Treatments & Procedures

Valves in leg veins, working with the calf muscles, normally pump blood from the legs back to the heart. If one of the valves leaks or fails, however, then blood can pool in the vein instead of returning to the heart. This pooling blood causes the vein to bulge and become enlarged — creating what is known as a varicose vein.
 
For mild cases of varicose veins, regular rest and elevation of the legs may be sufficient to improve the condition. This reduces the blood flow to the lower leg and can ease the thickening of the veins. Compression stockings or support hose are another option for individuals with circulatory disorders or diabetes. Compression socks foster circulation in the feet and legs and can control blood flow to lessen the pain and discomfort. Medications such as ibuprofen or other anti-inflammatories are also used to help relieve the worst effects. It is not uncommon for a doctor to recommend that a patient use more than one of these methods at the same time.
 
For more serious cases of varicose veins, more involved procedures may be necessary: 

• Sclerotherapy is a process that involves injecting the affected veins with medications to block the blood flow, causing them to shrink and disappear. 
• Endovenous thermal ablation is another option, in which a laser or radiofrequency electrode is used to heat the vein. This causes the vein to seal, stopping the blood flow to the affected area. Subsequently the varicose vein is eliminated. It is usually done as an outpatient procedure in a varicose vein clinic, although some cases may require inpatient treatment.

During endovenous ablation, an ultrasound is used to visualize the vein; then a catheter is inserted into the skin and inside the dysfunctional vein. A radiofrequency electrode is inserted through the catheter into the vein to heat the vessel until it closes. Once the faulty blood vessel is sealed, the blood flow will divert to other healthy veins nearby. With this procedure there is a minimal amount of scarring, few side effects and a quick recovery time while it improves circulation in the area. A few days after this minimally invasive treatment, a follow-up exam with another ultrasound will evaluate the success of the treatment.

• Vein stripping is a surgical technique used to treat enlarged veins. The surgeon inserts a thin, plastic instrument into the vein and then pulls the vein out. This all takes place under the skin and all the incisions are small. Multiple veins can be treated in one procedure.
• Microphlebectomy is a minimally invasive procedure designed to remove varicose veins by making several small incisions just under the patient’s skin. Unlike vein stripping, microphlebectomy makes it possible for a doctor to remove the diseased vein without the use of a guide-wire.

During the microphlebectomy procedure, your doctor will identify and mark the veins to be removed and will then numb the area with a localized anesthetic. Once the area is sufficiently numb, a miniscule incision is made along the varicose vein before using a hook to grasp and remove it with little-to-no tissue damage. It is normal for patients to have their skin dressed in compression stockings or bandages following this 30 to 45 minute procedure. Most patients are able to resume their normal activities immediately after the procedure; however, it is crucial to avoid strenuous exercise or activity for the first week following microphlebectomy to ensure proper healing. Your doctor may also recommend compression stockings or dressings for the first week following the treatment to help maintain the results.
 
Most patients find that they are able to resume their normal activities soon after these procedures. It is important, however, to consult with your doctor to determine the course of action that is best for your individual case. At Houston Methodist a multidisciplinary team works with each patient to ensure that you receive the best possible care.