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Q. Is varicose vein treatment painful?   A. In most cases there is no pain but there may be some minor discomfort.   Q. How much will it cost?   A. If there is pain and discomfort, most insurance companies now cover the procedure.   Q. When can I get back to work?   A. You can go home that same day and can usually return to work the next day.   Q. What causes Varicose Veins?   A. Heredity is the number one contributing factor causing varicose and spider veins. Women are more likely to suffer from abnormal leg veins. More than 50% of American women may be affected. Hormonal factors including puberty, pregnancy, menopause, the use of birth control pills, estrogen, and progesterone affect the disease. It is very common for pregnant women to develop varicose veins. Pregnancy causes increases in hormone levels and blood volume which in turn cause veins to enlarge. In addition, the enlarged uterus causes increased pressure on the veins. Varicose veins due to pregnancy often improve within 3 months after delivery. However, with successive pregnancies, abnormal veins are more likely to remain. Other predisposing factors include aging, standing occupations, obesity and leg injury.   Q. When and how are veins treated?   A. The most commonly asked questions are: Do veins require treatment and What treatment is best? Veins that are cosmetically unappealing or cause pain or other symptoms are prime candidates for treatment. There are two general treatment options: conservative measures, such as compression stockings, and "corrective" methods such as endovenous laser ablation, sclerotherapy, and minimal surgery. In some cases, a combination of treatment methods works best.   Q. What is Endovenous Laser Ablation treatment?   A. Endovenous Laser Ablation Treatment 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. Vigorous activity should be limited for some time after the procedure. For several days after the procedure anti-inflammatory medication has to be taken. Endovenous Laser Ablation Treatment is FDA-approved for the treatment of the greater and lesser saphenous vein.   Q. What is Sclerotherapy?   A. 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.   Q. What is Ambulatory Phlebectomy?   A. 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.   Q. What results can I expect?   A. 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 interventional radiologist specializing in venous diseases.

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