FAQ

  • What causes varicose veins?

    Heredity/Family History- You have a 90% chance of having venous disease if both parents had vein problems.
    Age- Venous disease worsens with age. Patients range from their teens to their mid-nineties.
    Gender- Women are three times more likely than men to develop varicose veins.
    Pregnancy- The chance of developing varicose veins increases with each pregnancy.
    Obesity- Obesity does increase the risk of venous disease, but only slightly.
    Trauma
    Standing Professions-Teachers, nurses, factory workers, and construction personnel are more likely to develop varicose veins.

  • What are varicose veins?

    Varicose veins are secondary to venous valvular insufficiency. The valves in the vein no longer close completely causing blood to pool in the vein, gradually weakening the vein walls. The weak vein walls become enlarged resulting in varicose veins. Varicose veins often appear to be dark purple or blue and look rope-like, lumpy, twisted and/or bulging. Varicose veins can cause swelling, aching, and tired legs; create a burning, throbbing, or itching sensation; and cause muscle cramps and a general restlessness in your legs. These bulging veins can be symptomatic, resulting in leg pain, edema (swelling), skin discoloration and even leg ulceration. Those who suffer from varicose veins are likely to complain of their legs feeling heavy, swollen, tired, restless and achy. Often sitting or standing in the same position for too long a period of time will worsen their symptoms as the day progresses. An estimated 15%-25% of the adult population suffers from varicose veins. In the United States, that translates into 40 million people. Varicose veins require medical treatment.

  • What are spider veins?

    Spider veins are very small varicose veins. Although they don’t usually cause discomfort, the deeper veins that often accompany them do. Many patients have a combination of both varicose and spider veins. While they may seek treatment for cosmetic improvement, many of our patients are looking for relief from pain.

  • What is the treatment for varicose veins?

    First, we recommend a physical examination in our office. When you come to us, we will review your complete medical history. Your circulation will be tested with a non-invasive ultrasound and an individualized treatment plan will be developed for you. The most common treatment for venous disease is endovenous ablation. Endovenous ablation is an FDA-approved, minimally invasive treatment that requires no hospitalization and no complicated surgery. The entire procedure, start to finish, will take about an hour. Performed under ultrasound guidance, we us energy to treat varicose veins by closing off the vein, preventing it from flowing in the wrong direction down the leg. Your body then naturally re-route blood to healthier veins.

  • What is the difference between vein stripping and ablation?

    Vein stripping was the main procedure performed by many surgeons for many years. This was often done in an operating room under general anesthesia. There were many complications with vein stripping including bruising, pain, blood loss and even death. The new technology has allowed us to perform the ablation procedure in our office without the severe complications patients experienced years ago. The complications are less than 1 in 1000.

  • Will I need to be hospitalized or take time off from work after the treatment?

    The procedure is done in our office and you will be able to return to your normal activities after the procedure.

  • Will my insurance cover this procedure?

    The procedure is covered by all insurance companies including Medicare and Blue Cross Blue Shield. The treatment for the small spider veins would not be covered by insurance and is considered cosmetic. Call us at 205-592-1800 if you have any questions and our insurance coordinator will be happy to assist you!

  • Is varicose vein treatment painful?

    Patients report feeling little, if any, pain during and after our procedures. Tumescent solution is local anesthetic used to desensitize the treatment area.

  • Is there any scarring, bruising, or swelling after the procedure?

    Patients may experience some bruising or swelling following varicose vein procedures. Long term, our patients report little to no scarring.

  • How quickly can I resume normal activity?

    Patients are walking immediately following the procedure; they typically resume normal activities within one day. Strenuous activities should be avoided for 7-10 days.

  • What is venous reflux disease?

    Venous reflux disease is a condition that develops in the superficial venous system when the valves in your veins that keep blood flowing out of your legs and back to your heart become damaged or diseased. This causes blood to pool in your legs. Common symptoms of superficial venous reflux disease include leg restlessness, pain, swelling, heaviness and fatigue as well as varicose veins.

  • Do varicose vein procedures require any anesthesia?

    All varicose vein procedures are performed in our office using only local anesthesia allowing patients to literally walk out of their procedure; thus, avoiding the need for extended recovery and the side effects associated with general anesthesia.

  • How soon after treatment will my symptoms improve?

    Most patients report a noticeable improvement in their symptoms within 1-2 weeks following the procedure.

  • What happens to the treated vein left behind in the leg?

    The vein simply becomes fibrous tissue after treatment. Over time, the vein will gradually incorporate into surrounding tissue. One study reported that 89% of treated veins are indistinguishable from other body tissue one year after the Closure procedure was performed.

  • Is losing the vein and vein’s function a problem?

    No. These veins are part of the superficial venous system, which is comprised of a number of veins. When a vein’s valves become damaged or diseased, it inhibits the proper blood flow out of the leg. In turn, the vein is no longer useful and cannot be repaired. When the diseased vein is ablated (closed) or removed, the blood is rerouted to healthy veins, restoring the proper blood flow.
    Damaged veins are no longer candidates for vein harvesting used in other procedures, i.e., open-heart surgery. However, as previously stated, our superficial venous system is comprised of a number of veins. For this reason, there are other healthy veins that can be used for vein harvesting used in other procedures.

  • What are the potential complications of the procedure?

    No serious complications have been reported in well over 2000 cases through March 2009. A small number of treated patients have had transient paresthesia (numbness) and even fewer have had superficial clotting or DVT (<6). The risks of foregoing treatment far outweigh those of having it. Our board-certified Cardiovascular surgeons and staff are well trained and our surgical suites are properly equipped should an emergency arise. Our physicians and staff will discuss the nature, purpose, risks and benefits of our procedures in your initial consultation and anytime thereafter.

  • What are the symptoms of varicose veins?

    - Large, ropy veins
    – Leg pain or aching
    – Leg numbness or tingling
    – Leg swelling
    – Unsightly spider veins
    – Restless legs
    – Leg burning or cramping
    – Skin discoloration
    – Leg sores or ulcers
    – Tired, heavy legs

  • Am I at risk from exposure to laser/RF energy?

    No. You will be given a special pair of glasses to protect your eyes in case of accidental firing of the equipment outside the body.

  • Why does it occur more in the legs?

    Gravity is the culprit. The distance from the feet to the heart is the furthest blood has to travel in the body. Consequently, those vessels experience a great deal of pressure. If vein walls and valves weaken, the reflux of blood can cause superficial veins to become varicose.

  • What are venous stasis ulcers?

    Venous ulcers are areas of the lower leg where the skin has broken down exposing the tissue. Typically, skin discoloration as well as itching will occur around the ankle before a venous ulcer will form. Ulcers can range from the size of a penny to completely encircling the leg. They are painful, open wounds, which weep fluid and can last for months or even years if left untreated.

  • What is the short-term treatment for varicose veins?

    ESES (pronounced SS) is an easy way to remember the conservative approach. It stands for Exercise Stockings Elevation and Still. Exercise, compression hose/stockings, elevation and rest will not make the veins go away or necessarily prevent them from worsening due to the underlying venous reflux disease not being addressed; however, it may provide temporary relief of the symptoms associated with varicose veins. Weight reduction is also helpful. If there are inflamed areas or an infection, topical and/or oral antibiotics may be prescribed.

  • What is sclerotherapy?

    Sclerotherapy is commonly used for treating spider veins and small varicose veins. It involves the injection of a FDA-approved foamed sclerosing solution (a mixture of saline and Sotradecol®), which causes chemical endovenous ablation of the vein, which collapses and diminishes in appearance.

  • When are VNUS Closure® and ClosureRFS™ procedures used?

    ClosureFast®, also known as endovenous radiofrequency ablation, is used to treat venous reflux disease of the saphenous veins. The ClosureRFS™ Stylet is the only device cleared by the FDA for treatment of incompetent perforator veins. Both of the procedures use radiofrequency as the heating method to close (ablate) the incompetent vein. They are performed in our office using only local anesthesia and require little to no down time.

  • What is the main difference between arteries and veins?

    In simplest terms, arteries pump oxygen-rich blood FROM the heart; veins return oxygen-depleted blood TO the heart.

  • What are the three main categories of veins?

    The deep venous system returns blood directly to the heart and is in the center of the leg, near the bones. The superficial venous system is just beneath the skin; it has less support from surrounding muscles and bones than the deep venous system. Perforator veins serve as connectors between the superficial and the deep systems.

  • Are all bluish surface veins varicose veins?

    People should not be too quick to identify any blue veins as being varicose veins. Fair-skinned and/or thin individuals are prone to slightly more prominent veins. Varicose veins are slightly raised and typically more noticeable upon standing.

  • Does pregnancy cause varicose veins?

    Pregnancy does not cause varicose veins; rather, it can aggravate an existing tendency toward the condition. More blood circulates in the body during pregnancy to meet the demands of the developing baby. This increased blood ?ow can burden an already weakened venous system. The growing fetus can also press on the pelvic veins and hinder the passage of blood. Finally, some researchers speculate that hormones present during pregnancy may contribute to dilated vessels. Prominent, uncomfortable veins that do not diminish postpartum should be evaluated by a vascular surgeon; though, some insurance providers require a six-month waiting period postpartum be observed before treatment is a covered benefit.

  • My legs often ache or throb if I am on them too long. Is this related to my varicose veins?

    It depends. Leg aching and/or throbbing are symptoms of varicose veins and are most likely related to them. However, since there may be other conditions related to your leg discomfort, it is recommended that anyone experiencing leg pain should have an evaluation by a vein specialist. Temporary relief of these symptoms may be achieved by avoiding prolonged sitting and/ or standing If you have a standing profession or if you find yourself standing for an extended amount of time, shift your weight from leg to leg. When sitting for more than 30 minutes, try to elevate the legs above heart level. If that is not possible, stand up and walk around for a few minutes before sitting again. In either case, wearing compression hose is recommended.

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