Veinwave™
Understanding Problem Leg Veins
Do your legs feel tired and achy at the end of the day? Have you stopped wearing shorts because you don't like the way your legs look? Vein problems are not related to artery problems such as those that can cause heart disease. But, abnormal veins can affect your health and your self-image. Treatments for these veins include self-care, minimally invasive treatments, and surgery. They can relieve symptoms and help you feel better about your appearance, too.
Varicose Veins
Varicose veins are most often swollen, gnarled veins that most frequently occur in the legs, ankles and feet. They often can be found around the knee area. They are produced by a condition known as venous insufficiency or venous reflux, in which blood circulating through the lower limbs does not properly return to the heart but instead pools up in the distended veins.
More than 25 million Americans suffer from venous reflux disease. The symptoms can include pain and fatigue in the legs, swollen ankles and calves, burning or itching skin, skin discoloration and leg and foot ulcers. In less severe cases, thin, discolored vessels – “spider veins” – may be the only symptom.
Gender and age are two primary risk factors in the development of venous reflux. An estimated 72% of American women and 42% of men will experience varicose veins symptoms by the time they reach their sixties. Women who have been pregnant more than once and people who are obese, have a family history of varicose veins or spend a great deal of time standing have an elevated risk for the condition, but it can occur in almost anyone at almost any age. Varicose veins never go away without treatment and frequently progress and worsen over time. Severe varicose veins can have a significant impact on the lives of people who work on their feet – nurses, teachers, flight attendants and many other occupations.
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Diseased Veins
Venous reflux disease, also known as venous insufficiency, is a medical condition affecting the circulation of blood in the lower extremities. The tiny valves that normally force blood back up towards the heart no longer function, causing blood to pool up in the legs, and the veins of the legs become swollen.
Venous reflux disease commonly produces varicose veins, the abnormally swollen and discolored superficial leg. Varicose veins can range from small, thin purple lines just under the skin (known as “spider veins”) to thick, bulging veins that can protrude well beyond the skin surface. In any form, varicose veins serve as indicators of venous reflux, a progressive disease that can cause significant circulatory problems.
Workup and Treatment: VNUS Procedure
To effectively diagnose a patient showing symptoms of varicose veins, a physician will conduct a duplex ultrasound to determine if truncal insufficiency is present. Once diagnosed, the physician will decide if endovenous laser treatment is an appropriate solution.
The endovenous laser treatment is a 30-60 minute in-office procedure with no down time or scarring. The physician will determine the particular treatment procedure that is most appropriate for the patient. Generally described, the skin is numbed before treatment. The vein is accessed percutaneously and a catheter is inserted into the vein. The laser filament is inserted through the catheter. Once inside the vein, the placement of the laser filament is verified using ultrasound and by visualizing the aiming beam. The laser is then slowly withdrawn as it emits energy. This laser energy seals the vein shut.
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Recovery
Once the procedure is complete, a compression dressing is placed on the treated leg for 2 days followed by 1 week of compression stockings. Under normal conditions the patient may return to work the following day. A repeat ultrasound will be done in 7-10 days to check the deep leg veins, and again in 4 weeks to ensure that the treated veins are sealed. Occasionally, a treated vein will reopen, requiring either injection of foam schlerotherapy or repeat laser treatment.
As with any procedure, some mild side-effects might occur. You may experience a slight redness to your skin tone in the treated area, which will fade away within a few days. You might also notice a slight swelling in the treated area.
Spider Veins
Spider veins are the mildest symptom of venous insufficiency, similar to varicose veins but smaller. They are small, often tangled groups of tiny blood vessels just under the skin surface that frequently resemble spider webs or tree branches. They are generally red, blue or purple and are clearly visible, usually on the thighs, lower legs and face. Spider veins can sometimes cover large areas of skin, but they are a cosmetic problem only, rarely causing physical symptoms. At least a third of all women and a smaller percentage of men are believed to display the condition.
Spider veins are capillaries, thin vessels directly connected with the larger venous system, and like varicose veins they are caused by venous reflux. Spider veins may be isolated or associated with “feeder” veins or with larger underlying varicose veins, but they are not varicose veins – they do not bulge above the skin surface and do not require medical treatment.
Spider veins can be diagnosed merely by sight. Even in the absence of physical discomfort, some physicians observing spider veins prefer to conduct ultrasound exams to determine the extent of the problem and the underlying causes of the condition.
Risk factors for spider veins are similar to those for varicose veins – age, heredity, pregnancy, hormonal changes, obesity and extended periods of standing – as well as sun exposure, particularly in fair-skinned people, and injuries to the skin surface. Dr. Mountcastle believes that exercise, weight loss and the wearing of support hose and flat shoes instead of high heels can reduce the occurrence of spider veins.
Spider vein treatments are non-invasive or minimally invasive and include sclerotherapy and laser procedures. They are considered cosmetic procedures and are not covered by health insurance or Medicare unless a more serious underlying condition is diagnosed.
Sclerotherapy
Sclerotherapy is a cosmetic medical procedure used to treat varicose veins and spider veins. A tiny needle is used to inject a solution directly into the vein. The solution irritates the lining of the vessel, causing it to swell and stick together, and the blood to clot. Overtime, the body will absorb the treated vein. Mild discomfort may occur, and a cramping sensation may be felt for 1 to 2 minutes when larger veins are injected. The number of veins injected in one session is variable, depending on the size and location of the veins, and the patient's overall medical condition. Anywhere from one to several sclerotherapy sessions may be needed for any vein region. Medically prescribed support hose and/or bandages may need to be worn for several days to several weeks to assist in resolution of the veins. In general, spider veins respond to treatment in 3 to 6 weeks, and larger veins respond in 3 to 4 months.
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Veinwave™
Veinwave uses a new method called thermo-coagulation. It can be used on any type of skin, without causing bruising and there is no need for bandages. One treatment session lasts about 15 minutes and can treat up to 30 cm of veins on any part of the body. There are no major side effects, no allergic reactions and no bruising. It can be used on sensitive areas of the body. Some trials have shown that 80% of patients prefer Veinwave to injections.
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