Varicose veins, bulging or ropey veins, are usually caused by disease in the major superficial vein at the top of the leg called the great saphenous vein. This disease affects people of all ages and the symptoms tend to progress and get worse as time goes on. Heredity is the most common risk factor for varicose vein development, followed by gender and age. Other factors that can contribute to the formation of varicose veins are obesity, standing for prolonged periods of time and history of leg trauma. Women have a higher incidence of varicose vein disease. This is mostly due to the effect that female hormones have on the vein walls and most often occurs during pregnancy. In the United States, approximately 25 percent of women and 18 percent of men are afflicted with venous disease. Valves within the veins are responsible for the prevention of blood pooling in the legs. When blood pools it leads to venous hypertension in the legs and can cause symptoms of heaviness, pain, aching, throbbing and can even led to edema or swelling in the leg. The most common cause of symptomatic varicose venous disease is reflux of the great saphenous vein. This means that the valves in the vein are not working properly. Without good valves, the blood flows backwards causing pooling of blood in the leg and bulging of the veins. All of this results in bulging, painful veins and swollen, achy legs. 

Unfortunately, there is little that can be done to stop the formation of varicose

veins. However, there has been an increase in the treatment options,which can be offered to patients suffering from this problem. There are three treatments used to alleviate varicose vein symptoms. The first involves stripping the vein

in the operating room. This older treatment requires an incision in the groin and can have complications, including possible nerve damage or postoperative infection. The vein stripping method is used only for patients whose veins cannot be treated by another option. It is no longer considered the first modality of care for venous insufficiency.

The second is local injections of medication called sclerotherapy. Injections do not, however, address the cause or source of the vein problems. Injections are mostly used

for minimal venous disease or small veins that are primarily visually displeasing to the patient. The third and newest treatment option is EndoVenous Laser Treatment (EVLT). EVLT was developed fairly recently. Vascular surgeons, as well as other physicians, have learned to use the EndoVenous Laser Treatment in order to seal off a poorly functioning

vein. This procedure is performed safely using ultrasound guidance, which assists with proper positioning of the laser device. Ablation or closure of the leg vein at the malfunctioning valve treats the underlying cause of venous insufficiency and often is all that is needed to eliminate any bulging veins. Treatment of painful varicose veins

leads to improvement in patients’ general health and sense of well-being. 

Because EndoVenous Laser Treatment is minimally invasive, patients can be treated in the doctor's office. It does not require any general anesthesia. Local anesthesia is used to make the patient more comfortable, and the procedure is generally very well tolerated. The entire process takes only about one hour. The patient is then able to leave the office with only a compression stocking on their leg. There is minimal scarring or pain, and no sutures are required. During the first two days following the procedure, patients are instructed to take an over-the-counter anti-inflammatory medication for mild discomfort and for the inflammatory response that may occur in the treated vein. Treatment of venous disease is an important health decision, which can halt the progression of disease. Without treatment, permanent skin discoloration, swelling in the legs and ulcers may develop as the disease worsens. EndoVenous Laser Therapy treats the source of venous disease with excellent clinical and anesthetic results. The success rate of EVLT is approximately 98 percent at one month and 93 percent at a two-year follow-up visit. EVLT offers patients an effective solution to getting rid of varicose veins, returning to normal activities right away with a rapid recovery and minimal postoperative pain. For all these reasons, venous insufficiency can be treated easily, and patients no longer have to suffer physically and/or psychologically from this common but under-treated problem.

Natalie Weger, D.O. is a general, endovascular and vascular surgeon. John Leonard, M.D. is a General and Vascular surgeon.  They both perform this procedure and can be reached at 720.494.3135.