treatment spider veins - Discussion of Varicose Veins and FAQ's about treatment options
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Discussion of Varicose Veins and FAQ's about treatment options

What are varicose veins, spider veins, and reticular veins? Varicose veins are ropy, swollen veins that are close to the surface of the skin. Reticular veins are the smaller, fine blue veins that are under the skin. Spider veins are smaller, red or blue veins that are in the skin layer.


A vein is a blood vessel that carries blood low in oxygen content from the body to the lungs and heart. It is a normal part of the circulatory system. Veins can become budge with pools of blood when they fail to circulate the blood properly. These visible and bulging veins, called varicose veins, are often associated with symptoms such as tired, heavy, or aching limbs. In severe cases, varicose veins can rupture, or open sores (called "ulcers") can form on the skin. Varicose veins are most common in the legs and thighs.


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 What Are The Complications Of Vein Management? Sclerotherapy and EVLT have rarely been associated with any serious complications. Minor complications of these procedures include bruising, mild itching, tingling, tenderness and tightness in the treated leg for up to two weeks after the treatment. Allergic reactions to the sclerosant have been reported, but are extremely rare. Ulceration of the skin after sclerotherapy can rarely occur. If they occur, the usually heal in 2-3 months and leave a small scar. Deep Vein Thrombosis is a very rare complication following sclerotherapy of larger varicose veins or EVLT. Other potential complications include: 1. Staining or brown pigmentation at the site of treatment. This occurs in about 30% of patients. In most cases the staining resolves but it may take many months. 2. Clots under the skin. These clots may affect the treated veins. These are not dangerous and can be removed through a small incision if necessary. Most of these clots dissolve by themselves. 3. Bruising at the injection sites usually resolves within one to two weeks. 4. Capillary matting is an increase in the number of fine red vessels around the injection site. This problem may disappear on its own, or can be treated by further injections.

Varicose veins develop as a result of gravitational forces. This may just be due to simple aging. To counteract this doctors may prescribe that the legs be elevated above the heart for a prescribed period of time during the day in order to help the blood trapped in the veins return to the heart for oxygenation.

Will Abnormal Veins Come Back After Treatment? After sclerotherapy for spider veins, a small number of patients who have a natural tendency to form spider veins will need yearly treatments or "touch-ups". Larger varicose veins can also recur, especially if one gains weight, or does not wear compression hose. These recurrences are usually not as severe as the initial episode, and can be treated with sclerotherapy or microphlebectomy.

complete removal of the vein from ankle to groin may be necessary (ligation and stripping). Several treatments may be required before a satisfactory resolution is achieved. Laser treatment can also be effective for these varicose and spider veins. The majority of people with varicose veins manage by using simple conservative treatment measures. Varicose veins are not a disease in themselves although they can cause daily irritation and worry. People with this problem should consult their GP to discuss whether treatment is necessary.

These are Symptoms for varicose and spider veins >> Aching, heavy legs (often worse at night and after exercise). >> Appearance of spider veins (telangiectasia) in the affected leg.

If you do opt for sclerotherapy keep in mind that your legs may be red, discolored or bruised for a couple of weeks after the injections. In fact your legs may look worse than they did in the first place so don't get this operation with the expectation that you will look better in a bathing suit after a few days. Like most plastic surgeries, sclerotherapy is not a quick fix for varicose veins.

For more questions about all things venous, including deep venous thrombosis (DVT) and the latest management techniques such as thrombolysis of DVT's and pulmonary emboli, please visit my vein website at www.my-varicose-veins.com. I am a Vascular Surgeon in Dallas. I have been voted by my colleagues to be one of the best Vascular surgeons in the Dallas Fort-Worth area according to Dallas Magazine for 2006. My expertise is in circulation surgery, especially in vein problems. I am being featured in the cable TV show "Heartbeat of America" hosted by William Shatner and Doug Llewelyn from "The People's Court." I also will be featured in the Dallas Fort-Worth edition of Redbook, Women's day, and Good Housekeeping for the April/May edition for my work on varicose veins. http://www.my-varicose-veins.com

In addition to the elevation of the legs most doctors will prescribe a regimen of walking or aerobic exercise as well as the application of a compression bandage that winds around the affected area. This helps decrease the volume of blood trapped in the legs and over time makes the veins shrink.

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clinical syndrome in patients with varicose veins and other chronic venous insufficiency. How to treat varicose and spider veins? >> Frequent rest periods with the legs elevated.

The most common surgical procedure used to correct varicose veins is called sclerotherapy. This is a procedure that is used to decrease the visibility of spider veins that mostly occur on the legs but can occur on other places of the body as well. Before having this operation you should also be aware that it could be very uncomfortable because basically an irritant is injected into the veins to induce an inflammatory response. This causes the veins to shrink. You should also be aware that sclerotherapy only works on tiny veins and not larger ones.

The first sign of varicose veins is a swelling along the course of the veins. This may be followed by muscular cramps and a feeling of tiredness in the legs behind the knees. In some cases, the normal flow of blood towards the heart may be reversed when the patient is in an upright position. This results in veinous blood collecting in the lower part of the legs; the skin becomes purplish and pigmented, leading to what is known as varicose eczema or varicose ulcers. Both these conditions cause severe pain.

The reason varicose veins develop is not fully understood. One of the basic problems is damage to the valves. This means that blood can't travel up the veins as easily, and is more likely to pool. It is possible that people inherit a tendency for weak valves. Alternatively, the vein walls may become weak, which causes bulging of the vein and so damage to the valves. There is a greater risk of getting varicose veins during pregnancy, and if you are very overweight because this increases the pressure in your abdomen and so in your veins.

eczema (eczema), because of waste products building up in the leg. >> Minor injuries to the area may bleed more than normal and/or take a long time to heal.

How Long Will It Take For Me To See Results After Treatment? You will see some immediate results after treatment for varicose and spider veins. The best results will be seen after 3-6 months, when the swelling and bruising has completely resolved.

What are the symptoms of varicose veins? Varicose veins may cause aching of the legs. The ankles, calf and feet may swell towards day's end, especially in hot weather. Varicose veins can become sore and inflamed, causing redness of the skin around them. Skin changes from long standing vein problems include thickening of the skin, a brown discoloration, red rashes, and skin infections. Some patients with severe vein problems can develop sores on the ankles, known as venous ulceration. These are often difficult to heal, and can be helped by treating the underlying vein problem to prevent the reflux that led to the ulceration.

You might also experience a phenomenon known as vein matting, which means that tiny clusters of veins around the site of the injection area could turn blue. Unfortunately this is because sometimes the attempt to remove one varicose vein creates several smaller ones. Sometimes these veins can be treated with another injection but the success rate of this treatment is very low.

How can varicose veins be treated? There are several ways to treat varicose veins, depending on the symptoms and types of veins present: 1. Compression stockings: The conservative management of varicose veins is to wear compression hose, exercise, control your weight, and elevate your legs above your waist as much as possible in order to drain the vein blood out of your legs. Compression hose will assist the vein in pumping blood up the leg and back to the heart. However, this technique will not make the varicose veins go away. Nevertheless, the use of compression hose is very important in not just preventing worsening of varicose veins, but also in preventing recurrent problems after treatment. 2. Sclerotherapy: This technique is used for the treatment of smaller varicose veins, as well as reticular veins and spider veins. A small amount of a medication (sclerosant) is injected directly into the diseased vein. The medication irritates the inner lining of the vein and causes it to seal shut. The newer types of sclerosants are not painful when injected using a very tiny needle, and multiple sites of injection are typically needed. In addition, one usually needs anywhere from 2-6 treatments to obtain 70-80% clearance of the spider veins. The procedure is performed quickly and easily without the need for anesthesia. Sometimes, we use ultrasound guidance for sclerotherapy. The number of treatments required will vary with each individual, depending on the extent of visible varicosities and spider veins. A range of 2-6 treatments can be expected in order to achieve a 70-80% clearance of the spider veins. We also use a Lyra 1064 nm YAG laser to treat stubborn spider veins. 3. Surgical Stripping: In the past, surgical removal or "stripping" of the diseased vein out of the leg was the best treatment we could offer patients with vein problems. This procedure required an operating room, general or spinal anesthesia, and recovery times that varied from 2-6 weeks. Vein stripping is an antiquated procedure and should be very rarely used in the management of varicose veins with the newer techniques that are currently available. 4. Microphlebectomy: This procedure involves the use of several, 1 mm, tiny incisions along the course of the leg veins in order to remove the diseased vein in segments. These tiny incisions heal well with minimal discomfort. Microphlebectomy can be performed by itself or in combination with another type of vein treatment. 5. Endovenous Laser Therapy: The use of lasers in the management of vein problems is replacing the standard surgical approach to treating large varicose veins. With Endovenous Laser Therapy (EVLT) a very thin fiber or catheter is inserted into the diseased vein through a small needle puncture in the leg, requiring only local anesthesia. The laser delivers energy directly to the inner lining of the vein, causing the vein to close. The procedure can be performed in the physician's office in approximately one hour. Patients are usually able to resume their routine activities immediately after the procedure.

 

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Varicose veins are enlarged, twisted, painful superficial veins resulting from poorly functioning valves. Varicose veins are common. They mostly affect women. Varicose veins are also called varicosity and varicosis. In severe cases, varicose veins can lead to skin changes resulting in eczema, pigmentation, and ulceration or bleeding.

>> In mild cases, lightweight elastic compression stockings should ease the discomfort but they will not remove the varicose veins. >> A loss of weight, if obesity is a problem.

www.doctor-ursel.com

Will My Health Insurance Cover My Care For Vein Problems? Most insurance companies will cover treatments for varicose veins that are causing problems despite conservative management. Conservative management means a trial of compression hose for 3-6 months. If you continue to have pain or swelling despite wearing compression hose, then most insurance carriers will cover EVLT or microphlebectomy. Insurance does not usually cover the treatment of spider veins, and these treatments are paid for by the patient.

Will Getting Rid Of Varicose And Spider Veins Hurt My Circulation? The varicose veins that are being treated are not doing their job, and therefore are not missed when they are treated. The body has numerous other veins that are taking blood back towards the heart, and they take over the role of the varicose veins after treatment.

How Does Endovenous Therapy Work? Endovenous Laser Therapy (EVLT) treats the incompetent greater saphenous vein (GSV). The GSV vein courses along the inside part of the leg from the groin to the ankle, and is frequently the underlying cause of varicose veins. The procedure is done in the office under local anesthesia using ultrasound guidance. A laser fiber is passed through a small sheath inserted into the GSV. As the laser is activated, the resulting heat treats the inner lining of the vein causing it to seal. The whole procedure is performed through a tiny skin incision, so there is no post-operative scarring. Pressure is applied to the treated veins using compression hose or other compressive dressings. The recovery time from EVLT is rapid as there are no large surgical incisions or side effects of general anesthesia. Normal activities can be resumed the net day. Vigorous physical activity such as weight lifting and aerobics are not advised during this time, and we advice that patients do not take plane flights for at least one week after the procedure. Why Endovenous Laser Therapy Instead of Other Treatment of Varicose Veins? The benefits of EVLT are the following: 1. A simple procedure 2. Performed under local anesthetic 3. Minimally invasive, so minimal risk of scarring and postoperative infection 4. The procedure takes about one hour and avoids surgery in the operating room with its associated costs 5. Rapid recovery with reduced postoperative pain 6. Normal activities can be resumed almost immediately 7. Excellent clinical and aesthetic results 8. Covered by most insurance companies including Medicare after failure of conservative medical management

Who is at risk for varicose veins? There are numerous risk factors for varicose veins. These risks include a family history of varicose veins, obesity, pregnancy, hormonal changes at menopause, work that requires prolonged standing or sitting, and past vein diseases such as phlebitis (inflammation of a superficial vein) or deep venous thrombosis (blood clot in the deeper veins). Women also tend to suffer from varicose veins more than men. In addition, varicose veins can appear after trauma to the area.

What Is Involved In The Care After Treatment? We recommended compression hose or some other type of compression dressing after treatments. These dressings are usually worn for one day following sclerotherapy and 1-2 weeks after EVLT. Compression stockings come in different styles, sizes and colors. We advise return to a normal physical activity routine after the procedure, but vigorous aerobic exercise is not recommended for 2 weeks after ELVT. Sclerotherapy patient can resume normal exercise the day after treatment.

What causes varicose veins? The normal function of leg veins is to carry blood back to the heart. During walking activity, the calf muscle acts as a pump, compressing the leg veins and forcing blood back towards the heart.To prevent blood from going in the wrong direction, veins have one-way valves valves that prevent blood from flowing backwards down the leg. If the valves are faulty (a condition known as valvular incompetence), blood flows back into superficial veins and down the leg. This process is known as reflux. Reflux results in veins enlarging and becoming varicose. Once veins become varicose, they lose their ability to snap back into their correct shape, and become more plastic rather than elastic. Varicose veins unfortunately cannot heal themselves, and this condition is either stabilized with compression hose, or managed with one of the vein treatment plans. The greater saphenous vein is one of the most frequently damaged veins that leads to varicose veins in the leg.

So, before you spend a lot of money on an operation, make sure you try the above solutions first as both elevation and compression treatments have a higher success rate and show quicker results than surgery.

The word "varicose" refers to a vein that is unnaturally and permanently distended. Vein walls or vein valves near the skin can become damaged from natural stretching or weakening because of the pressure of the blood flowing through the veins. Varicose veins often appear through the skin on a person's legs as blue, bulging and twisted veins; in some cases the veins may be raised or stand out on the surface of the skin.

>> Ankle swelling. >> A brownish-blue shiny skin discoloration near the affected veins. >> Redness, dryness, and itchiness of areas of skin - termed stasis dermatitis or venous

>> The injection of a sclerosing solution into the vein will close it. >> If the condition becomes more serious and the whole leg is affected by varicose veins, a

Spider veins and small varicosities frequently form on the legs. These can be easily and safely treated using painless injections of special solutions which shrink the blood vessels. Effective treatment usually requires several visits to the office with gradual improvement after each visit. On the initial visit, your vein problem will be assessed and an estimate regarding the time required and the approximate cost of your treatment will be given. After treatment is complete, reassessment and treatment may be required on a periodic basis to ensure that your vein problem never returns.Sometimes larger veins require more aggressive treatments. For medium sized veins, surgical treatment may be required. This can usually be done under local anesthetic using a procedure known as ambulatory phlebotomy. For the largest veins, a new, painless treatment known as Endovenous Laser Treatment or EVLT is used. Dr. Ursel was one of the first doctors trained in Canada to do this procedure and now teaches other doctors to do it.Dr. Ursel was one of the first doctors for treatment of spider veins.

You should also realize that one quarter of patients that do receive sclerotherapy also end up with a hyper pigmentation on their legs around the injection sites, which may be as objectionable to look at as the varicose veins.

Before considering having a procedure done to surgically treat your varicose veins, keep in mind that most varicose vein problems can be treated without resorting to an invasive operation. In fact, if your varicose veins do not respond to the following commonly prescribed treatments for varicose veins then it is possible that the varicose veins are a symptom of a much more serious problem such as obesity, impending stroke or a heart condition. This is why it is so important for you to try elevation and compression treatments before you resort to surgery.

Varicose veins are abnormally swollen (dilated) and tortous (twisted) veins. Varicose veins are usually situated quite near the surface and are often visible beneath the skin. Varicose veins can vary in size from quite small (2-3mm across) to very large (2-3cms across). Very small veins are called "thread veins" or "spider veins". These veins are different to varicose veins because they are situated within the layers of the skin itself. Although they may be unsightly, they are not the same as varicose veins and can be more difficult to treat.

>> In some people the skin above the ankle may shrink (lipodermatosclerosis) because the fat underneath the skin becomes hard. >> Restless Legs Syndrome Restless Legs Syndrome appears to be a common overlapping

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