Another modern and less invasive vein closure system involves the use of a radiofrequency (heat powered) catheter. In this technique known as Radiofrequency Ablation (RFA), a small catheter is inserted into the vein and heat energy is applied causing the vein to close permanently. This is not harmful to your body because it is a Superficial Vein that is being eliminated, without causing any harm to the Deep Venous System. By now I’m sure you realize that the EVLA method of vein closure is not that different from RFA, they both are closure systems using heat to eliminate incompetent veins. The RFA procedure takes about an hour and a half and is done in a doctor’s office. After the procedure, the patient can walk immediately and may return to work the next day. Mild bruising of the leg, as well as mild pain, is normal after this procedure. Compression stockings must be worn for several weeks after an RFA procedure, to assure complete closure of the vein. RFA is usually performed on large veins, such as the Great Saphenous Vein and Small Saphenous Vein.

EVLA, RFA and Foam Sclerotherapy are covered by Medicare and most PPO insurance plans.

These are the bulging veins that are visible to the naked eye. Varicose veins are typically branches of the great saphenous or small saphenous vein. Varicose veins are usually painful, tender and indicative of a deeper problem of venous reflux. When varicose veins progress untreated, a condition known as - Chronic Venous Insufficiency may result. In severe cases, the legs become swollen and brown hyperpigmentation occurs at the shins and ankles, from there the skin can break down into open wounds known as ulcers.

These are the tiny (<1mm) veins just under the surface of the skin. They are thin, string-like, red or purple with several winding branches. They often occur in the thighs or calves, and can cause symptoms of pain, burning and itching.

The venous system of the legs consists of Deep Veins & Superficial Veins. This is sometimes a point of confusion for patients. The Deep Veins are embedded in the muscles of the legs and are the “lifeline” of your extremities. Many patients are concerned about “blood clots” in the veins and the potential dangers. It is true that blood clots are serious, but it is the blood clots in the Deep Vein system that are dangerous and life threatening; which is why the Deep Veins are not to be touched.

The Superficial Vein system is where varicose veins arise. The Superficial Veins consist of two large veins (Great Saphenous & Small Saphenous) and the many branches that come off from these veins. Like branches of a tree, these 2 “main” veins branch out into smaller and smaller branches that go superficially into the skin - varicose veins and spider veins. Blood clots in the Superficial Veins are in general not dangerous, they are tender and painful, but usually self-limiting and not life threatening; which is why these veins can be operated on to improve health.

The return of venous blood from the legs back to the heart is accomplished by numerous valves which are in the veins, and the leg’s “muscle pump”. Normal, healthy, veins contain one-way valves that allow the blood to flow back towards the heart. These valves are necessary because of the effect of gravity, which would otherwise cause the blood to pool in our feet and legs every time we stand.

Large varicose veins are formed when the valves in the legs malfunction. The valves become “incompetent” and begin to leak, this is relative to age & activity. As a result, blood can leak back down to the feet and legs, because of gravity. This causes the veins to become distended, creating larger vein channels. Over time, the veins become large, “ropy”, and visible to the naked eye - varicose veins.

Superficial, small blue or red-blue spider veins are a result of vein reflux just below the skin. Spider veins may cause symptoms of pain - especially pain which is aggravated by prolonged periods standing - as well as itching or tingling sensations.

Another very successful technique for treating varicose and spider veins involves using a liquid chemical compound known as a “sclerosant”. The sclerosant is injected into the vein with a small needle, the chemical interacts with the wall of the vein, causing the vein to close. Foam Sclerotherapy is a very simple procedure that takes about an hour and a half and is done in a doctor's office with very minimal discomfort. Following Foam Sclerotherapy, the patient must wear compression stockings for several weeks.

EVLA, RFA and Foam Sclerotherapy are covered by Medicare and most PPO insurance plans.

Graduated Compression Stockings are a non-surgical treatment option in eliminating varicose veins. They work by compressing the superficial veins, while ensuring your leg circulation is still intact by way of the Deep Vein System. This allows the stronger Deep Veins to circulate the blood in your legs back to your heart. This process slows down the degeneration of the Superficial Veins but does not cure or directly treat venous insufficiency. A disadvantage to compression stockings is that they are a temporary solution, and the symptoms of vein disease recur when the stocking is removed. Graduated compression stockings are prescribed by your provider and come in various strengths or levels of tightness.

Graduated compression stockings are also an important step following treatment of varicose veins. During your healing stages, this stocking will help reduce the inflammation and pain in the Superficial Veins. Typical stocking strengths for treatment of varicose veins are 20-30mmHg.