Large varicose veins can be visible, bulging, palpable (can be felt by touching), long, and dilated (greater than 4 millimeters in diameter).
Small "spider veins" also can appear on the skin's surface. These may look like short, fine lines, "starburst" clusters, or a web-like maze. They are typically not palpable. Spider veins are most common in the thighs, ankles, and feet. They may also appear on the face. The medical term for spider veins is telangiectasias.
Varicose veins are caused by weakened valves and veins in your legs. Diagnostic evaluation includes physical examination, lower extremity venous color duplex ultrasound and sometimes other imaging such MRI scans specially performed to evaluate the veins of pelvis, or abdomen. The proper treatment depends on the clinical, imaging, and venous flow testing results and may include many of the procedures reviewed on this website.
EVLT™ (endovenous LASER treatment)
Endovenous Laser Ablation is a technique which received FDA approval and utilizes a small fiber placed inside the vein to deliver LASER light inside the vein. The light striking the vein wall and blood inside the vein creates heat which seals the vein shut. This technique is ideal for the big varicose veins: big and small saphenus veins. The fiber is inserted under local tumescent anesthesia and no incision in the upper thigh is needed.
is a minimally-invasive procedure to remove segments of large varicose veins near the skin. involving 2-3 mm (less than 1/8 inch) incisions. Microphlebectomy is a very important procedure in modern management of varicose veins since it involves removal of large abnormal veins with faster recovery of the tissues than with other techniques.
Although microphlebectomy can be used to treat isolated small varicose veins, microphlebectomy usually is performed to treat large, ropy varicose veins over 5 mm in diameter.
Sclerotherapy is an alternative for treating large varicose veins, but sclerotherapy may leave a cord under the skin or dark pigmentation of the skin for weeks after treatment of large veins. Patients who are treated with microphlebectomy for large varicose veins often have better cosmetic results sooner than with foam sclerotherapy.
Treatment for veins over about 3 mm in diameter with liquid sclerotherapy becomes less successful with enlarging vein size since the liquid sclerosant is diluted very rapidly by blood. A method of generating a foam by mixing a liquid sclerosant with CO2 allows injection of small amounts of a foam into abnormal veins. The foam briefly displaces the blood inside the treated veins allowing the sclerosant component of the foam to come into contact with the cells lining.