The information below was last updated on 2/23/07 by Dr. Theodore King , M.D. on behalf of Vein Clinics of America (VCA).

About Vein Disorders

What are varicose veins?
What causes varicose veins?
What are spider veins?
Does vein disease affect women and men equally?

About Vein Treatment

What should I look for in a physician?
Why isn't surgery a good idea?
What is the difference between endovenous lasers and surface lasers?
What is sclerotherapy?
How does the sclerosant work exactly?
Does sclerotherapy cause any damage or side effects?
What is Endovenous Laser Treatment (ELT)?
Does Endovenous Laser Treatment (ELT) cause any damage or side effects?
How will my blood circulate if I eliminate my varicose veins?
Just how serious a problem is recurrence?
Is it okay to postpone treatment?
What about treating other parts of the body affected by veins?
Will I need to be hospitalized or take time off from work?
How are the doctors at Vein Clinics of America trained?
What happens during a physician consultation?
Will I have to undergo any testing before treatment?

Insurance and FSAs

Is vein treatment covered by insurance?
Can I use my Flex Spending Account (FSA) to pay for my vein treatment?

 

Q: What are varicose veins?

A: A varicose vein is a failed vein, the contents of which are stagnant or refluxing. Either way, this blood is out of circulation. The function of your veins is to channel blood back to the heart. The larger veins have valves which direct the flow of blood. When any of these valves fail, blood can accumulate under pressure, engorging and distorting the veins in your leg. Varicose veins appear as either bulging and rope-like, or small and thread-like. They can result in aching, tired and swollen legs; create a burning, throbbing, or itching sensation; and cause muscle cramps and a general restlessness in your legs. Varicose veins are a vascular disorder requiring treatment for medical reasons.

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Q: What causes varicose veins?

A: One clear factor is heredity. Most patients who suffer from varicose veins have a family history of the condition. Another factor is hormonal changes that specifically affect women. Pregnancy or birth control pills further increase your chances of developing vein disorders. Other contributing factors include prolonged standing, being overweight and/or trauma to the leg.

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Q: What are spider veins?

A: Spider veins appear to be hormonally induced and are associated with pregnancy and menstruation. Although spider veins are not usually symptomatic, the accompanying reticular veins, found deeper in the skin, often cause discomfort. Reticular veins are also referred to as “feeder” veins. Many women have a combination of both varicose and spider veins. While they may seek treatment for cosmetic improvement, many female patients are in fact looking for relief from pain.

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Q: Does vein disease affect women and men equally?

A: Women account for approximately 85-90% of varicose vein cases, mainly because of the unique additional risk factors for females, including estrogen levels and pregnancy. Women are particularly afflicted with reticular veins. These light blue veins usually appear in a lattice framework, giving a marbled appearance to the skin. They are the most harmless looking veins, but they are usually the most symptomatic of all. Reticular veins are the cause of the high rate of Restless Leg Syndrome (RLS) in women. When these veins are effectively treated, the discomfort and automatic movements diminish.

In men, the pathophysiology is similar, but instead of reticular veins, the culprits are multiple, small-branching varices and “high pressured small vein disease” (hpsvd). The varices, unfortunately, are often mistaken for “cosmetic” telangiectasia (spider veins). The difference is important because the treatment is different. The association between RLS and vein disease has been overlooked, most likely because of the innocent appearance of the reticular veins. We see dozens of cases each day with RLS, and we expect improvement after only a few treatment sessions.

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Q: What should I look for in a physician?

A: Experience matters. Varicose vein disease can be very complex and each patient is unique. Therefore, it’s important to find a physician experienced in treating the entire spectrum of vein disease from spider veins, to large ropey varicose veins to leg ulcers.

At Vein Clinics of America, we have been successfully treating vein disorders without surgery since 1981. In fact, it’s all we do. Unique to the treatment of vein disease, VCA utilizes state-of-the-art Endovenous Laser Treatment (ELT) along with the non-surgical, minimally invasive COMPASS technique of ultrasound-guided sclerotherapy. This allows us to meet the specific needs of each patient – from the largest varicose vein to the smallest spider veins.

Our physicians are dedicated to making patients feel at ease throughout the process. They will thoroughly evaluate your condition, discuss the details of your situation so you feel comfortable and present you with a course of action that works best for you.

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Q: Why isn't surgery a good idea?

A: The documented failure rate for surgery is 30 to 80% in one to five years. Removing a varicose vein surgically is not the same as removing an appendix – a one-time-only procedure – because varicose veins are a chronic problem plagued with new growth in many places in the leg. Repeated surgery is not an acceptable solution for a recurrent problem.

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Q: What is the difference between endovenous lasers and surface lasers?

A: An endovenous laser is used to treat large veins beneath the surface of the skin. Surface lasers treat the lighter, more delicate spider veins that appear close to the skin's surface.

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Q: What is sclerotherapy?

A: Sclerotherapy is a microinjection procedure that requires no pain medication or surgery. Abnormal veins are destroyed by injecting a solution called a sclerosant, which irritates the vein wall. It is not simply injecting the sclerosant, but paying attention to the volume, concentration and “exposure time” that makes the difference between success and failure.

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Q: How does the sclerosant work exactly?

A: The sclerosant we use is an FDA-approved medication, which intentionally causes injury to the inner vein wall. This injury occurs in a controlled manner, depending on the volume and concentration of the medication used in each site. The medication is inactivated quickly by dilutional effect and interaction with structural components of the vein wall, making the effect localized. The initial injury to the vein wall results in a healing process which causes the vein to literally heal shut over time. This results in shrinkage of the vein, and eventually, complete obliteration of the target vein.

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Q: Does sclerotherapy cause any damage or side effects?

A: As with all medical procedures, side effects and complications are possible. This is why it is important to seek treatment from an experienced physician. Allergic reactions are extremely rare and are mild when they do occur. They are somewhat more likely to occur when treating larger varicose veins because the medicine is more concentrated and used in greater volumes.

You may develop itching dermatitis (inflammation of the skin) and a mild, temporary increase in pigmentation (staining of the skin) if you have any of the following: darker skin, overly sensitive skin, very dense spider veins, or if your skin is already damaged because your veins have deteriorated too much.

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Q: What is Endovenous Laser Treatment (ELT)?

A: Endovenous Laser Treatment (ELT) was FDA-approved in 2002, and extensively reviewed by the physicians of Vein Clinics of America to be certain it was safe and effective before introducing it to our patients. ELT is a quick, minimally invasive laser treatment that requires no hospitalization and no complicated surgery. The entire procedure, start to finish, takes about one hour and causes minimal to no pain. Performed under ultrasound guidance, ELT uses laser energy to treat the underlying cause of varicose veins by closing off the vein to any future blood flow. Your body then naturally uses other healthy veins to return blood from the heart.

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Q: Does Endovenous Laser Treatment (ELT) cause any damage or side effects?

A: Major complications resulting from ELT are very rare. Various levels of discomfort can occur as well as some bruising.

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Q: How will my blood circulate if I eliminate my varicose veins?

A: Varicose veins are a burden on your circulation. Because the blood inside them is refluxing (going backwards), correcting the flow can only improve your circulation. In treating varicose veins, we eliminate only the bad veins and safeguard the healthy veins for normal circulation. We also preserve healthy veins for possible future use as a bypass graft source. Ultrasound helps to ensure that treatment is highly selective.

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Q: Just how serious a problem is recurrence?

A: If you have a chronic vein problem, your chances of recurrence are affected by several factors, the most important of which is the thoroughness of your treatment. Unfortunately, many patients quit treatment too early – usually, once they believe their legs look “good enough.” In fact, remnants of the veins left in the leg can quickly grow into more veins.

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Q: Is it okay to postpone treatment?

A: As you probably know, postponing any type of treatment can have its drawbacks. Varicose vein disease is a progressive disease that, if left untreated, will only get worse. When making a decision about your varicose veins, keep in mind that the sooner you get your veins treated, the easier they are to treat and control.

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Q: What about treating other parts of the body affected by veins?

A: The physicians of Vein Clinics of America have treated not only the veins in their patients’ legs, but also their hands and face. We’ve even successfully treated the veins around their eyes. Dark circles under the eyes are more common with age, and are usually a condition in women. These patients have feeder veins coming from their scalp that drain into the veins under their eyes. The blood collects and distends those veins, making their eyes darker. We can see the feeder veins at the upper front temple regions. Treatment of these veins can markedly reduce or eliminate dark circles – with no adverse affect on your brain, or the blood circulation to your eyes. Prominent veins are a proliferative condition here also, and treatment (eradication) involves reducing the number of veins to a more normal level.

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Q: Will I need to be hospitalized or take time off from work?

A: Treatment is on an outpatient basis during convenient office visits. You can resume most activities shortly after each session.

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Q: How are the doctors at Vein Clinics of America trained?

A: Unlike common “weekend training seminars” for physicians, all our new physicians participate in a preceptorship, which is an extended period of practical training under the supervision of one of our experienced physicians. After training – which lasts approximately three to four months – new physicians are heavily mentored for a full year.

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Q: What happens during a physician consultation?

A: When you come to us, you will complete a patient medical history form. A medical doctor specializing in phlebology will examine you and answer your questions. Your circulation will be tested with a non-invasive Doppler, and an individualized treatment plan will be developed for you. If a condition other than a vein disorder is identified, you will be referred back to your personal physician.

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Q: Will I have to undergo any testing before treatment?

A: Your VCA phlebologist may recommend diagnostic tests, including Arterial Doppler and continuous Wave Doppler, Duplex Ultrasound and Light Reflection Rheography. This state-of-the-art technology provides painless and non-invasive testing, and is performed in the physician's office.

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Q: Is vein treatment covered by insurance?

A: Varicose vein treatment is often covered by insurance. In fact, VCA is in network with most major insurance plans. We will work with you to maximize your insurance benefits. Call us at 866-923-8346 to learn more.

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Q: Can I use my Flex Spending Account (FSA) to pay for my vein treatment?

A: FSAs are a valuable benefit to help pay for medical expenses. Reimbursable FSA expenses cover a variety of heath-related treatments including many treatments for vein disorders, such as varicose veins and leg ulcers. To learn more call us at 866-923-8346.

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The information found on this website is designed to support, not replace, the patient/physician relationship. Please contact us at 866-923-8346 to meet with a doctor.