numerous incisions to pull the diseased vein out. The surgery usually leaves visible scars along the leg. Given how invasive the procedure is, patients oftentimes reported significant post-procedural pain and discomfort.

The recovery for this older procedure was difficult. Most patients were out of work for potentially long periods of time, accompanied with many restrictions. The stripping method also had a high recurrence rate where the veins grew back, often more severe, years after the procedure.  


  • Performed in an OR requiring anesthesia
  • Multiple large incisions requiring stitches
  • Sometimes required inpatient hospital stay
  • Higher risk of infection and bleeding
  • Visible scars
  • Significant recovery time/requires time off of work  
  • Post-operative bruising and pain
  • High recurrence rate
  • Veins can grow back

Thermal Ablation: RFA (radiofrequency) and EVLT (laser)

Thermal ablation relies on heat energy that is carefully delivered into the diseased vein to form scar tissue, which sufficiently closes off the bad vein. This method is done in a comfortable office setting with only local anesthesia or mild sedative for the affected leg. Patients are awake and they can listen to music or watch TV. Most are able to walk around immediately after the procedure.

There are no major incisions, only a tiny nick in the skin where the catheter is inserted into the vein, which is then covered with a small bandage. The nick is so small that it does not require stitches and heals very quickly. There is generally no scarring. Most patients experience an easy recovery, returning to their jobs, social events, and normal daily activities immediately following the procedure, with only minimal restrictions. Thermal ablation has lower recurrence rate due to the minimally invasive nature of the procedures.


  • Outpatient procedure – patients return home immediately following the procedure
  • No anesthesia
  • No major incisions, just a tiny nick to the skin, so small that it does not require a stitch
  • No blood loss
  • Minimal if any scarring
  • Immediately return to most regular activities
  • Easy recovery
  • Low recurrence rate

Radiofrequency Ablation (RFA) and Endovenous Laser Ablation Therapy (EVLT)

At the initial consultation, all the incompetent varicose veins are mapped out via ultrasound and the procedure details are discussed. On the procedure day, the interventional radiologist numbs the skin and then makes a small nick. A small catheter is inserted using direct ultrasound guidance. After numbing the entire length of the vein, the doctor delivers the RFA or EVLT energy to directly heat the diseased vein. Following the treatment, patients must wear a compression stocking for up to two weeks but can otherwise return to most routine activities right away. In fact, they are encouraged to exercise right away. During follow-up visits, the interventional radiologist uses a duplex ultrasound to ensure the vein is closed.

Still Not Sure If You Need Vein Treatment?

If you’re not sure if you have varicose veins or if you would be a good candidate for treatment, sign up for a free vein screening! You’ll learn more about the symptoms and causes of varicose veins, what treatment is like, and how best to find relief. We’ll perform a limited ultrasound on your legs and educate you if treatment can help. Contact us if you have any questions.

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