Varicose veins are dilated (enlarged) veins that usually occur in the legs. They may appear as small,l branching channels that resemble spiders legs (hence the term spider veins), or they may be larger, up to one or two centimeters in diameter. Veins transport blood back to the heart. Veins have valves in them that are supposed to prevent blood from flowing backwards, away from the heart. Varicose veins develop from poor functioning of these valves, which allows the blood to pool in the veins. They appear blue or purple, because venous blood has less oxygen in than red, arterial blood. Risk factors for developing varicose veins include age, female hormones and pregnancy, obesity and genetics. All of these factors may contribute to a loss of elasticity in the veins, which can cause failure of the valves. However, anyone can develop varicose veins.

The symptoms of varicose disease may be purely cosmetic, as in the case of spider veins. Larger dilated veins may also be only cosmetic, or they can be painful, and can cause hyperpigmentation (dark skin), ulceration or even bleeding. The treatments vary, depending on the type and loacation of the veins.

Treatment of Varicose Veins

There are several types of treatments for varicose veins, depending on the size, symptoms and location of the veins:

1. Venous sclerotherapy involves injection of a liquid solution into the veins that scleroses, or scars, the endothelium, or inner lining of the vein, causing it to collapse. The body then absorbs the vein, and it disappears. At the Boca Vein Center, we employ a very small needle, 32 guage, for the injections, which makes them practically painless. Hypertonic saline, a salt solution, similar to the salt in our bodies, but more concentrated, is used for the injections. Veins up to five to six millimeters (one quarter of an inch) can be injected. These veins may take up to three to four months to disappear completely, but reinjections may be necessary.

2. Vein stripping is a surgical procedure, requiring regional or general anesthesia, that is performed in an operating room. In this procedure, long segments of large, dilated varicose veins are literally stripped from the leg, using two or more small incisions. With the advent of laser treatments, this procedure is rarely performed.

3. EndoVascular Laser Treatment of large varicose veins utilizes a laser to treat the veins. This procedure is performed in the office, with local anesthesia. It is similar to sclerotherapy for the smaller veins, except that the sclerosis of the lining of the veins is caused by the laser, rather than injection.

4. Phlebectomy is the surgical removal of small segments of the larger dilated veins through small incisions in the legs. This procedure is also performed in the office, under local anesthesia.

Before Your Procedure

Very little preparation is required before any vein procedure. You should refrain from taking Aspirin, Advil, Alleve or any other anti-inflammatory medication for one week prior to the procedure. You should inform the staff if you are taking Coumadin, as that should not be stopped without consulting your Primary Care Physician. You mat take Tylenol at any time before or after your procedure. In general, antibiotics are not prescribed before these procedures. You should bring comfortable clothing, such as athletic shorts, to wear during the procedure, as well as loose pants or a skirt to wear over your compression stockings when you leave the office. You should bring compression stockings with you to the procedure, as you will need to wear them home after the procedure.

Post Procedure Care

In general, after most procedures performed at the Boca Vein Center, we recommend the use of compression hose, for at least one week. Knee high, thigh high or waist high hose, depending on the location of the veins being treated, can be used. These can be obtained at most medical or surgical supply stores and at many drug stores and pharmacies.

Walking is the best post procedure exercise, as the use of the leg muscles helps to promote normal blood flow through the deep veins of the legs. We prefer that patients refrain from heavy exercise for one week after the procedure, as this may cause sweating, which increases blood flow to the skin and may increase blood flow to the recently treated veins.

We prefer refraining from taking baths or the use of hot tubs for one week after the procedure. Again, these hot environments may promote increased blood flow to the skin, which we prefer to avoid. Of course, you may take a shower the next day, and every day after the procedure.

You may resume medications such as Aspirin, Advil, Alleve, Coumadin or any other anti-inflammatory medications two days after your procedure.