Deep vein thrombosis or DVT is a very serious and life threatening condition. DVT means that a blood clot gets stuck in a deep vein, usually in the leg. The problem is that this blood clot, called an embolus, can become dislodged, circulate throughout the bloodstream, and then get stuck near the lungs, stopping blood flow. This is called a pulmonary embolism. A pulmonary embolism can damage the lungs, other organs, and even lead to death.

Taking blood thinners, which lower the blood’s ability to clot, can be taken for DVT. It’s also a good idea to exercise your legs, especially during long trips like plane rides, so that your blood will keep circulating properly and have less chance of clotting.

Risk factors for DVT include:

History of DVT
Being overweight
Being over 60
Pregnant women
People receiving ongoing cancer treatment
Being inactive for a long time, ie. a long trip, or bed ridden from an illness

Talk to your doctor if you are concerned about your DVT risk.

Sclerotherapy is one treatment option for varicose and spider veins. A simple salt solution with local anesthetic is injected into the veins. This salt solution irritates the vein lining, causing the vein to collapse, shrink, and become out of sight. One sclerotherapy session usually lasts between 15 to 45 minutes. The doctor will usually give one injection for every inch of spider or varicose vein. Often, there will be around 40 injections per session.

The patient needs to have at least 2 sclerotherapy sessions. This is a cosmetic procedure which is generally not covered by insurance, unless the doctor proves that the sclerotherapy session is required to eliminate pain, rather than simply for cosmetic reasons.

Sclerotherapy is not always permanent, and it can only be done to veins that are already varicose or spider. Sclerotherapy does not prevent varicose or spider veins.

Generally, healthy people between the ages of 30 to 60 are candidates for sclerotherapy. Ask your doctor for more information.

You should also consider the alternatives to sclerotherapy. VNUS vein closure and laser treatment are two common alternatives.

In general, an “ablation” is the removal or destruction of a body part or tissue.

Vein ablation is a surgical procedure for varicose veins. Modern vein ablation procedures include endovenous laser therapy and VNUS vein closure. During both of these procedures, heat energy is applied inside certain large veins, causing the veins to shrink. These procedures can both be done using local anesthetic and completed in around an hour.

These modern vein ablation techniques are much better than the old painful and expensive surgical techniques like vein stripping.

Vein closure is a modern procedure that is done to eliminate varicose veins. The doctor will put a catheter, which delivers radio frequency energy, inside the greater saphenous vein. This energy causes the vein wall to shrink and collapse, hence close the vein. When this vein closes, many nearby veins will also shrink. Vein closure can be done for cosmetic reasons or to relieve the pain caused by varicose veins. Watch this short video to get a good idea of how the vein closure procedure works.

Vein ligation is a surgical procedure that means “tying off a vein”. The reason for ligating a vein (tying it off) is so that this vein will no longer have blood flowing through it. This vein will then shrink and become out of sight. This procedure is often done to large damaged veins (generally the large saphenous vein in the legs) that have become varicose.

It’s possible for only a portion of a vein to be ligated, thus leaving the healthy portion of the vein intact.

Quite often but not always, ligated veins will then be stripped or ablated.

What is EVLT?

This stands for (Endovenous laser therapy). This is a modern technique for getting rid of varicose veins.

What happens during the varicose vein laser treatment procedure?

You will be awake during the entire procedure. The leg is first prepared and draped. The doctor will put a local anesthetic in your leg so you won’t feel any pain. (This is a freezing similar to what you get at the dentist). Then the doctor will make a tiny incision in your leg and put the laser fiber inside your vein. The entry point is usually slightly above the knee. The doctor will slowly move the laser fiber through your entire vein, with the laser pulsating intermittently. A 30 cm vein takes under two minutes to complete.

How long does the procedure take?

The entire procedure usually takes under an hour.

How does the laser treatment work?

The laser applies heat energy directly to the vein tissue. This laser is designed to heat only the blood and cells inside the vein so that it won’t damage any surrounding tissue. This heat kills the cells in the vein, which causes the vein to shrink and close.

Wouldn’t it be unhealthy to “kill” this large vein? Don’t I need it?

No. There are many veins in your legs. Closing off a few won’t cause any problem. Your body will just re-direct blood flow through the other veins.

How long will it take until I can see results?

Patients usually see results within the first couple of weeks.

What are the risks associated with laser treatment?

There are always risks with anything you do. Crossing the street carries some risk. The risks associated with laser treatment are very minimal.

When Can I return to work?

Patients can generally return to their daily routines immediately.

What are the alternatives to laser treatment?

The old practice for treating varicose veins was a relatively expensive and painful surgery.
Another option is sclerotherapy. With sclerotherapy, a solution is injected into the vein which causes the vein to collapse and virtually disappear from sight. Read more about this procedure here.

Does the laser hurt?

No. Most patients may feel a little tingling sensation but no real pain. A few patients who didn’t receive enough freezing reported minor pain.

What are the advantages of laser treatment?

• Painless
• Relatively cheap
• Fast acting
• Long lasting
• Very low risk of complications

Are there any long term side effects associated with laser treatment for varicose veins?

Since EVLT is a relatively new procedure for treating varicose veins, we can’t really comment on long term side effects. Lasers, however, have been used effectively in medicine for decades, and it would be very surprising if there were many serious long term side effects with this treatment.

What are varicose veins?

Varicose veins (common misspelling is vericose veins) are veins that have become dilated and appear to pop out of the skin. They are usually blue-ish green in color and often appear on the legs, although they can appear in other places such as the face.

Are Varicose veins common?

Yes! Up to 60% of the American population will get varicose veins, or a smaller variation, at some point in their lives. Varicose veins are more common in women than in men. They are also more common with increasing age.

What causes varicose veins?

First we need to understand a little about how veins work. Arteries carry oxygenated blood away from the heart to nourish our body tissue. Veins carry deoxygenated blood (blue-ish green in color) back to the heart, which is why veins appear that color. When we move and breath, the muscles in our legs contract and help to squeeze the blood through our veins and up to our hearts. When we are standing still, the blood sits in the veins in our legs. Blood in our legs has to work against gravity to get back to our hearts. Luckily, our veins are designed with one-way valves to prevent the blood from flowing backwards. Unfortunately, when we stand still for long time periods, the pressure from the gravity takes its toll on our veins, causing both damage to the valves and the walls of the veins to dilate (swell). When this happens, a lot of blood collects in the veins, causing them to stick out of our skin. (Varicose veins).

Genetics: Heredity is a major risk factor for developing varicose veins. Nothing we can do about this one.

Aging: Our veins lose their elasticity as we age, making it much easier for varicose veins to develop.

Hormones: Certain hormones such as progesterone and estrogen cause veins to enlarge, hence increasing the odds of developing varicose veins. Pregnant woman are at an increased risk of developing varicose veins because of their elevated hormone levels, increased blood volume, as well as from the pressure the enlarged uterus puts on the blood vessels. The birth control pill and estrogen replacement therapy are also associated with an increased risk of developing varicose veins.

Extremely strenuous exercise: Performing extremely strenuous exercise that puts a lot of pressure on the veins can damage the valves, leading to varicose veins.

Being sedentary: It’s extremely important to move around as much as possible. People who’s occupations cause them to stand in one spot for long periods of time are much more likely to get varicose veins.

Read How to prevent varicose veins

Are Varicose veins dangerous?

No. Varicose veins are sometimes itchy

Can varicose veins be cured?
What are the different treatment options for Varicose veins?