FAQs - Novant Health Vein Specialists, Vein Treatment



A Vein Doctor in NC on Vein Disease and the Heart

Q:Is varicose vein treatment painful?

Patients rarely report feeling any pain at all during and after our treatments. A local anesthetic is used to numb the treatment area.

Q: Will there be any scarring, bruising, or swelling?

Patients might have a little bruising or swelling after varicose vein treatments. But our patients report no scarring in the long term.

Q: How soon can I get back to regular activity?

Patients are usually encouraged to walk directly after the procedure; typically, they resume normal activities within a day. Excessive activities should be avoided for 7-10 days.

Q: What is venous reflux disease?

Venous reflux disease occurs in the superficial vein system when the valves in your veins that normally keep blood flowing out of your legs and up to your heart malfunction. This results in blood pooling in your legs. Frequently seen symptoms of venous reflux disease includes leg restlessness, pain, swelling, heaviness, fatigue and varicose veins.

Q: Do varicose vein procedures require any anesthesia?

All varicose vein procedures are performed in our office using only local anesthesia allowing patients to literally walk out of their procedure; thus, avoiding the need for extended recovery and the side effects associated with general anesthesia.

Q: How soon after treatment will my symptoms improve?

Most patients report a noticeable improvement in their symptoms within 1-2 weeks following the procedure.

Q: What happens to the treated vein left behind in the leg?

The vein simply becomes fibrous tissue after treatment. Over time, the vein will gradually incorporate into surrounding tissue. One study reported that 89% of treated veins are indistinguishable from other body tissue one year after the Closure procedure was performed.

Q: Is losing the vein and vein's function a problem?

No. These veins are part of the superficial venous system, which is comprised of a number of veins. When a vein’s valves become damaged or diseased, it inhibits the proper blood flow out of the leg. In turn, the vein is no longer useful and cannot be repaired. When the diseased vein is ablated (closed) or removed, the blood is rerouted to healthy veins, restoring the proper blood flow.
Damaged veins are no longer candidates for vein harvesting used in other procedures, i.e., open-heart surgery. However, as previously stated, our superficial venous system is comprised of a number of veins. For this reason, there are other healthy veins that can be used for vein harvesting used in other procedures.

Q:What are the potential complications of the procedure?

No serious complications have been reported in well over 2000 cases through March 2011. A small number of treated patients have had transient paresthesia (numbness) and even fewer have had superficial clotting or DVT (<6). The risks of foregoing treatment far outweigh those of having it. Our board-certified General Surgeon and staff are well trained and our surgical suites are properly equipped should an emergency arise. Our physicians and staff will discuss the nature, purpose, risks and benefits of our procedures in your initial consultation and anytime thereafter.

Q: What are the symptoms of varicose veins?

– Large, ropy veins
– Leg pain or aching
– Leg numbness or tingling
– Leg swelling
– Unsightly spider veins
– Restless legs
– Leg burning or cramping
– Skin discoloration
– Leg sores or ulcers
– Tired, heavy legs

Q: Am I at risk from exposure to laser/RF energy?

No. You will be given a special pair of glasses to protect your eyes in case of accidental firing of the equipment outside the body.

Q: What are varicose veins?

Varicose veins are secondary to venous valvular insufficiency. The valves in the vein no longer close completely causing blood to pool in the vein, gradually weakening the vein walls. The weak vein walls become enlarged resulting in varicose veins. Varicose veins often appear to be dark purple or blue and look rope-like, lumpy, twisted and/or bulging. These bulging veins can be symptomatic, resulting in leg pain, edema (swelling), skin discoloration and even leg ulceration. Those who suffer from varicose veins are likely to complain of their legs feeling heavy, swollen, tired, restless and achy. Often sitting or standing in the same position for too long a period of time will worsen their symptoms as the day progresses. An estimated 15%-25% of the adult population suffers from varicose veins. In the United States, that translates into 40 million people.

Q: Why does it occur more in the legs?

Gravity is the culprit. The distance from the feet to the heart is the furthest blood has to travel in the body. Consequently, those vessels experience a great deal of pressure. If vein walls and valves weaken, the reflux of blood can cause superficial veins to become varicose.

Q: What are venous stasis ulcers?

Venous ulcers are areas of the lower leg where the skin has broken down exposing the tissue. Typically, skin discoloration as well as itching will occur around the ankle before a venous ulcer will form. Ulcers can range from the size of a penny to completely encircling the leg. They are painful, open wounds, which weep fluid and can last for months or even years if left untreated.

Q: What is the short-term treatment for varicose veins?

ESES (pronounced SS) is an easy way to remember the conservative approach. It stands for Exercise Stockings Elevation and Still. Exercise, compression hose/stockings, elevation and rest will not make the veins go away or necessarily prevent them from worsening due to the underlying venous reflux disease not being addressed; however, it may provide temporary relief of the symptoms associated with varicose veins. Weight reduction is also helpful. If there are inflamed areas or an infection, topical and/or oral antibiotics may be prescribed.

Q: What is sclerotherapy?

Sclerotherapy is commonly used for treating spider veins and small varicose veins. It involves the injection of a FDA-approved foamed sclerosing solution (a mixture of saline and Sotradecol®), which causes chemical endovenous ablation of the vein, which collapses and diminishes in appearance.

Q: What is the main difference between arteries and veins?

In simplest terms, arteries pump oxygen-rich blood FROM the heart; veins return oxygen-depleted blood TO the heart.

Q: What are the three main categories of veins?

The deep venous system returns blood directly to the heart and is in the center of the leg, near the bones. The superficial venous system is just beneath the skin; it has less support from surrounding muscles and bones than the deep venous system. Perforator veins serve as connectors between the superficial and the deep systems.

Q: Are all bluish surface veins varicose veins?

People should not be too quick to identify any blue veins as being varicose veins. Fair-skinned and/or thin individuals are prone to slightly more prominent veins. Varicose veins are slightly raised and typically more noticeable upon standing.

Q: Does pregnancy cause varicose veins?

Pregnancy does not cause varicose veins; rather, it can aggravate an existing tendency toward the condition. More blood circulates in the body during pregnancy to meet the demands of the developing baby. This increased blood flow can burden an already weakened venous system. The growing fetus can also press on the pelvic veins and hinder the passage of blood. Finally, some researchers speculate that hormones present during pregnancy may contribute to dilated vessels. Prominent, uncomfortable veins that do not diminish postpartum should be evaluated by a vascular surgeon; though, some insurance providers require a six-month waiting period postpartum be observed before treatment is a covered benefit.

Q: Legs ache or throb if I am on them too long. Varicose related?

It depends. Leg aching and/or throbbing are symptoms of varicose veins and are most likely related to them. However, since there may be other conditions related to your leg discomfort, it is recommended that anyone experiencing leg pain should have an evaluation by a vein specialist. Temporary relief of these symptoms may be achieved by avoiding prolonged sitting and/ or standing. If you have a standing profession or if you find yourself standing for an extended amount of time, shift your weight from leg to leg. When sitting for more than 30 minutes, try to elevate the legs above heart level. If that is not possible, stand up and walk around for a few minutes before sitting again. In either case, wearing compression hose is recommended.

Q: Is treatment covered by insurance?

One of the questions I am most often asked when doing screenings for vein disease is “Is treatment covered by insurance?” As usual, most medical questions are not easily answered and so the answer is yes, and no. All insurance companies consider varicose vein disease treatments medically necessary, and will therefore cover it, if there are complications such as bleeding or ulceration. Most consider treatment medically necessary if there are symptoms and reflux can be demonstrated on a Doppler exam. Of course some of the newer treatments are considered “experimental” and therefore not covered. Spider vein treatments are considered cosmetic and no longer covered by any insurance plans of which we are aware. Lastly, not only does each insurance company have its own requirements but each individual policy can vary within the general guidelines of the company. Sounds confusing and it is. The best way to find out if your particular situation meets the requirements necessary for insurance coverage is to come in for an evaluation.