State-of-the-Art Varicose Vein Treatment at JVAI

There are many reasons why veins dilate and become incompetent, resulting in varicose veins. Age is a primary factor. As we become older, the elastic walls of the veins slowly wear out and are damaged by overstretching. Veins are also dilated by certain occupations that require standing for prolonged periods producing venous stasis. Nurses, auto mechanics, store personnel and waitresses are good examples. The increased pressure in the lower abdomen during pregnancy makes it difficult for the veins of the legs to drain and creates back pressure in the leg veins. This back pressure dilates the veins and is responsible for the varicose veins that are often seen during and after pregnancy.

For the most part, varicose veins are not dangerous. However, large varicose veins can lead to very slow blood movement through the dilated vessel. Blood has a natural tendency to clot when it is moving very slowly, making it more likely for blood clots to form and lodge within the vein. This condition is called thrombophlebitis or simply phlebitis. If present only in the superficial veins under the skin, it is not dangerous and usually will respond to moist heat and elevation. If the clot extends into the deep venous system, it is considered dangerous and therapy with blood thinning medications is recommended.

The first and most important step when seeking spider vein and varicose vein treatment is to understand the cause of the condition. Many vein centers do not provide treatment for underlying venous disease. They are not operated and staffed by physicians who are phlebologists or vein treatment experts and are not equipped or capable of diagnosing or treating underlying venous pathology. Podiatrists, dermatologists, internists and other practitioners who offer cosmetic vein treatment are known to take a weekend training on cosmetic treatment for spider and varicose veins for adding another stream of income to their practice. They are focused on providing a cosmetic treatment that eliminates the existing spider veins and/or varicose veins only. Their patients are not generally told that when venous disease is present, more spider veins and varicose veins are likely to develop in other areas of the legs.

At JVAI, many patients come to us for cosmetic spider vein treatment and varicose vein treatment. While they are bothered by the unsightly appearance of these veins, we can often offer them cosmetic solutions and treatment that addresses and permanently eliminates their underlying venous disease.

We use microphlebectomy to provide cosmetic treatment for veins on the surface of their legs. Through laser ablation, we correct the problem with incompetent valves in the saphenous and perforator vein systems. This vascular surgery procedure prevents future spider and varicose vein development from that source. Unlike cosmetic vein treatment centers where payment is the patient’s responsibility, our diagnosis and treatment of venous disease is generally covered by Medicare and private insurance.

When it is determined that venous disease is present, the venous diagnostic evaluation and vascular surgery vein treatment is often covered by Medicare and private insurance. When performed for cosmetic purposes only, spider vein and varicose vein treatment are solely the patient’s financial responsibility. Our front office will gladly assist you in the insurance reimbursement process when that option is available.

Incompetence of the greater saphenous vein has traditionally been treated by vein stripping – an outdated vascular surgery procedure associated with a long and painful convalescence. Patients present with venous disease leg symptoms that may include swelling, pain, prominent varicose veins and skin discoloration with or without ulceration. The procedure almost always involves removal of the greater saphenous vein which lies along the inside of the thigh and lower leg. An incision is made in the groin to tie off and divide the top of the vein. A vein stripper is then inserted into the vein. It is generally pushed through the vein above the knee and brought through the skin by a second incision. A small stripping device is then connected to the stripper and it is pulled back through the leg tearing the vein out with it. Pressure is then applied to the leg to reduce bleeding. This procedure is uncomfortable for the patient post-operatively and may result in bruising under the skin that can take months to completely resolve.

Varicose veins are removed by Microphlebectomy at JVAI. This European technique involves removing the prominent veins through tiny needle punctures, virtually leaving no scars. It is quick and relatively painless and produces superior results than traditional treatment. We treat patients of all ages, both male and female. Using Microphlebectomy, we have satisfactorily treated a number of young aerobic instructors and models who were looking for a superior cosmetic result. Sclerotherapy is also utilized for smaller varicose veins when indicated.

At the Joyce Vein & Aesthetic Institute, Great and Small Saphenous Vein Laser Ablation is used as an alternative to obsolete vein stripping procedures for the treatment of varicose veins of the saphenous system. In this procedure, a small diameter laser filament is inserted into the vein through a needle puncture. This is done right in our office with minimal anesthesia. The laser filament is connected to a laser system that closes off the greater saphenous vein from the inside. There is very little trauma to the leg and almost no bruising. Postoperative discomfort is minimal. Patient satisfaction is high. In fact, patients who have had vein stripping of the other leg have stated that they wish they had waited until this laser technology was available before having their previous procedure.