Watch a video on spider vein treatment with sclerotherapy.
Sclerotherapy is considered the ‘gold standard’ of treatment for leg veins.
Sclerotherapy involves an injection of a medication into the vein. This will cause the vein to collapse and gradually fade away. Sclerotherapy has been used to treat spider veins for decades, but new solutions such as AscleraTM allow for spider veins to be treated with minimal discomfort and immediate return to activities. Saline solutions are rarely used these days by vein specialists, because alternatives solutions are less painful and better tolerated. Sclerotherapy is preferred by most vein specialists over laser because spider veins often have underlying ‘feeder veins’ that can easily be treated with sclerotherapy, but are not addressed by laser. Many people will require more than one treatment session for optimal results. The national average is 2 to 5 treatment sessions. Wearing compression stockings after treatment will improve results.
La Jolla Vein Care’s Dr. Nisha Bunke was a guest on this morning’s episode of San Diego Living on CW’s channel 6. Dr. Bunke spoke about the dangers of varicose veins.
Venous thrombosis is an extremely important condition, that we take very seriously at La Jolla Vein Care. Since we deal with veins, we frequently diagnose this condition in our office. This condition always requires attentions, as consequences can be severe and life-threatening in some cases. The following about World Thrombosis Day, which is a movement to increase public and professional education about blood clots, is reprinted from worldthrombosis.org.
World Thrombosis Day (WTD) is one day – October 13 – around the world dedicated to focusing attention on the often overlooked and misunderstood disease burden caused by thrombosis globally…but it is not a one-time observance.
Thrombosis refers to a blood clot that forms in your artery or vein. It is the one disorder that causes the world’s top three cardiovascular killers: heart attack, stroke and venous thromboembolism (VTE) – a blood clot mostly in the leg or lungs. While most people are aware of heart attack and stroke, fewer people know about VTE. That’s why VTE is our initial focus for WTD.
La Jolla Vein Care supports World Thrombosis Day
The World Health Assembly has set a global target of reducing premature deaths from non-infectious disease, including cardiovascular disease, by 25 percent by 2025. To meet this goal, we must reduce thrombosis.
Venous malformation of the lateral leg before treatment. Venous malformations appear like abnormally dilated bluish vessels near the surface of the skin. They appear in clusters and look different than typical varicose veins. They often appear during childhood, as opposed to varicose veins.
Venous malformations comprise either superficial or deep veins that are abnormally formed and dilated. Although they usually are present at birth, they may not be seen until years later into adolescence or even adulthood. The natural history of a venous malformation is slow, steady enlargement. However, events such as surgery, trauma, infection, or hormonal changes associated with puberty, pregnancy or menopause may cause rapid expansion.
At La Jolla Vein Care, we frequently evaluate and treat superficial venous malformations of the legs. Prior to treatment, it is important to have thorough diagnostic imaging, such as an ultrasound examination to ensure an accurate diagnosis of a pure venous malformation. If an arterial connection (arterial venous malformation) is suspected on ultrasound evaluation, further imaging with CT or MR arteriogram may be necessary. Venous malformations can also occur in other syndromes, such as Klippel -Trenaunay syndrome and may involve the abnormal development of the deep veins.
Pure venous malformations can be treated without surgery. Foam sclerotherapy is a common treatment type. Foam sclerotherapy uses a technique to inject a foamed sclerosing solution into the cluster of varicose veins, which will cause them to collapse and eventually dissolve.
Venous malformation after treatment with ultrasound-guided foam sclerotherapy at La Jolla Vein Care. Treatment can reduce the symptoms associated with venous malformations such as leg pain, aching and throbbing.
Animation of sclerotherapy treatment of spider veins
To see before and after pictures for sclerotherapy treatment of spider veins, please see our blog postings and before and after gallery.
This picture demonstrates spider veins at the surface level may actually arise from veins that are not visible to the naked eye. These can be seen with ultrasound scanning.
Venous duplex ultrasound allows us to identify problems within the blood vessels that are not visible to the naked eye. Sometimes, the varicose veins or even small spider veins on the surface of the skin are just the ‘tip of the iceburg.’
This is a normal ultrasound examination. It is negative for venous reflux in the great saphenous vein.
These doppler signals demonstrate 3 seconds of backflow or retrograde flow through incompetent valves. This test is positive for venous reflux in the great saphenous vein.
An ultrasound is a type of noninvasive test that uses sound waves to “see” inside your body, without being exposed to radiation. For this specific exam, it is to see how blood moves through your veins. It can evaluate symptoms including leg pain or swelling, varicose veins and suspected blood clots. There is no preparation needed for this ultrasound and there are no associated risks involved. The test is performed both lying down on a table and/or in the standing position. A technologist will apply a special gel to the entire area that is going to be examined. Then the ultrasound wand is pressed against the skin and moved back and forth. Sometimes the pressure can cause some mild, temporary discomfort, but most people find the test to be completely painless. As the wand is moved up and down the leg, images and videos are being projected onto the monitor and stored. The test takes between 20-50 minutes and there are no special instructions after it is completed, you should resume all normal activities. In a venous exam, particular attention is paid to the function of the valves inside the veins. These valves act as one-way gates for blood to travel up the leg. When a vein becomes weak it dilates causing the valves to leak and not close properly, resulting in a back flow of blood. This is called venous insufficiency or reflux. Reflux is most common in our superficial venous system; in our great saphenous vein and small saphenous vein. When reflux is identified in these veins, it can be treated with great success by a vein specialist.
One of La Jolla Vein Care’s incredible patients returned to surfing just two weeks after varicose vein treatment.
Over the past decade, advances in the treatment of vein conditions have improved the safety, efficacy, comfort, and success of therapy. Newer procedures have replaced old-fashioned vein stripping surgery. In 2008, a statement by the American College of Phlebology announced that these newer methods, called endovenous procedures are considered the ‘new standard of care,’ replacing vein stripping surgery. Modern vein treatments are performed in the office, without anesthesia, and return to normal activities is almost immediate. The average procedure time is 60 minutes. There are several different treatment options depending on the type of veins, the extent of disease, ultrasound findings, and other factors. Normal activities and regular walking can be resumed immediately after vein treatments, whereas, return to heavy rigorous exercises, such as running and spinning is about two weeks.
Vein procedures are generally a covered benefit by most insurance types (including Medicare) if they are considered medically necessary. Medical necessity requirements varies by the individual policy, but in general the varicose veins must cause symptoms such as leg pain, heaviness, fatigue, aching, restless legs, swelling or skin changes such as darkening of the skin around the ankles. Sometimes varicose veins can cause complications such as phlebitis, bleeding, ulceration or skin changes; these are considered medical conditions. If varicose veins do not cause symptoms, they are considered to be a cosmetic issue in the eyes of insurance.
An ultrasound examination is necessary to provide an overall assessment of the severity of the vein condition. This is a diagnostic study and usually covered by insurance.
In most cases, insurance companies require that conservative measures have been tried for several weeks. Conservative measures include compression stockings, leg elevation, exercise, weight loss or maintaining a healthy weight, NSAIDS or other medication and hot/cold packs. Many insurance types REQUIRE 6 to 12 weeks of wearing medical grade compression stockings prior to being approved for treatment.
Sometimes, flexible spending accounts can be used to pay for or may reimburse for compression stockings, varicose veins and spider vein treatments.
For more insurance information and questions, email info@ljvascular.com
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