Vein Physicians dedicated to studying and treating venous disease.

Varicose veins are large swollen veins that bulge under the skin and are typically blue or green in color.

An abnormal valve or a weakened vessel wall causes the bulging. In a normally functioning vein, the valve prevents blood flowing in the wrong direction back towards the foot. In a varicose vein, the valve is damaged and does not close properly. Varicose Veins

Spider veins are small-dilated veins near the surface of the skin and measure about 0.3 to 1.5 millimeters in size. They may be red, blue, purplish, or greenish in color.

The medical term for spider veins is telangiectasia. Spider veins can develop anywhere on the body, but are commonly found on the face and legs. There are larger superficial veins called reticular veins that may be the source of spider veins. Spider Veins

Facial veins are treated with different modalities depending on their size and location. The most common veins are small red veins on the cheeks and around the nose. Sometimes the veins around the nose are slightly larger and blue in color. These veins are similar to spider veins on the legs. Facial Veins

Hand veins are bulging veins on the backs of your hand. The reasons for bulging veins are many, but usually are related to a gradual increase in size of the veins over a period of years since the hands are below the heart level. Your doctor should make sure that there is no blockage in the veins in the shoulder area. Hand Veins

A venous ulcer is a sore on the lower leg and usually occurs just above the ankle. These ulcers may be large or small and occur because there is a breakdown of normal tissue. The reason this occurs is because there is a long history of high pressure in the veins in your legs.

Once an ulcer occurs, treatment needs to begin immediately. It is essential to reduce the pressure in the veins in the legs. Venous Ulcers


Spider Vein treatment

Treatment options include sclerotherapy, laser, ohmic thermolysis, surgical techniques and intense pulsed light (IPL). Read more

Varicose Vein treatment

The commonly used treatment options for veins include; compression therapy, thermal ablation, sclerotherapy, phlebectomy and high ligation and stripping. It is important to familiarize yourself with these treatment types and then discuss the best option with your doctor. Most experts in the field of venous disease consider thermal ablation to be the safest, simplest, and most effective treatment type in producing the best long-term results when treating GSV or SSV problems. Read more

Selected Glossary Terms

High Ligation
Refers to the process of dividing the saphenous vein in the groin when the patient has saphenous insufficiency. In the United States, this procedure is being rapidly replaced with thermal ablation.

Small Saphenous Vein
(SSV) The small saphenous vein is located in the back of the leg. The vein starts at the crease in the knee and runs down the back of the calf and angles to the outside of the foot. This vein is responsible for varicose veins in 10% of patients. Varicose veins are located on the back of the calf or thigh. The vein empties into a deep vein called 'popliteal'. The popliteal vein is the main deep vein in the knee area. -- Also called: Short Saphenous Vein, Lesser Saphenous Vein

Thermal ablation
Saphenous vein is treated with heat from a laser or radio-frequency device to cause eventual scarring and occlusion of the vein.
  -- Endovenous Thermal Ablation of Superficial Venous Insufficiency of the Lower Extremity: Single-Center Experience with 3000 Limbs Treated in a 7-Year Period
  -- Histological changes occurring after endoluminal ablation with two diode lasers (940 and 1319 nm) from acute changes to 4 months

TIRS Technique (Terminal Interruption of Reflux Source)
Using an ultrasound a foamed sclerosant solution is injected into a vessel to clot off a venous ulcer bed
  -- http://www.ncbi.nlm.nih.gov/pubmed/21098501

Varicose Vein
Varicose veins are dilated veins near the surface of the skin that occur secondary to weakened valves and veins in your legs. In veins, there are one-way valves that keep blood flowing from your legs back up to your heart. When the valves are not functioning properly, blood collects in the veins in your legs and the pressure builds up. The veins become weakened, enlarged, and have a twisted appearance and may be dark blue in color. Varicose veins tend to run in families. Other causes of varicose veins include prior pregnancy, standing for long periods of time, age, tall stature, obesity, sedentary lifestyle, and oral contraceptive use. Varicose veins are commonly found in the lower extremities.
  -- Evaluation of varicose veins: what do the clinical signs and symptoms reveal about the underlying disease and need for intervention?
  -- The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum

Venous Malformation
Refers to a large group of venous problems that are usually congenital conditions

Frequently Asked Questions

I have had many spider vein treatments over the years and they keep coming back. Why does this happen?
There are many different reasons this can occur. It may be that the source of the problem (reticular veins) was not treated. This also could be due to your genetic makeup. Spider veins may also be due to hormonal changes. In our practice, we see some patients that form veins very easy no matter what treatment they have. Thankfully, most people just form a few new veins once in a while.
Can I be out in the sun during treatment??
Most of this depends on the treatment you are having done. If your doctor is doing intense pulse light (IPL) or laser therapy you should avoid sun exposure. This is because the sun produces a lot of melanin in your skin and competes with the laser and IPL wavelength. If this occurs, you may develop blisters or skin pigment problems. Even if you are doing only sclerotherapy, sun exposure can cause some darkening of the area treated.
Air Travel Before & After Procedures
For a thermal ablation of the saphenous vein, we scan the patient 2-days post procedure and are free to fly under a 4-hour trip. For longer trips, we recommend at least a week. There really is no hard data to say how long the time should be. For a phlebectomy (removing superficial veins), you can fly the next day. For foam sclerotherapy, long trips should be avoided for a week unless you can get up and move frequently. We recommend wearing compression stockings and doing calf muscle pumps (moving foot up & down frequently).
How long will I need to take off from work for a thermal ablation?
One to two days off is generally all that is needed. A majority of patients have minimal discomfort after the procedure. Most patients resume normal activities within one week.

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