Varicose Vein Treatments
Minimally-Invasive, Painless Treatment for Vein Issues
Columbia's interventional radiologists have expertise and experience with minimally-invasive varicose vein treatments, including endovenous laser therapy (EVLT), sclerotherapy, and radiofrequency ablation. Using ultrasound guidance, our interventional radiologists perform hundreds of procedures each year to treat varicose veins.
Varicose veins are a common condition characterized by blue, bulging, or twisted veins, usually in the legs. Aside from the cosmetic issues associated with varicose veins, they can be painful and, when left untreated, sometimes lead to health issues. Veins have one-way valves that help keep blood flowing up the legs and to the heart. When these valves weaken or stop functioning, blood naturally flows towards the feet, eventually pooling in the veins and causing them to dilate. Spider veins, which resemble a spider or spider web, are a mild variation of varicose veins.
Women are more prone to varicose veins than men, as are people with a family history of varicose veins, older people, people with excess weight, and people who spend a large part of their day on their feet.
Consult Our Interventional Radiologists About Your Veins
A consultation with an interventional radiologist will help you understand both the health risks associated with your varicose veins and your options for treatment. We will look at your veins, ask you questions about symptoms or concerns, and we may use a hand-held ultrasound to get images of the veins inside your legs. You will get detailed information about treatment options and receive guidance as to which treatment best for your veins.
Sometimes varicose veins are managed by wearing compression stockings, elevating legs regularly, losing weight, and exercising. In other cases, the veins can be eliminated with minimally-invasive procedures. We will make recommendations based on your individual health and cosmetic needs.
Varicose Vein Treatments at Columbia Interventional Radiology
Treating your varicose veins improves your appearance and your health. Treatments are painless and short, with little or no recovery time.
Interventional radiologists use three approaches to improve the circulation of blood through your veins and improve your legs’ appearance: laser treatment, sclerotherapy, and radiofrequency ablation. All interventional radiology treatments use ultrasound to guide physicians as they treat the veins. Treatments aim to close off the weakened vein, so that blood flows through other veins instead.
Endovascular laser venous treatment (ELVT)—also called endovenous ablation—is a painless procedure developed by interventional radiologists that uses radiofrequency or laser energy to close abnormal veins. With a 98 percent success rate, the long-term results of EVLT are equal to or better than results for surgery (such as vein stripping), microphlebectomy (the removal of a large or medium sized varicose vein through a tiny incision in the leg), and sclerotherapy. EVLT causes little-to-no post-procedure pain or scarring. This procedure is most effective for large veins that are relatively straight.
We perform EVLT in our interventional radiology suite. Using ultrasound guidance, we insert a tiny fiber-optic probe into the varicose vein through a catheter. This probe transmits laser energy to the affected vein. The laser energy kills the diseased tissue in the varicose vein, causing the vein to close and eventually be reabsorbed by the body. The procedure usually takes between 45 minutes to one hour, and you will see results over the following weeks and months.
Sclerotherapy is a minimally invasive procedure used to treat small diseased or cosmetically undesirable veins close to the surface of the skin. The physician injects a liquid called a sclerosing solution (usually a concentrated saline solution) into the diseased vein, which causes an inflammatory reaction in the tissues lining the veins. As a result, the vein closes, blood reroutes to healthy veins, and the diseased vein eventually disappears.
Sclerotherapy is an outpatient procedure, which we perform in our interventional radiology suite. After determining the location and contours of the veins using ultrasound guidance, we use a very fine needle to inject the solution into them. Depending on the size of the area to be treated we may do several injections during your procedure. In some cases we need to schedule an additional sclerotherapy session. The procedure takes betweem 15 and 30 minutes.
Radiofrequency ablation is very similar to EVLT. In this treatment we transmit short bursts of electrical energy (instead of laser heat in EVLT), through a catheter to close the vein. In some cases, radiofrequency ablation may be preferred over EVLT. Your interventional radiologist will recommend the best treatment for your particular vein issue.
Will my insurance cover varicose vein treatment?
Most health insurance companies cover treatment for symptomatic varicose veins after several weeks of "compression therapy” during which you will be required to wear prescription-strength compression stockings. If the compression stockings fail to address the symptoms associated with your varicose veins, treatment is covered. Treatment solely for cosmetic purposes is not covered by insurance.
Your interventional radiologist will review your symptoms and make recommendations for treatments, including compression therapy.
Are there any risks?
Complications from ELVT, sclerotherapy, and radiofrequency ablation are extremely rare. Your interventional radiologist will discuss the possible side effects or complications from the treatment you choose.