The nature of venous disease stretches from minor cosmetic problems to major debilitating pain and discomfort to chronic wounds that don’t heal for many months, sometimes years, 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 Gabor Winkler, MD. “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.”
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. 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.
So far, VenaSeal is not covered by insurance. In some western states, the Medicare providers have started to cover it. Once the federal government Medicare program covers a treatment, private insurers usually follow.
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 an Ambulatory 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