Orange County Laser Vein Removal Treatment: spider, varicose , sclerotherapy, ultrasound

Spider veins, varicose veins, painful veins, bulging veins, leg swelling, laser vein treatment, orange county, leg veins, facial veins, Sclerotherapy, vein stripping, vein injection, EVLT  

Varicose vein

Healthy veins return blood to the heart and lungs so it can be re-oxygenated. A system of valves makes this happen by allowing the blood to flow in only one direction. When valves fail or leak, blood flows backward under the force of gravity and distends the veins. This backward flow, called “reflux,” causes blood to pool in the veins, resulting in varicose veins.

Ignoring the situation can result in symptoms such as pain, fatigue, itching, burning, swelling, cramping and throbbing. People who suffer from these symptoms instinctively lie down and elevate their legs to reduce the pooling of blood and relieve their discomfort. However, over time, these symptoms will intensify, and quite often, a person’s varicose veins will become large and “ropelike.” Overly distended varicose veins, especially near the ankle, can rupture and cause profuse hemorrhaging. Some legs can even deteriorate with swelling and dermatitis (skin irritation and inflammation), which can lead to leg ulcers.

Spider veins

      Spider veins grow from “reticular” veins, also known as “feeder” veins. These feeders exist in a dense network, and are usually a bit deeper in the skin. They form a network of blue or green veins, sometimes giving a marbled appearance to the skin. They might even be difficult to see in some women because they are a little too deep in the skin. But they’re present nonetheless and must be eradicated in order to get the best results possible, while reducing the chance of recurrence. Many women, not knowing the proliferative nature of spider veins, don't want them treated. These women figure as long as the veins aren’t too ugly, they can avoid treatment and save money. But in reality, when left untreated, spider veins provide a platform for the growth of additional spider veins.

Vein Treatment options:

Sclerotherapy, surface Laser treatment, Endovenous Laser Treatment (EVLT), Ambulatory Phlebectomy
We not only treat the unsightly surface spider veins, but also the feeders that actually “feed” them. Treating the feeders treats the source of the problem. This allows us to greatly improve our already sound, long-term results. This procedure is performed in our office and takes less than an hour. 

      Visual Sclerotherapy: Sclerotherapy at present is one of the most prevalent treatments for spider and varicose veins.  During the treatment, a solution is injected into the vein through a tiny needle.  Treatment can last from 15-45 minutes, depending on the number of veins treated in a particular session.  The solution replaces the blood in the vein, generating irritation and corrosion to the walls of the vessel.   The body then initiates the natural healing process and the vein begins to decompose, shrink and eventually disappear. The vast majority of patients who have Sclerotherapy will have significant clearing of the veins.  However there can be no guarantee that vein treatment will be effective.

Ultrasound guided Sclerotherapy: This is an in-office treatment alternative to surgical stripping. With this technique and based on the clinical judgment of the doctor, Sclerotherapy is done with either a liquid or "foamed" sclerosant, while the doctor visually monitors the vein on an ultrasound screen. This enables treatment of veins that can't be seen because they are below the surface of the skin.

Surface Laser and Light Sources: A variety of laser/light source treatments are available today. A light beam is pulsed onto the surface of the skin targeting veins in order to seal them off and cause them to dissolve. Light-based treatment is generally used only to treat small veins. Treatments may be combined with Sclerotherapy. Multiple treatments are usually required.

During Treatment	Shortly After Treatment	In The Weeks After Treatment

AMBULATORY PHLEBECTOMY Ambulatory phlebotomy is a method of surgical removal of surface varicose veins. This is usually done in the office using local anesthesia. Incisions are tiny (stitches are generally not necessary) and typically leave nearly imperceptible puncture mark scars. After the vein has been removed by phlebotomy, a bandage and/or compression stocking is worn for a short period

Procedure:

     Endovenus Laser Treatment (EVLT): Traditionally, patients diagnosed with venous reflux would undergo vein stripping surgery. Today a procedure called CTEV can treat the condition, a minimally invasive alternative to painful vein stripping surgery.   CTEV is a clinically proven, minimally invasive procedure that treats varicose veins and their underlying cause with little or no pain.

This procedure can be performed on an outpatient basis using local anesthesia in which the physician numbs the leg before treatment. CTEV patients can walk away from the procedure and be back to everyday activities. 

This Procedure consists of 4 steps:This Procedure consists of 4 steps: 

Mapping of the Saphenous Vein: A typical procedure begins with noninvasive ultrasound imaging of the diseased vein to trace its location. This allows the physician to determine the site where the laser fiber will be inserted and to mark the desired position of the fiber tip to begin treatment. 

Insertion of the Laser Fiber: After the physician accesses the saphenous vein, the laser fiber is inserted into the vein and advanced to the uppermost segment of the vein. The physician then typically injects a volume of dilute anesthetic fluid into the area surrounding the vein. This numbs the leg, helps squeeze blood out of the vein and provides a fluid layer outside the vein to protect surrounding tissue from heat once the fiber starts delivering laser energy. 

Delivery of Laser Energy and Withdrawal of Fiber: Noninvasive ultrasound is used to confirm the fiber tip position and the physician then activates the laser machine. As the vein wall is heated, the vein shrinks and the fiber is gradually withdrawn. During fiber pullback, which typically occurs over 4 to 10 minutes, the entire vein is ablated (or closed). 

Confirm Closing of Vein: After treatment, ultrasound imaging is used to confirm closing of the vein. If a portion of the vein is not closed, the fiber can be reinserted and laser reapplied. After the procedure, the narrowed vein gradually becomes fibrous, sealing the interior of the vein walls and naturally redirecting blood flow to healthy veins. Experienced physicians often complete the procedure in 30 to 45 minutes. 

Procedure: 

Is sclerotherapy for me?
A majority of people who receive sclerotherapy are cleared of their small varicosities, or
see a large improvement. Approximately 10% of patients have fair to poor results, meaning the veins have not disappeared after 6 treatments. Very rarely, the veins can become worse after treatment or new veins may develop.

You are a candidate for sclerotherapy if you have spider veins, reticular varicosities, recurrence of varicosities, are advanced in age, or any combination of these.

Contraindications for sclerotherapy: Pregnancy, patients who are bed-ridden or experience decreased mobility, diabetic patients, obesity, history of deep vein thrombosis, allergies to sclerosing agents, and hypercoagutable states (Lupus, etc.).

How many treatments are required?
The number of treatments is dependent upon a.) the extent of the varicosities and b. ) the patient's agreement to follow post-treatment instructions. One to six treatments may be necessary, and the average is usually three to four.

What are the most common side effects?
Itching -- This depends on the type of solution used. You may feel itching along the route of the vein, normally lasting 1-2 days after treatment.
Telangiectatic making (hyperpigmentation) -- This occurs in approximately 10-30% of patients. You may notice a slight discoloration of brown streaks along the veins after treatment. Rarely, the darkening of the vein may last 4-12 months. It will usually not keep you from continuing treatment. Spontaneous resolution of the hyperpigmentation occurs in 70% of patients at 6 months, and in 99% of patients within 1 year.
Sloughing and ulceration -- This type of reaction may occur at the injection site. It looks like a small blister and heals slowly. If the blister opens, or if it is not well taken care of, it may turn into an ulceration. A scar may develop, but it should return to normal color when the healing process is completed.
Allergic reactions -- These reactions are extremely rare, but may occur if you are allergic to the sclerosing agent used. You may also experience an allergic reaction to the material in the compression stockings (Spandex and Lycra), however this is also rare.
Pain -- You may experience mild to moderate pain at the injection site, with some possible bruising. The veins may be tender after the treatment, and an uncomfortable sensation may run along the route of the vein. This is temporary, usually lasting days.

What are the other side effects?
You may feel burning during the injection of the solution. Sometimes new tiny blood vessels develop after treatment, but this is usually temporary. Transient phlebitis-type reactions (swelling of the veins that may cause your ankles to swell), temporary wheels or blebs (similar to hives), and wound infection, poor healing or scarring may also occur. If an arteriole is injected it may lead to arterial embolism and/or pedal gangrene.

Phlebitis is a rare complication, occurring in approximately 1 out of every 1000 patients. If usually happens in the treatment of veins 3-4mm in diameter or greater. The dangers of phlebitis include: possible pulmonary embolus (blood clot to the lungs that could result in death), and post-phlebitis syndrome (when the blood is not carried out of the legs). This may result in permanent swelling of the legs.