Frequently Asked Questions

How do veins work? 

The main purpose of veins is to return blood up from the leg to the heart.  The blood is pumped up the legs by muscle contraction and breathing.  All veins have valves that help to move the blood back to the heart.  When you have varicose veins, the valves do not work correctly so the blood does not move up towards the heart.  Blood pools in the legs which eventually results in dilated veins giving the lumpy bumpy appearance of varicose veins. 

What are varicose veins?

Varicose veins are the larger dilated veins that often cause raised bumps over the skin.  Some of these dilated veins are located deep in the fat and cannot be seen on the surface.  These veins are diseased and allow blood to stagnate causing a variety of symptoms such as pain, burning and swelling. 

What are spider veins?

Spider veins are small dilated veins filled with blood which makes them visible through the skin.  At times they resemble a spider’s web.  They can be blue or red in color. 

What causes varicose veins and spider veins?

Hereditary is the number one factor causing varicose and spider veins.  Women are more likely to suffer from varicose veins, especially because of pregnancy and hormonal factors.  These factors include pregnancy, menopause, the use of birth control pills, estrogen and progesterone.  It is very common for pregnant women to develop varicose veins during their first trimester.  Pregnancy causes increases in hormone levels and blood volume which in turn cause veins to enlarge.  In addition, the enlarged uterus causes increased pressure on the veins.  Varicose veins due to pregnancy often improve within three months after delivery but never go away.  Other predisposing factors include standing, sitting occupations, obesity, trauma, and intense weight training.  Patients who are prone to varicose veins have a tendency to develop recurrent varicose veins throughout their life.

How are spider veins treated?

Spider veins may be treated by a variety of techniques; however, sclerotherapy or injection is the most common treatment.  The spider veins are injected with a solution that causes irritation of the lining of the vein and subsequent disappearance.  In one session several veins can be injected.  Complete disappearance may take several weeks.  We have found that treatment of the spider veins with the 940-nm wavelength laser in combination with sclerotherapy results in less pigmentation and faster fading.

How are varicose veins treated?

A variety of techniques are available including laser ablation with the DORNIER™ 940-nm wavelength laser.  Under local anesthesia a thin fiber can be inserted into the vein.  The laser energy is applied while the fiber is removed resulting in permanent closure of the varicosity.  The reversal of blood flow is then eliminated as are the symptoms.  Mini-phlebectomy is another treatment for varicose veins that are located close to the skin.  Using local anesthesia, a needle size incision is made and the veins are removed.  The incisions are so small that they often do not require closure.  Often, laser ablation and mini-phlebectomy are combined during the same operation to achieve satisfactory results.  Sclerotherapy may be used to treat residual veins

Why does sclerotherapy sometimes fail?

The reason for sclerotherapy failing to work is typically because the problem was not correctly identified and treated.  When you come in for your consultation, we will show you the larger veins that are insufficient and causing your spider veins secondary to elevated venous pressure.  We will instruct you on how to treat those larger veins and at the same time, in most cases, clear your spider veins. 

If my varicose veins are removed or occluded where does the
blood go?

The varicose vein is no longer working and the blood has already been rerouted.  Ninety-five percent of your blood is carried by your deep system which is located next to the major arteries deep inside the leg.  The varicose veins we treat are all superficial.  You will never miss removal of any of your superficial veins.

What if I need open heart surgery?

A varicose vein is never used for bypass.  There are many other veins or arterial conduits that can be used instead. 

How many treatments are needed?

For most large bulging veins, one treatment is all that is needed.  Spider veins do require several treatments.  The average person requires 3 to 5 sessions spaced 4 to 6 weeks apart in order to get resolution. 

What is a treatment like?  Is it painful?

The laser treatment for spider veins is a hot sensation but it is very quick.  There is no lingering discomfort once the treatment is done.  Usually an ice pack is used for comfort.  For the injections, a very small needle is used and the solutions used are not painful.  During the ELAS procedure (endoluminal laser ablation of the saphenous veins), once the tumescent numbing is completed, there is no pain during the procedure.