Know your options for treating varicose veins

If you have painful, unattractive varicose veins, you are not alone: More than 30 million Americans, men and women alike, are affected by the condition called venous insufficiency, which includes varicose veins, spider veins, and telangiectasias. While rarely serious to your health, varicose and spider veins can affect your psychological and physical sense of well-being—from their unsightly appearance to the feelings of pain, cramping, heaviness and fatigue that failing veins can produce. In some cases, changes in the skin, and even leg ulcers, may develop.

“Venous insufficiency occurs when the vein’s valves become damaged and cannot transport blood back to the heart efficiently,” says Misaki M. Kiguchi, MD, a vascular surgeon at MedStar Heart & Vascular Institute and a specialist in the management of vein disorders. “Family history, multiple pregnancies, occupations  requiring long periods of standing, obesity and age are all contributing factors.”

Fighting against gravity, healthy veins rely upon valves to open and close tightly, keeping the blood flowing in one direction: back to the heart and lungs. When the valves cease to function as they should, some blood leaks backward and pools in the legs, straining blood vessel walls.

The result is visually swollen veins close to the skin’s surface. Unfortunately, varicose veins will not  resolve by themselves and, left untreated, may worsen over time.

Approaches to the common condition range from conservative therapy to surgical intervention.

“Compression hose, which no one likes to wear, actually work

by providing extra support and pressure,” Dr. Kiguchi says. “But it’s like wearing prescription eye glasses:  You’re not really fixing the problem—only treating the symptoms.”

Today’s improved, minimally invasive techniques cannot only relieve pain, but address the root cause of the problem and  improve appearance, safely and effectively.

Radiofrequency ablation (RFA), for instance, uses a needle, a small catheter and  heat to collapse varicose veins. Similarly, sclerotherapy involves using a chemical injection to close off either spider or varicose veins. For the appropriate patients, these approaches produce results that are as effective as more invasive approaches, with less pain and recovery time.

“RFA and sclerotherapy are both well tolerated,” Dr. Kiguchi concludes. “Most patients are surprised by how quick and easy the treatments are.”

And what happens to those now-destroyed blood vessels? The body eventually reabsorbs them, as other veins take over their important job:  keeping blood moving back to the heart and lungs.