Vein Treatment Varicose Veins Laser Lipo & Vein Care Center Ask the Doctor

What is the VeinWave?

Veinwave works using radio waves that are pulsed directly to the desired area, so vein treatment is quick and pain free.

- Dr. Wright

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Is there any danger in wearing compression stockings daily for a long period of time?

No, the daily use of compression stockings, particularly for an individual whose occupation or activities require standing or sitting for prolonged periods can only help your legs. The only time there might be a concern would be in an individual who has significant arterial disease, in which case the stocking might reduce already limited arterial blood flow in the limb. A venous specialist will be able to evaluate you and determine if their use is appropriate in your case.

- Dr. Wright

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I have spider veins on multiple areas of my body, and I’d really like to have more than just the ones on the legs treated. Can spider veins on the face/neck area, hands, and arms be treated, and what procedure do you recommend?

Spider veins of the face are usually treated with laser light therapy but some of the bluish veins around temples are often treated better with sclerotherapy. Spider veins of the hands and legs tend to do better with sclerptherapy but some tiny reddish vessels are well treated by a cutaneous laser or light treatment.

- Dr. Wright

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After receiving Vnus laser ablation with ultrasound guided sclerotherapy I developed several large ulcers BELOW the knee area. Any explanation for what could have happened?

Ultrasound Guided Sclerotherapy can cause ulceration at the site of injection. This is a rare but a possible complication of any type of sclerotherapy. There are several possible mechanisms of ulcer formation. Two of the possible cause  are as follows. Inadvertent injection of the sclerosing solution into the tissues around the vein can create the damage. More commonly is an essentially unavoidable potential for an injected vein to have a microscopic connection (fistula) with a small artery so that the vein solution gets shunted to the artery and causes an artery closure thereby damaging the skin fed by that small artery. When an unexpected event like this occurs the best approach is to speak with your provider. There are many causes of developing ulcers after your procedure some very simple and some not so simple. Your provider knows your exact history and procedure and will be able to provide you with the best care. I would encourage you to speak with him/her first.

- Dr. Wright

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Is the foam a separate ingredient? What are the chances of an allergic reaction?

Foam is created when a sclerossant is mixed with air or gas. Typically, room air is mixed with the solution to create the foam. This technique is very safe when done properly. The risk of any type of allergic reaction is due to the solution being used, not the air.

- Dr. Wright

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Could some or all of the cost of sclerotherapy be covered by my provider?

It depends on what type of vein is being treated: Bigger veins that are symptomatic might be covered by an insurance company; smaller asymptomatic spider veins generally are not.

It also depends on the individual benefits of the insurance plan you have. Policies regarding vary depending on the insurance company.

Finally, sometimes it depends on whether the sclerotherapy treatment is done as part of a larger treatment plan that includes treatment of the saphenous vein. Our experience has been that insurance does not cover any sclerotherapy unless it is completed following an endovenous laser procedure.

- Dr. Wright

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When is it unnecessary? I already know I have varicose veins, so what are the benefits of having a venous reflux exam?

If you have varicose veins which bulge, or other symptoms of venous insufficiency such as achy legs, swelling in the legs, or skin discoloration or ulceration then you should have a venous insufficiency ultrasound evaluation. A venous reflux exam also evaluates the deep venous system making sure it is working properly and without insufficiency or thrombus (DVT). Venous reflux exams are necessary for all patients with suspected venous insufficiency and especially those that are being considered for vein procedures.

- Dr. Wright

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I had a phlebectomy that was not successful, then laser ablation and sclerotherapy within 2 months of each other. I now have shooting pains in my leg… is this something that is normal?

This is not typical. If the phlebectomy did not give you any improvement in the appearance of the varicose veins, that probably means they were not removed. If you noticed immediate improvement but then new varicose veins appeared, that would indicate that the underlying cause (a leaky vein) was not treated. That would be the purpose of laser ablation. Shooting pains in the leg could be part of the healing process or it is possible that a nerve injury has occurred. I would recommend discussing these symptoms with your doctor.

- Dr. Wright

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I am significantly overweight and have very painful varicose veins in my legs. Is it better for me to have surgery or endovenous laser treatments?

EVLT or ELVeS/radiofrequency ablation are preferable in most individuals and even more so for overweight individuals. There are several reasons for this preference. First, general anesthesia is not used for EVLT or ELVeS ablation and overweight patients are at higher risk for complication for general anesthesia. Another reason is that ligation and stripping procedures require incisions. In overweight individuals carry there is an added risk of poor healing and infection with incisions form stripping procedures. This would be especially applicable to a groin incision that usually requires to treat the greater saphenous vein.

- Dr. Wright

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I’ve heard that ELVeS can prevent new varicose veins from occurring, and from recurring once a given area has been treated. Is this true, and if not, can any treatment prevent varicose veins?

ElVeS (Endo Laser Vein System) is a new endovenous laser treatment that treats the underlying cause of most varicose veins: saphenous and small saphenous vein insufficiency. Treating the underlying cause in turn will likely prevent the development of new varicose veins in the area of the leg that is served by the treated vein.

- Dr. Wright

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I have both spider veins and varicose veins. Will endovenous laser ablation treat both of these problems?

Endovenous laser ablation treats a leading and prominent cause of varicose and spider veins. Usually [>80% of the time] sine sclerotherapy (injection treatments) is needed to “clean up” the remaining varicose and spider veins that are not reduced by the endovenous laser treatment. Occasionally, less than 20% of the time, the treatment of the underlying reflux with the EVLT leads to enough improvement or resolution of both spider or varicose veins that no additional treatment is required.

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