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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


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Spider Vein treatment

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

Ablation
A generic term that refers to the closing of the greater saphenous vein (GSV), small saphenous vein (SSV), or anterior accessory saphenous vein using heat from a laser or radio frequency catheter.
  -- Endovenous Thermal Ablation of Superficial Venous Insufficiency of the Lower Extremity: Single-Center Experience with 3000 Limbs Treated in a 7-Year Period

Deep Venous Disease
Any abnormality that affects the deep venous system, such as reflux or clots.
  -- The hemodynamics and diagnosis of venous disease

Duplex Ultrasonography
Combines ultrasound with a doppler commonly used today. The doppler is able to measure blood flow.

Laser (Light Amplification by Stimulated Emission of Radiation)
A laser is used to treat veins. The laser delivers a single wavelength of intense electromagnetic radiation (light energy) directly into the vein, causing intense heat that destroys the lining of the vein. The vein will eventually clot and scar down.
  -- 940-nm laser for treatment of saphenous insufficiency: histological analysis and long-term follow-up,

Lateral Reticular Vein
Refers to the venous system on the lateral aspect of the leg that is the most common site for spider veins.

Sclerosant
A term used for the solution used to do sclerotherapy for spider veins. FDA approved solutions are Sotradecol & Polidocanol. Other solutions doctors might use are glycerin and solutions that contain dextrose. Saline is rarely used since the effectiveness is low and it causes pain.

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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