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Frequently Asked Questions (FAQ)

Click on each question to link down to the answer.


What are varicose veins?
Varicose veins are enlarged, dilated blood vessels that appear under the skin.
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What are spider veins?
Spider veins are small varicose veins and typically present as tiny dilated veins that fan out from a central point on the skin surface.
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How do varicose veins and spider veins form?
Venous insufficiency is the culprit. The one way valves in the leg veins allow blood to slowly make its way back to the heart. When these valves get damaged, the blood begins to leak back down in these veins towards the feet. "Venous insufficiency" or "venous reflux disease" is the medical term describing the downward flow of blood in the dilated veins with damaged valves.
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Who gets varicose veins? What are the causes?

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How common is venous insufficiency (venous reflux disease)?
10 times more people suffer from venous insufficiency than peripheral arterial disease in the US. It can affect all age groups. 24 million Americans have varicose vein disease and 6 million have severe disease with skin changes (darkening of the skin/ulceration).
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What are the symptoms?

(All of the symptoms typically progress throughout the day, making it difficult to stand or sit for long periods)
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How have varicose veins been treated in the past?
Traditionally the treatment has been surgical vein stripping or ligation.
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What is the new method of treatment for varicose veins?
EVLA (Endovenous Laser Ablation). A laser catheter is inserted into the damaged vein, and the vein is "closed" from the inside by the energy delivered from the laser. This is performed as an outpatient procedure and is done under local anesthesia. The procedure takes about one hour and patients walk out of the office afterward.
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What is sclerotherapy and what is it used for?
This is the injection of a solution into an abnormal vein through a small needle. The solution that is injected destroys the vein wall, with the vein then scarring and shutting down. As opposed to laser treatment, which is termed thermal ablation, sclerotherapy is a form of chemical ablation. Sclerotherapy is typically performed on the smaller varicose vein branches, reticular veins, and spider veins.
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What happens to the blood in my legs once the varicose veins are closed and treated?
After treatment the previously painful and bulging varicose veins disappear. The numerous other normal veins (with healthy valves) will take over the work of getting the blood from your feet back to the heart. Your symptoms associated with the varicose veins will resolve.
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Can varicose and spider veins return after treatment?
Venouse disease is a chronic and progressive condition. Despite the effectiveness of EVLA and sclerotherapy re-occurrence may develop over time.
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