Treatment

In the past the only treatment available for varicose veins was stripping.  This was a procedure that usually involved a general anesthetic.  There was quite a bit of pain and down time.  Today, new treatments are available which provide even better treatment with minimal discomfort.  The procedures are done in the office under local anesthesia.  At the Bakersfield Varicose Vein Center each patient under goes a history and physical examination to assess the symptoms and underlying problem.  If indicated a venous ultrasound examination is performed which will provide a detailed “road map” of the superficial and deep veins in the leg and can aid in planning  the best course of treatment.  Dr. Derrick has acquired one of the most advanced, in office, duplex ultrasound machines in Bakersfield

Sclerotherapy

Sclerotherapy remains the mainstay of treatment for smaller veins and spider veins.  A tiny needle is used to inject a solution into the vein causing irritation and closure.  The sclerosing agent we use is sodium tetradecyal sulfate which is a fatty acid with detergent properties.  In larger veins it is injected as a foam.  We do not use saline because it is painful, stains the skin, and can cause ulceration.  The solutions we use are not painful at all.  The solution causes the vessel walls to be damaged and then the body absorbs the damage just like a bruise.  In some cases foam sclerotherapy is injected using ultrasound guidance.  Several treatments are often required over the course of several weeks. 

Spider Vein Treatment

There are many ways to treat spider veins (lasers and injections), but most important is to identify the cause and prevent recurrence.  Spider veins are due to high pressure in the venous system.  If the larger veins are treated then frequently the spider veins improve.  Often each spider vein has a feeding vein (reticular vein) which transmits higher than normal pressures.  The feeding vein must be occluded in order to treat the spider vein.  These larger feeding veins can be treated with either sclerotherapy or the 1064 Nd:YAG laser. 

We frequently use a combination of treatments depending on the size and location of the spider veins.  We combine laser and injection therapy.  Most spider veins require 3 to 5 sessions spaced one month apart to fade.  If a 940-nm laser treatment is performed at the same time as the injection therapy we have found less staining and hyper-pigmentation.  The 940-nm wavelength has been found to be very effective in treating spider veins.  This laser “erases” the spider veins by causing damage to the vessel.  The laser passes safely through the skin and penetrates the target vessel.  From the lasers heat blood is coagulated inside the vessel causing it to collapse and seal.  The reason we use the laser in the first treatment is because it decreases the amount of blood in the spider veins so you have less change of staining.  Using the combination will cause a double injury effect and will fade your spider veins much quicker. 

Ambulatory Mini Phleboctomy

This procedure is ideal for treating larger veins that are close to the surface.  The removal of the veins is done using local anesthesia.  Multiple small 1 – 2 mm incisions are made and the vein is removed through these incisions.  No significant scaring is appreciated.  We recommend the use of elastic compression hose after the procedure. 

Endovenous Laser Ablation

This most modern technique treats large varicose veins using local anesthesia and ultrasound guidance.  A small fiber is threaded into the vein.  As the fiber is removed laser energy is delivered to the vein resulting in shrinkage and closure of the vein.  We utilize the 940-nm wavelength DORNIER™ laser.  Successful permanent closure of the vein is achieved in over 95% of cases.  Elastic compression is used for approximately one week.  Usual activities can be resumed the following day. 

Other Treatments