Vein Treatments

Vein Ablation

Traditionally, “stripping” the saphenous vein was the treatment of choice for saphenous vein reflux. With the introduction of the ClosureFast radiofrequency device (also known as VNUS Closure and Venefit) there has been a revolution in the treatment of varicose veins. This technique is referred to as “Vein Ablation.” It has become the standard of care for treating saphenous vein reflux. This procedure allows eliminating venous reflux by obliterating the inside of the vein with heat derived from a catheter emitting radiofrequency energy. A catheter is inserted into the vein and energy is delivered to the vein wall, causing the vein to seal shut. As the catheter is withdrawn from the leg, a sealed vessel is left behind. Once the diseased vein is closed, blood is automatically re-routed to other healthy veins. Patients are required to wear medical support hose for a short period of time following the treatment. This procedure is associated with much less pain and fewer complications compared to traditional vein stripping. Most patients report a noticeable improvement in their symptoms within 1-2 weeks following the procedure. Many patients can resume normal activities immediately. Saphenous vein ablation usually takes about 30 minutes and can be done under local anesthesia in our clinic. Most insurance carriers will cover the cost if it is deemed medically necessary.
Problems associated with saphenous vein ablationsThe following complications can occur but are uncommon:• Vessel perforation• Phlebitis• Infection• Hematoma or bleeding• Nerve injury• Skin burn• Deep venous thrombosis• Pulmonary embolus• Failure to ablate the vein being treatedAn important factor to consider is that the great saphenous vein is used for heart and leg bypasses for cardiovascular surgery. If the vein is severely diseased and would not be a suitable conduit for future bypass surgery, eliminating the vein is not an issue. But if the vein is still suitable despite being diseased, it may not be wise to ablate it. The choice should be determined by the patient’s age, symptoms, desired outcome, and associated cardiovascular disease.

Phlebectomy

Phlebectomy involves removing bulging varicose veins using cosmetic minor incisions (3mm incisions). Local anesthetic is used to anesthetize the skin and the procedure can be done in the clinic. The incisions are so small that no sutures are needed to close them.

Sclerotherapy

Sclerotherapy is the minimally invasive treatment of unsightly veins on the surface of the skin using small injections to administer a medication to close the veins. At Houston Vein Specialists, we use Asclera® (polidocanol) for sclerotherapy. We do not use compounded sclerotherapy agents. Asclera works by damaging the inner wall of the vein, and eventually causing the vein to collapse on itself. Over time, typically 4-6 weeks, the damaged vein is replaced with tissue. While individual results may vary, most patients will require multiple injection sessions for complete treatment success, which are usually done every 4-6 weeks. Treatment is done in the office and typically takes 20 minutes. Patients are able to return to regular activity immediately after treatment with no downtime. Patients will wear medical grade compression stockings for one week after each treatment. The veins will typically look worse immediately after the treatment and may take 4 weeks to look better. Sclerotherapy for the cosmetic treatment of spider and small varicose veins are not covered by insurance plans.