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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). Spider Vein Treatment
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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. Varicose Vein Treatment
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Art of Micro-Phlebology Symposium

New Techniques Based on Anatomical Principles. Become familiar with cutaneous pathophysiology and histology. Techniques for unloading cutaneous venous hypertension. New advances in sclerotherapy and much more! Learn More

Selected Glossary Terms

Aneurysm of the Vein
The definition is a ballooning of the vein at greater than 1.5x the diameter of the adjacent veins. Aneurysms can be benign and cause no problems or they can be the source of a clot that can travel to the lungs (pulmonary embolus). The treatment depends on the location and the nearby anatomy.
  -- Aneurysms of the superficial venous system: classification and treatment

Blood Clot
A blood clot may occur from trauma, inflammation, or abnormal clotting factors and is simply a mixture of blood components that have formed from a liquid to a solid state.
  -- http://www.clotconnect.org/

Endovenous Laser Treatment (EVLT)
This is where a small laser filament is inserted into a vein to cause thrombosis of the vein and scarring.
  -- Endovenous thermal ablation of superficial venous insufficiency of the lower extremity: single-center experience with 3000 limbs treated in a 7-year period.
  -- 940-nm Laser for Treatment of Saphenous Insufficiency: Histological Analysis and Long-Term Follow-Up
  -- Histological changes occurring after endoluminal ablation with two diode lasers (940 and 1319 nm) from acute changes to 4 months

Perforator
Perforator veins connect the superficial system to the deep system. These veins normally drain blood from the superficial veins to the deep veins as part of the process of returning oxygen-depleted blood to the heart.

Spider Vein
Small red and bluish veins located just beneath the skin surface. Spider veins are usually associated with higher venous pressure in the reticular venous system. They can be associated with hormonal changes, pregnancy, heredity, and reflux in the deeper venous system.
  -- Microshunt histology in telangiectasias.
  -- Telangiectases in Venous Insufficiency: Point of Reflux and Treatment Strategy
  -- Red and blue telangiectasias. Differences in oxygenation?

Vein of Giacommini
Connects the greater saphenous vein (GSV) with the small saphenous vein (SSV). If it refluxes it can cause varicose veins or spider veins in the posterior thigh.
  -- Treatment of Incompetent Vein of Giacomini (Thigh Extension Branch)

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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