Minimally Invasive Varicose Veins Surgery (MIVS)
Varicose veins are an enlargement of veins that result from pooling of blood which force the vein walls outward. Heredity factors play an important role in their development. Other factors that contribute include pregnancy, hormonal therapy including post-menopausal hormones and birth control pills. Prolonged standing or sitting, obesity and aging are additional causes.
Symptoms include discomfort in the legs especially at the end of the day. This can include heaviness, tiredness, aching and swelling. If symptoms persist for a long period of time it can result in phlebitis, skin changes, ulcerations and bleeding.
Graduated compression stockings which are tighter at the ankle than the calf or thigh can alleviate some symptoms but will not rid your legs of varicose veins. This option is good for women who are pregnant.
Surgical and Other Treatment Options
Sclerotherapy is an office based procedure in which a sclerosing solution is injected into the veins using tiny needles. This makes the vein disappear and may require multiple treatments in order to close the veins completely. This is excellent for spider veins.
Phlebectomy or removal of varicose veins is a minor surgical procedure to remove larger varicose veins. Tiny incisions are used resulting in barely visible scars and is performed on an outpatient basis.
Surgical Stripping and Ligation
People with large varicose veins may have incompetent valves in the greater saphenous vein. This vein runs from your ankle to the groin where it meets the main vein of your leg, the femoral vein. The valves allow blood to pass up the vein to your heart and should prevent blood from pooling in the vein or flowing in reverse fashion.
When this occurs a greater pressure is exerted causing this vein and its branches to bulge thus causing varicose veins. This results in venous insufficiency and worsening of varicose veins. Ultrasound is needed to document this and if diagnosed removal of the saphenous vein from the knee to the groin will alleviate this problem. This procedure requires general or spinal anesthesia and results in longer recovery and more bruising and discomfort then less invasive procedures.
EVLT (Endovenous Laser Treatment of the Saphenous Vein)
This is a new minimally invasive laser procedure that can be performed instead of vein stripping as described above. The procedure is relatively short and less painful than vein stripping. It can be performed under local anesthesia and the post-operative recovery time is less than a stripping procedure.
During this procedure a laser fiber is passed into the saphenous vein through a 2-3 mm incision. Laser energy is delivered to the vein wall causing it to close off. Little or no scarring is seen.
Normal activity and walking is encouraged immediately afterwards and compression stockings are also worn for one week post-operative. Some bruising and soreness can occur for 7-10 days after treatment and usually requires only Tylenol or Advil type of medication for relief.