1. What are varicose veins and what causes them?
Varicose veins are abnormally enlarged surface veins of the leg caused by non-working valves. The majority of patients with varicose/spider veins experience aching, tired and swollen legs. Other symptoms include burning, throbbing, or an itching sensation. There is no known cause of varicose veins, but there are contributing factors such as aging, female gender, multiple pregnancies and some form of genetic transmission.
2. What will happen if I don’t treat my varicose veins?
Varicose vein disease is a progressive disease that if left untreated can cause complications to develop, such as superficial phlebitis, hyperpigmentation (dark brownish discoloration of the skin), lipodermatosclerosis (hardening of the skin and underlying fat) and eventually a venous ulcer.
3. What are spider veins?
Spider veins are abnormal, tiny red veins of the skin that look like threads. Some larger spider veins can be blue in color. Spider veins are mistakenly thought to be just “cosmetic,” but in reality, a large number of patients have symptoms due to “just” spider veins. Once the spider veins are treated, the symptoms disappear. Many women have a combination of both varicose veins and spider veins.
4. What should I expect during my consultation with Dr. Fort?
During your initial consultation, I will take a thorough health history, perform a comprehensive evaluation of your affected veins, and if indicated, do a duplex ultrasound exam of your legs. The results of the ultrasound exam, combined with the physical exam and medical history, give me a complete picture of your vein condition. This allows me to tailor a treatment plan targeted to your specific needs.
5. What is sclerotherapy?
I believe that it is equally important to treat both the esthetic and health components of varicose/spider veins in order to accomplish and meet patients’ expectations of a definitive result.
Sclerotherapy involves the use of a very small needle to inject a solution into the diseased varicose/spider veins. Since the needle is so small, this is relatively painless and often described as a “mosquito bite.” The solution works by causing the veins to shrink, close off and gradually disappear. Laser treatments for varicose/spider veins produce very poor results.
6. How many sclerotherapy sessions will I need?
I inject as many veins as possible in a session; the number of sessions will depend on the amount of varicose and spider veins present and the maximum amount of sclerosing solution that can be used safely during a session.
It varies from individual to individual, but typically 2 to 5 treatments are required for patients who have predominantly spider veins of both legs. In patients with milder cases, 1 to 2 sessions will suffice.
Some patients show improvement in as little as two weeks, but results are usually seen 2 to 3 months following the completion of the total number of sessions required for your condition.
7. What is Ultrasound Guided Sclerotherapy?
The Ultrasound Guided Sclerotherapy (UGS) procedure is a safe, effective, advanced vein procedure that allows me to “see” the non-working varicose vein below the skin using ultrasound. This allows me to treat the cause, or “source,” of the visible varicose veins on the patient’s leg.
In 2004, I implemented a modification of Ultrasound Guided Sclerotherapy in which the liquid sclerosant solution is made into foam. The use of foam causes a more effective and better distribution of the sclerosant through the diseased “source” vein and its visible varicose vein branches.
Patients who are excellent candidates for UGS include those who have recurrent varicose veins from prior surgical or laser ablation procedures, large varicose veins from incompetent perforators, and vaginal or pelvic varicose veins.
8. What is the ClosureFastTM Procedure?
The ClosureFast procedure is a minimally invasive method for treating large varicose veins that has eliminated the need for surgery. Under ultrasound guidance, a thin catheter is inserted through a small needle puncture into the diseased saphenous vein. The ClosureFast catheter transfers RF energy (high-frequency sound waves) to seal and close the saphenous vein with heat. Your body then naturally uses other healthy veins to return blood to the heart.
The procedure takes about an hour, is performed at my Vein Centre, and is done under local anesthesia with light sedation using oral diazepam (Valium). In March of 2000, I was the first physician to use this innovative technology in the North East and have successfully treated thousands of patients since then.
9. What is the VenaSealTM Procedure?
VeanaSeal is a new innovative technology that treats saphenous vein insufficiency using a medical grade adhesive, delivered via a thin tiny catheter using only one needle puncture. The medical-grade glue itself has been used in medicine for more than 50 years without any side effects. Under ultrasound guidance, the glue is slowly injected into the diseased saphenous vein which triggers an inflammatory reaction that seals the vein completely and is eventually reabsorbed by the body. This procedure does not use heat to seal the vein and so no anesthesia is required, except at the site of the one needle puncture.
The procedure is done in half the time that an RF or laser ablation requires. There is no bruising, swelling or discomfort afterward. Patients don’t need to wear compression stockings afterwards and can resume all of their normal daily activities, including exercising, the same day.
10. Will it be expensive to treat my varicose/spider veins?
Since many consider varicose and spider veins a cosmetic issue, there a false idea that it will be too costly (as cosmetic procedures usually are) and their insurance company will not cover the costs. Since the majority of patients with varicose veins have an underlying venous condition, the consultation and ultrasound examination are covered by all insurance companies. Almost all insurance companies will cover vein treatments that are medically necessary.
11. How will my blood circulate if I eliminate my varicose veins?
Removal of the diseased veins will not adversely impact your blood circulation. In fact, more efficient blood return can be accomplished through the remaining healthy veins since the pooling of blood in the diseased veins is eliminated.
12. Will treating my varicose veins cause more varicose veins to appear?
Blood flow through varicose veins is slow and congested and a burden on the return of blood back to the heart. Treatment of the abnormal veins actually removes this burden and allows the surrounding veins to once again return blood to the heart, thus improving the venous circulation. The treatment of the diseased veins will cause the disappearance of your symptoms and the unsightly varicose veins and spider veins. Treatment also allows the body to redirect blood flow into stronger, healthier, superficial and deep veins within the leg.
13. Should I wait until after my last pregnancy to treat my varicose veins?
Pregnancy is one of the most common risk factors for varicose and spider veins. The blood volume in your body increases while the growing uterus puts pressure on your veins. This will happen with every pregnancy, and with every pregnancy your varicose veins and debilitating symptoms will worsen. It’s a common misconception that treatment of varicose veins should be postponed until you are finished having children. Today the recommendation is to treat your varicose veins as soon as possible, regardless of how many more babies you plan to have. That way you will not have to suffer from varicose veins during future pregnancies and your varicose vein disease will not get progressively worse with each pregnancy.
14. What can I do to prevent Varicose Veins?
Contrary to what you may read online, there is no absolute way of preventing the development of varicose/spider veins. The truth is, medical science still doesn’t know why varicose veins develop, so it’s not possible to target preventive measures at something if there is no known cause. There are no special diets, vitamins, exercise, weight loss or creams that have been scientifically proven to prevent or stop the progression of vein disease. Again, a healthy diet, exercise, and weight loss are good for your overall health but have little or no impact on your varicose veins.
15. Can other unsightly surface veins be treated?
Hands: Currently, sclerotherapy, when performed correctly, is the safest and most effective treatment for eliminating large, bulging hand veins. The treated hand veins will be gradually reabsorbed by the body over a period of 3 to 4 months, and because they are not varicose veins they will never come back. There are some physicians that advocate the surgical removal of hand veins; I find this to be much more traumatic and prone to complications, such as nerve injury and unsightly scars. I have patients that fly in from all over the country to come to my Vein Centre for me to do sclerotherapy of their hands.
Face: There are two types of veins in the face:
1) Spider veins are usually fine, red threadlike lines on the nose, cheeks, and chin, and sometimes appearing in combination with Rosacea. Spider veins on the face are very resistant to laser. The new VeinGogh technology is the most effective way to remove them, and currently, I am the only doctor in New York State north of Manhattan to perform this treatment.
2) Reticular veins of the face, which are blue-green in color and bulge ever so slightly, are found on the temples, along the cheekbone and under the eye. These reticular veins can be safely treated with low dose sclerotherapy and is less traumatic and scarring than surgical removal.
Breast/Chest: Reticular blue veins can be found on the chest and sometimes extending into the breast. These veins respond extremely well to sclerotherapy.
Feet: Veins of the feet are usually more visible in women as they age and can be quiet large in slender people. These foot veins, like hand veins, are not abnormal but can be safely eliminated with sclerotherapy.