Strong Heart and Vascular Center

Division of Vascular Surgery

Varicose Veins

Diagnosis

Varicose veins occur when normal veins in your legs weaken and enlarge. They can cause cosmetic distress, local pain, or be associated with problems (pain, swelling, achiness, or chronic skin damage) lower in the leg. All are reasonable reasons for treatment in patients who are at low risk for surgery. Superficial varicose veins that lie within the skin itself are referred to as telangiectasias or spiders. Varicose veins can be spontaneous (primary) or be secondary to some underlying cause such as failure of the valves in the main superficial vein of the leg.

Today's Visit

We will perform ultrasound testing if data do not already exist. We will also discuss your medical history, the details of your situation, and options for treatment in better detail.

What You Can Do

No known treatment can prevent varicose veins, or, short of the procedures addressed below, can make them disappear.

Nonsurgical Treatment

Gravity worsens both symptoms and the veins themselves, and swelling from the veins causes many of the symptoms. If your veins are bad enough and certain factors are present, we may recommend prescription compression stockings. Elevation is always helpful, as well, but to work the legs must be elevated at or above the heart. Simply sitting, even with the legs propped up, does not help.

If the veins are within the skin or are very small, injections with an irritative substance or laser therapy can be useful. Not all physicians within our practice specialize in these techniques and if one is appropriate we will refer you to the right person.

Surgery

If the veins are large, physical removal is often recommended. The scattered veins you see are branches of the main superficial vein, and are usually removed using multiple small wounds (ambulatory phlebectomy). At times, we will recommend formally removing the main superficial vein (greater saphenous vein). This is usually done using vein stripping through two small incisions, but other techniques can be considered as they become available. Surgery does require general or spinal anesthesia, but is almost always performed on a same-day basis.

After Surgery

If all goes well, you will go home several hours after surgery. At home, we want you to remain at very limited activity, lying down with your legs above your heart for approximately 36 to 48 hours (bathroom privileges and limited movement from bed to couch is OK, but meals should be taken on the couch). You can remove your wrapping and dressings, shower, and gradually resume normal activities the morning of postoperative day 2. You will be sore and should plan to have someone at home with you to help with meals, house keeping, grocery shopping, and so on, for the first few days or so. You will see your surgeon 2 to 3 weeks after discharge for routine follow-up. Depending on your job and how extensive surgery is, you will require anywhere from 1 to 6 weeks off work.