Varicose Vein Treatment in St. Louis, MO
Enlargement of veins close to the skin is called varicose veins (varix from the Latin word for vein - usually twisted and swollen).
Hereditary predisposition plays a significant role in the formation of these unsightly veins of the legs. If you carefully questioned your relatives, you'd almost surely find an ancestor or two with similar problems.
Hormonal effects also play a contributing role in the formation of these abnormalities. Increased levels of estrogen (and progesterone during pregnancy) cause a dilatation of healthy veins. In pregnancy, the enlargement of these veins is in response to the increased total blood volume that the fetus demands. Interestingly, the varicose veins of pregnancy almost always revert to normal size within six months post-partum. That is one of the reasons our office strongly advises against surgery during this time. As a rule, our patients are placed in support stockings for the duration and undergo surgical therapy during pregnancy exclusively for an occasional case of phlebitis (inflammation of an individual vein).
However, if there is a positive family history for varicose veins, there is a very real chance that your veins will not return to normal after pregnancy. At that time a referral to our office is indicated.
Men also develop these varicose veins but, being men and usually wearing pants, tend not to "self-refer." We see about three women for every man in our office with these varicosities. Again, heredity plays a very substantial role in the formation of these bulging and painful veins. Injury from work or sports is another contributing factor.
Symptoms of Vein Disease/Chronic Venous Insufficiency
Signs are what you and the surgeon can see on physical examination. Evidence of venous disease consists of small spider veins, blue-green veins under the skin, and varicose veins. Varicose veins can visibly bulge above the skin and appear ropey, or twisted.
When these veins are left untreated, they can lead to an increase in symptomology with long term ramifications such as skin erosion causing Venous Stasis Ulcers and in some cases deep or superficial blood clots.
Symptoms are what you, as the patient, can feel. Symptoms of vein disease are many and varied. Venous disease may be present without symptoms and only presenting because there are signs on physical examination.
Self-care methods can help to manage your symptoms. In addition to developing a clinical plan for you, we suggest exercise, elevating the limbs, applying cold or heat, medications such as Advil or Tylenol and compression/support stockings. Vein disease symptoms can be made worse with sitting and standing for prolonged periods, premenstrual, pregnancy, exercise and walking/stair climbing. Leg cramps and restless leg syndrome can disrupt sleep cycles.
Vein Disease: Common Symptoms
- Leg Cramps
- Restless Leg Syndrome
- Spontaneous Bleeding
- Skin Changes
Treatment for Venous Insufficiency and Varicose Veins
For over 100 years, the only treatment for varicose veins was 'Stripping and Ligation". This procedure was (and still is) performed in hospitals under general anesthesia. Blood loss during the surgery process was significant.
Out-dated treatments cause patients severe pain for a prolonged period (4 – 6 weeks) during which the patient is unable to work or carry out most activities of daily living.
Scarring is common due to multiple larger incisions made the entire length of the leg. Many people suffer from nerve damage and later have a recurrence of varicose veins and symptoms. The clinical staff at Vein Specialties do not use stripping or ligation - instead, they use the latest technology to ensure patients receive the best results with minimal downtime.
Laser Treatment (Endo-Venous Laser Ablation)
Endovenous ablation uses heat from the laser to treat a vein which is not functioning correctly. The most common veins treated are the Large Saphenous Vein and the Small Saphenous Vein. It can also be used to treat incompetent branches of these veins if indicated. The procedure is done in our office under a particular type of local anesthesia and takes approximately 30-45 minutes.
A small laser fiber is inserted into the vein and positioned using Duplex Ultrasound. These are not incisions but rather, small punctures which leave little or no marks when healed. As the laser activates, the heat it produces seals the vein from the inside. The patient experiences no pain during this procedure. The laser ablates the tissue and closes the vein behind it; the blood is no longer able to pool and returns to the heart through other healthy veins. Afterward, we apply light dressing along with a compression stocking. Once the dressing is complete, we encourage patients to walk around the office to promote circulation. Post ablation, patients wear compression stockings for for one week depending upon lifestyle. We often recommend compression socks for those who are not their feet a lot for maintenance.
Patients can return to work and most normal activities within two days. In many cases, patients return to work the next day.
Micro (small) Phleb (vein) Ectomy (removal).
Microphlebectomies are a wonderfully successful approach to the elimination of large painful, unsightly varicose veins. It is performed in the office under local anesthesia while the patient is awake and alert. Dr. Bein creates a small nick in the skin and removes the vein with a fine surgical hook. The "incision" is comparable to blowing up a balloon. If you write on the balloon and deflate it, the writing is minuscule. Hence, quite large veins are removed through tiny nicks with an excellent cosmetic result as well as relief from symptoms associated with larger varicose veins.
This procedure is often done in conjunction with EVLA (Endovenous Laser Ablation) for deeper vein malfunction.
Sclerotherapy (injection) of Larger Varicose Veins
Some patients undergo "injection of sclerosing solutions" into the larger varicose vein and also non-functioning (incompetent) veins.
This procedure is still performed today but is only appropriate in certain cases. This therapy can be associated with blood clots or collections necessitating repeated trips to the office for drainage. Another complication can be the loss of skin overlying the areas treated. This treatment is often ineffective due to the size of the veins and the inefficient contact made between vein wall and the injected solution. As a Board Certified vascular trained surgeon, I perform microphlebectomy on these veins (see above)
Dornier 1470 Diode Laser
The Dornier 1470 Laser is a highly advanced system that physicians are using throughout the world to quickly and safely treat the cause of painful and unsightly varicose veins.
This system is employed in the Endo-Venous Laser Ablation (EVLA) which is FDA approved. Endovenous is the procedure of choice compared to vein "stripping" of the past (which is a procedure performed in a hospital, usually with general or spinal anesthesia and a painful and extended recovery period. Scarring is often associated with stripping.)
Ablation procedures are quick (usually about 30 minutes), one time, and minimally invasive with little or no marks. Patients can return to most normal activities within a day or two. Walking is encouraged immediately after the procedure and for the recovery time.
Dornier Medical Technology is a leader in the laser field for laser treatment of incompetent veins.
More Information About Varicose Veins
Varicose Vein Common Questions
Varicose Vein Before and After Pictures
Want to learn more about varicose vein treatment? Call our St Louis, MO office at (314) 993-8233 today!