Blood travels from the heart throughout the body through the arteries. It is returned to the heart and lungs through the veins.

As venous blood flows towards the heart, it travels from superficial to deep veins. Superficial veins are located close to the surface of the skin. Deep veins are in the muscles of the arms and legs. The walls of the veins are not as strong as the walls of an artery. This is because the blood flow through a vein is under less pressure and does not flow as fast, therefore not requiring as strong of a wall.

Unlike arteries, veins have valves along their length that open as blood flows toward the heart. The valves close to prevent blood from moving away (refluxing) from the heart. Failure of these valves is the source of most varicose veins and venous ulcers.

Diagnostic Testing

Venous Ultrasound: This is a non-invasive test which uses ultrasound to send high frequency sound waves which reflects from moving red blood cells. The test is used to diagnose blood clots, weak valves and incompetent perforator veins (the veins that connect the superficial and deep veins).

Venogram: This is a dye test used to diagnose abnormalities in your veins. This is done as an outpatient procedure when non-invasive tests are indeterminate.

Medical Treatment

Avoid prolonged standing, but if you must stand, flex your feet and move your ankles in a circle.

Elevate your legs above the levels of your heart.

Wear support stockings or fitted elastic support stockings prescribed by your physician. This will relieve symptoms and prevent the conditions from becoming worse.

Control your weight. Extra pounds cause increased pressure on the venous system in the lower extremities.

Minimally Invasive Treatment

Laser Ablation: Endovenous laser ablation (EVLA) is a technique for treating saphenous vein reflux without a major operation. Like vein stripping, Laser Ablation eliminates reflux through the saphenous vein and is considered a permanent fix. Unlike stripping, this new procedure does not require general anesthesia: it is done through a skin puncture so small it doesn’t even require a stitch.

How does it work??The word “endovenous” means inside the vein. An endovenous procedure is one that is done from the inside, rather than from the outside. Laser Ablation uses the same type of laser energy we’ve all seen in penlights and pointers. When this energy is delivered to the inside of the vein, it heats the vessel wall and seals it closed.

Sclerotherapy: This is an outpatient procedure that is done in the doctor’s office. A chemical is injected into the vein causing the walls of the vein to stick together. Cotton balls are put over the injection sites, and then the leg is wrapped with an elastic bandage or ace wrap. This is done by a physician or nurse practitioner.

Surgical Treatment

Vein Excision/Phlebectomy: Depending on the size of the vein(s) this procedure may be done in the office or the operating room. Small incision are made and the vein(s) are removed.

Vein Stripping: Your main superficial vein (the greater saphenous vein) is removed. You will have an incision in the groin and the ankle. This procedure is done in the operating room as an out patient under general or spinal anesthesia.