From an interview with
Dr. Carmen Piccolo
McLeod Vascular Associates

Venous disease can cause minor cosmetic problems, major debilitating pain and discomfort, and chronic wounds that don’t heal for many months, sometimes years. This is due to a failure of the veins to drain blood from the feet and legs back to the heart. Depending on the symptoms’ severity and the cause of the symptoms, different treatments are warranted.

“Many years ago, we used a treatment called vein stripping,” says McLeod Vascular Surgeon Dr. Carmen Piccolo. “That was a quite invasive procedure, where two incisions were made — one in the groin and one in the lower leg. A plastic tube was pushed through the vein and it was literally pulled out of the leg. At the time it was revolutionary, because it did not include a long scar to open the entire leg.”

NEWER TREATMENTS
Today, we use ultrasound guidance to place a small tube inside the vein and hook it up to a source of energy, which can be either radiofrequency or laser. It burns the vein from the inside, closing it down to prevent the blood flowing in the wrong direction and decreasing pressure on the varicose veins of the lower leg.

The newest evolution in treatment is called VenaSeal, where a catheter is placed inside the vein under ultrasound guidance. However, instead of hooking the catheter to a source of energy, a special glue is injected through the catheter that closes down the vein. The advantage of this approach is a lack of heat irritation that can affect the tissue around the vein.

In some situations, the VenaSeal procedure will be covered by insurance. It is best to check with your insurance provider to see if your treatment would be covered.

If the visible bulging veins that you can see have been there for a very prolonged period of time, even removing this pressure imbalance may not completely make them disappear. They may still also be painful. In those cases, the veins may need to be removed with a Stab Phlebectomy procedure. Very small needle sticks are made in the skin. A very small hook is inserted through these tiny little incisions and an extremely small surgical device removes the veins.

PREVENTING VEIN PROBLEMS 

• Most importantly, we have to control our weight, because being overweight contributes to increased pressure on the veins in the lower extremities.
• We should live an active lifestyle. Sedentary living — standing in one place, sitting in one place for prolonged periods of time – aggravates the symptoms. If you are sitting at the desk all day, make a point of walking around at least once an hour for several minutes.
• Elevating our legs is helpful when possble. The ankle would have to be above the heart level – admittedly not easy to do at work.
• People who cannot do anything about their lifestyle should use some form of compression stocking (ideally knee high). These can be found in uniform shops, as well as on the Web.

Find a Vascular Specialist near you.