Frequently asked questions

What is vein disease?
What are the different types of vein disease?
How do I know if I have vein disease?
How common is vein disease?
How does vein disease occur?
Can vein disease be prevented?
What are the treatment options for vein disease?
Who should not be treated?
If the vein is closed by the treatment, where does the blood go?
What can happen if varicose veins aren't treated?
What are the complications of vein treatment?
Will insurance cover the treatment?

What is vein disease?

Veins are the blood vessels that return blood to the heart from the body. To overcome the force of gravity, inside the veins are one-way valves. These valves open allowing blood to flow back to the heart and close to prevent "reflux" of blood back to the body. When these valves do not work properly, or if the vein is damaged and the valves don’t completely close, blood can begin pooling in the vein. This pooling can lead to a variety of vein problems.

What are the different types of vein disease?

Spider veins are the small, fine, blue or purple thread-like veins that usually are seen on the skin’s surface. Many people seek treatment of spider veins for cosmetic reasons. But spider veins can also cause substantial discomfort and require therapy. Varicose veins are the large, rope-like veins that are often one-fourth inch or larger in diameter. Varicose veins generally grow in size over time and can result in substantial pain and complications left untreated.

How do I know if I have vein disease?

Fortunately, most vein disease can be seen by looking at the size and color of the veins near the skin’s surface. In some cases, the diseased vein may be deeper in the body and not visible to the eye.

How common is vein disease?

Vein disease of the legs is one of the most common medical conditions. About one-half of the population has some form of vein disease. Varicose veins affect 15 to 25% of all adults, and about 50% of all people over age 50. Women are more likely to have vein disease than men.

How does vein disease occur?

The single most common cause of vein disease is heredity. About 70% of all patients with varicose veins have parents with the same condition. Pregnancy (especially multiple pregnancies) is another contributing factor of vein disease. Other factors include age, obesity and jobs that require standing for long periods of time.

Can vein disease be prevented?

Not really, especially if you have a family history of vein disease. It is important to remember, though, that being overweight can accelerate the development of vein disease, and that standing for long periods of time can make it worse. Diet and footwear aren’t generally believed to make a difference in the formation of vein disease.

What are the treatment options for vein disease?

Depending on the type and stage of vein disease, there are many treatments to choose from. Your physician can describe the different options. The following are common treatments performed for vein disease:

• Compression Stockings For minor pain from varicose veins, compression stockings may be beneficial. Basically, they assist the leg in pumping blood back toward the heart. Compression stockings alone can help relieve symptoms, but they won’t make the varicose vein go away.

• Sclerotherapy Used commonly for spider veins and small varicose veins, sclerotherapy involves injecting a small amount of a solution (a sclerosing agent) directly into the diseased vein. The sclerosing agent damages the lining of the vein and causes it to seal shut. This completely gets rid of the diseased vein. Sclerotherapy is performed quickly right in a doctor’s office with no anesthesia.

• Surgical Stripping Historically, the only treatment for large varicose veins was to surgically remove, or ”strip,” the vein from the body. Surgical stripping is done in an operating room under anesthesia and requires significant time to recover. More recently, a modified version of stripping known as ambulatory phlebectomy has become more popular. During this procedure, multiple incisions are made to hook and remove the vein, one portion at a time. More incisions are made than with conventional vein stripping, but it minimizes damage to the leg and reduces the time needed to recover.

• Endovenous Laser Therapy In the past few years, the use of lasers has become an accepted alternative to surgical stripping for the treatment of varicose veins. During endovenous laser therapy, a thin laser fiber is inserted into the diseased vein, generally through a small puncture in the skin above the affected area. Next, the physician uses an electronic device to deliver laser energy through the fiber. As the fiber is gradually removed from the vein, this energy causes the vein to collapse and close off blood flow. Endovenous laser therapy can be done right in a doctor’s office in less than 1 hour. Also, the procedure is minimally invasive, so the patient is encouraged to walk immediately afterward.

Who should not be treated?

You should wait at least 3 months after pregnancy or major surgery before being treated for vein disease. People with a suppressed immune systems, those with deep vein thrombosis or incompetence, and patients who can’t ambulate for other reasons are not good candidates for vein treatment.

If the vein is closed by the treatment, where does the blood go?

Your leg has many veins, so any blood that would have flowed through the closed vein simply flows through other healthy veins after the procedure. The loss of the diseased vein isn’t a problem for the circulatory system.

What can happen if varicose veins aren't treated?

Varicose veins generally worsen over time. At first, you’ll feel slight pain and restlessness in the diseased leg. If left untreated, this pain will increase you’ll experience limitations in walking and cramps during sleeping. Eventually, varicose veins can lead to open sores on the foot, blood clots and tissue loss.

What are the complications of vein treatment?

Fortunately, sclerotherapy and endovenous laser therapy have rarely been associated with any serious complications when properly performed. Common minor complications of these procedures include bruising, mild itching, tenderness and tightness in the treated leg for up to 2 weeks after treatment.

Will insurance cover the treatment?

Most insurance companies cover the treatment of vein disease when it’s associated with substantial pain and other complications. Each insurance company has its own rules for the types of therapy that are covered, however.

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