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Varicose Vein Therapy: Faster, Less Painful and More Effective
by Roberta Greenwood

Nearly 60 percent of American women and men suffer from some form of vein disorder according to the National Women’s Health Information Center. Women are more affected – It’s estimated that “41 percent of all women will suffer from abnormal leg veins by the time they’re in their fifties.” Venous disease, which includes generally harmless spider veins and frequently painful varicose veins, can cause symptoms that range from cosmetic discoloration to swollen, twisted and bulging veins.

What are Spider and Varicose Veins?
As the body attempts to return blood to the heart, one-way valves in the veins of the legs close, ensuring that blood flows in the correct direction. If the valves become weak, the blood pools and the veins become enlarged; tiny veins (spider veins) appear as short jagged lines and can be found on the face and legs. Large veins (varicose veins) are typically found on the legs and can be extremely painful. Although inadequate valve function is the primary cause of these uncomfortable and unsightly veins, many factors contribute to their development.

According to Dr. Michael Zammit, vascular surgeon and vein specialist at Stevens Hospital, several factors can result in the development of varicose veins. “Heredity is a large factor; when a patient is born with weak vein valves, it can lead to problems. Also, hormonal changes that occur during puberty, pregnancy and menopause can cause a woman to develop varicose veins or spider veins.” Zammit adds that while men also suffer from vein disease, his team of vein specialists treats women at a ratio of four-to-one.

Pregnancy history also plays a large role – with multiple pregnancies accelerating the onset of symptoms. Prolonged standing and sitting, as well as obesity, can aggravate weak veins and contribute to varicose veins, while spider veins on the face may occur from overexposure to the sun.

Treatment Options
Schlerotherapy, or injection therapy, is used primarily to treat spider veins. A tiny needle is used to inject a sclerosing solution into the vein, which irritates the lining and causes the vein to collapse and disappear. Zammit stresses that although effective, patients should understand that the procedure is ongoing, with follow-up treatments needed every one to two years.

Ligation and stripping has been the traditional treatment for problematic varicose veins. An invasive procedure, it requires general anesthesia and many patients report suffering mild to severe pain during recovery. In these procedures, the veins are tied off (ligated). If found to be heavily damaged or unhealthy, they are removed from the leg, or “stripped,” forcing other, healthier veins to carry the blood back to the heart. With the introduction of new technologies, these procedures are now being replaced with less-invasive treatments.

Zammit explains that more attention has been given to vein health over the past 10 years. “In the past, veins were largely ignored, with more attention given to arterial health and circulation; emerging trends in treatment are changing that viewpoint.” Using lasers or radio frequency to treat varicose veins allows doctors to offer patients safe, effective procedures in addition to traditional methods. “It’s an exciting time, with all the new treatments,” says Zammit.

Dr. Torrance Andrews, chief of vascular and interventional radiology at the University of Washington Medical Center agrees, saying that “vein ablation” (the use of laser or radio frequency to close veins) could very well replace stripping in the future.

“Vein ablation has a higher success rate – about 90 percent,” he explains, “and we’re noting a lower recurrence rate as well.” During the procedure, a thin catheter is inserted through a tiny incision in the thigh and a laser or radio-frequency beam is applied inside the vein, heating it and causing it to close. The patient remains awake and alert throughout the roughly one-hour treatment and can usually walk out of the medical facility. Most patients return to work immediately and only require over-the-counter pain medication. Andrews cautions that some cramping and soreness will be present for about a week, and patients must wear compression stockings for a few weeks.

“In fact,” he laughs, “I had the procedure done a few years back and I was skiing two weeks later.”

Both Andrews and Zammit emphasize the importance of appropriate testing prior to deciding how to treat spider or varicose veins. “Spider veins can sometimes indicate reflux (blood circulating incorrectly) or a deeper vein problem, and this can be diagnosed with ultrasound testing; it’s an important first step,” says Zammit. Stripping and vein ablation may be covered by medical insurance, but they must be deemed a medical necessity; most cosmetic procedures (spider veins) would be an out of-pocket expense.

Not all varicose veins require medical treatment, but if you’re experiencing pain, tenderness to the touch, a rash or skin ulcers, see your doctor. Dr. Zammit recommends the following precautions to help avoid or reduce the symptoms of varicose veins:

• Use sunscreen – it protects the face and decreases the chances of spider veins occurring.
• Control your weight.
• Exercise to improve circulation.
• Wear elastic (compression) stockings.

Statistically speaking, most women will face some type of vein disorder before 60; the good news is prevention works and treatment is no longer as painful.

Roberta Greenwood enjoyed a business career that spanned three decades. A community activist and writer, she lives in Bellevue with her husband and youngest daughter.

©2005 Caliope Publishing Company