Consider Minimally Invasive Options for Varicose Vein Removal

During the postmenopausal years, a red, blue, or raised rope-like vein may appear somewhere on your legs. In most cases, these varicose veins are nothing more than a cosmetic annoyance. In other instances, they are quite painful, and sometimes even the source of a non-threatening blood clot. Diagnostic imaging tests can identify which veins could be medically troublesome, and what treatment might be best—whether the therapy is aimed at reducing discomfort or alleviating aesthetic concerns—or both.

Causes and Symptoms

Women who have varicose veins do not usually have symptoms, but in cases where they do their legs may feel extremely tired, heavy, or achy. Other symptoms include throbbing or cramping, swelling, and itching. These symptoms are often the result of prolonged sitting or standing, which can cause pooling of blood in the legs and lead to the development of varicose veins over time.

These veins are more common in the postmenopausal phase of life because menopause can affect elasticity of vein walls and contribute to their development. “Hormones affect veins, and with each pregnancy varicose veins tend to worsen. Prior trauma to the legs, obesity, and family history of varicose veins are also risk factors,” says Soo J. Rhee, MD, co-director of the Comprehensive Vein Program, Division of Vascular and Endovascular Surgery at NewYork-Presbyterian/Weill Cornell Medical Center.

Diagnostic Testing

An ultrasound test will reveal if the veins are damaged, if the valves are not working properly, and if there is a blood clot. “When the valves do not work properly, this causes blood to pool in the veins, which can lead to symptoms such as pain, swelling, and even skin changes. The results of the ultrasound along with your symptoms will be used to determine whether treatment is recommended for your veins,” explains Dr. Rhee.

Health-Related Treatments

Most varicose veins are not associated with health problems, but those that are can cause:

Pain and swelling: Applying an ice pack to the painful area, elevating your legs above your heart, wearing compression stockings, and avoiding sitting or standing for long periods can offer relief.

Phlebitis: Phlebitis can cause redness, pain, and swelling. Phlebitis may occur with or without a blood clot. When caused by a blood clot, it’s called thrombophlebitis. Your doctor might recommend applying heat to the area, elevating the affected leg, and/or using a nonsteroidal anti-inflammatory drug (NSAID). “Treating varicose veins can decrease the risk for phlebitis,” says Dr. Rhee.

Ulcers: These are caused by long-term collection of blood in the veins. They can be painful and difficult to heal.

Bleeding: Skin over varicose veins can become thin, and injury to the vein can cause bleeding.

“Treatment of varicose veins is recommended when symptoms such as pain and/or swelling of the legs become more frequent and start impacting your ability to get through your day comfortably, or if you find yourself less active than you would like to be because of symptoms,” says Dr. Rhee. “Other complications such as skin changes around the lower leg, clotting, and bleeding from the veins would also prompt treatment.”

Non-Health-Related Treatments

There are a variety of varicose vein treatments, and some of them include:

Sclerotherapy: Typically used for smaller veins, this entails an injection of a solution directly into the vein. The solution causes the vein to turn into scar tissue and eventually disappear. “Sclerotherapy is minimally invasive, but healing can take a few months,” says Dr. Rhee.

Phlebectomy: This technique removes the faulty vein through a series of tiny incisions. Most people can return to normal activity the day after treatment. “Patients who are in good health and are not taking blood thinners do well with phlebectomy, which heals quickly,” says Dr. Rhee.

Endovenous thermal ablation: This includes endovenous laser vein treatment (EVLT) and radiofrequency ablation (RFA). These are minimally invasive techniques to close down main underlying veins from the inside using ultrasound-guidance.

Consult with a Physician

In the majority of cases, varicose veins are simply a cosmetic concern, but sometimes they are painful. The choice of varicose vein treatment depends on the severity of symptoms and the individual’s preferences. A consultation with a physician can help assess your situation so you can decide on the most appropriate option.

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