Varicose veins are enlarged, swollen, and sometimes painful veins close to the surface of the skin that often appear on people's thighs, calves, and ankles. These veins develop due to a diagnosis called chronic venous insufficiency, which is more heavily reviewed in one of our previous blog posts. In short, chronic venous insufficiency is leaking of blood backwards through valves in our veins. These valves are meant to carry blood flow only one way, back to the heart. When this leaking occurs in the deep veins, which are under the muscles and run alongside our major arteries, this can cause significant swelling, heaviness, and achiness in the legs. When this leaking occurs in the superficial veins closer to the surface of the skin, a person can develop varicose veins as well as swelling and discomfort. These varicose veins often arise from the greater saphenous vein or the short saphenous vein which are our major superficial veins in the leg. When people develop varicose veins, they often seek treatment due to these veins being painful, swollen, itchy, unsightly, and uncomfortable.
Treatment of varicose veins by vascular providers has evolved significantly over the years. Treatment initially consisted of what was called “vein stripping,” which involved surgical removal of superficial veins. Due to the nature of this procedure, vein stripping often required patients to be under anesthesia in an operating room. The procedure involves multiple incisions along the legs to directly remove varicose veins through the skin. While this did remove troublesome varicose veins, this procedure involved a lengthy recovery time and significant discomfort due to the amount and size of the incisions necessary to perform the procedure.
More recently a procedure called venous ablation was developed to treat varicose veins and venous insufficiency. This treatment uses heat or a glue material to close the larger superficial veins, such as the greater saphenous vein and short saphenous vein. Once these veins are shut down this can often depressurize the varicose veins in the legs and improve symptoms and appearance. While this was an improvement to traditional vein stripping, patients can still require surgical removal of any residual varicose veins in the operating room. This can occur because the vein ablation closes the large superficial veins, but it may not adequately depressurize the varicose veins on the surface of the skin. Recently, a procedure called Varithena was developed that can address varicose veins without a trip to the operating room.
Varithena, unlike other closure procedures, has an active ingredient called polidocanol, which irritates the inner lining of the vein and causes them to shut down. This chemical is already widely used for treatment of smaller varicose veins called spider veins by many vascular physicians. Varithena contains a specialized foam that delivers an advantage over other closure methods, as it can be easily used to close not only larger superficial veins but also smaller varicose veins throughout the legs. This allows vascular surgery providers to treat both large and small varicose veins in an office setting and avoid an operating room procedure. The patients also avoid multiple incisions and their associated risks of drainage, infection, and poor healing.
Varicose vein treatment has and will continue to evolve in the coming years. The development of the Varithena procedure is another option that your vascular surgical provider now has available to treat your venous insufficiency both safely and effectively. Vascular Associates is proud to be able to offer this new and less invasive option to our patients.