Treatment

What are the Treatment Options for Varicose Veins?

Treatment of varicose veins will often relieve any discomfort associated with the condition, such as swelling, fatigue, itching and cramps. If varicose veins are left untreated, serious medical conditions may arise, including ulcers or open wounds on the legs.

Non-invasive treatment methods such as wearing compression stockings, losing weight, walking, and elevating the legs may help treat symptoms but will not address the cause of the varicose veins. If you have tried these treatments for 3 months or more without improvement you may be a candidate for permanent minimally invasive correction of the problem.

A consultation is necessary to determine which treatment is the right option for you. During this consultation we will discuss a personalized plan, answer any questions, and discuss insurance options and related costs, if any.

More advanced treatments are required to address the underlying cause of varicose veins. These treatment options include:

Endovenous (Radiofrequency) Ablation

Radiofrequency Ablation is a minimally invasive alternative to surgical stripping used to treat varicose veins and its common underlying cause, venous reflux. A small radiofrequency catheter is inserted into the refluxing vein and catheter delivers radiofrequency pulses to the vein wall that cause it to constrict permanently. Once this abnormal vein is treated, the blood selectively travels through the more robust deep veins of the leg. Radiofrequency ablation is an outpatient procedure that takes about one hour to complete. You will be instructed to return to normal activities the following day.

Endovenous Laser Vein Treatment (EVLT)

Endovenous Laser Treatment (ELVT) is another minimally invasive procedure that treats the incompetence (backward flow of blood) of the greater saphenous veins. A hollow needle is inserted into the leg and vein followed by the laser catheter. The laser heats the vein wall and coagulates the blood inside the vein as the vein collapses. There is a low incidence of bruising and blistering with laser treatment. Usually, patients experience a slight stinging sensation. Following treatment, pain is rarely an issue, and some redness over the vein persists for 12 to 24 hours. Most improvement is noted within 2-6 weeks, but some veins may take several months to clear and repeated treatment may be necessary.

Sclerotherapy :

Sclerotherapy is a medical procedure used to treat the painful symptoms and the unsightly appearance of varicose veins. It is often performed in addition with ultrasound imaging to ensure precise results. The affected veins are injected with a solution that causes the veins to collapse and become absorbed into the bloodstream. The procedure takes about one hour and can be performed in the doctor’s office.

Microphlebectomy :

Microphlebectomy is a minimally invasive procedure used to treat large varicose veins that have been permanently deformed due to delayed treatment of the underlying cause by, for example, endovenous ablation. A specialized hook is used to remove the vein through multiple tiny incisions. The incisions do not usually require stitches and leave minimal scarring. Microphlebectomy can be performed for cosmetic or medical purposes, depending on the patient’s individual condition and goals for treatment. Following the procedure, the patient is instructed to wear compression socks temporarily. The incisions typically heal within two weeks.

Preparing for your treatment

In order to maximize treatment success of your endovenous ablation treatment, please follow these steps in preparation for your procedure.

Please take the time to talk with Dr. Weitzman and his staff about the procedure and the pre-op and post-op instructions. Please ask us if you have any questions regarding how to wear compression stockings.

Report all medications you are currently taking to including blood thinning medications. Dr. Weitzman will give specific advice regarding these medications.


The day BEFORE your procedure
  • You will receive a phone call the day before your procedure to review instructions.
  • Drink plenty of fluids the day before your procedure and after your procedure.

Pre and Post Op Instructions
  • Take a shower the morning of your procedure.
  • Do not eat or drink anything 8 hours before the procedure.
  • Avoid applying moisturizer or lotion to the leg.
  • Bring your prescribed compression stockings with you, if you have them.
  • Wear loose, comfortable clothing and loose-fitting shoes or sandals to your appointment.
  • Leave jewelry and other valuables at home.
  • Plan to have someone drive you home after your procedure.

During the Procedure
  • You may have IV sedation monitored by an Anesthesiologist to make you comfortable during the procedure.

Immediately After Your Procedure
  • Drink plenty of fluids after your procedure.
  • When sitting at home, elevate the leg to minimize any swelling. Please take ibuprofen (Advil, Motrin), Naprosyn or Tylenol as directed by Dr. Weitzman, if necessary.
  • Walk for 10-15 minutes every hour the first day after your procedure.
  • If the Ace Bandage feels tight along the back of your knee you may loosen the Ace Bandage.
  • It is normal for the Ace Bandage to feel moist or look wet with pink tinge after the procedure.
  • If you notice any heavy red bleeding through the Ace Bandage please place pressure on the area and call Dr. Weitzman.
  • The day after your procedure please resume normal activity. Being active helps the success of the procedure.

Days and Weeks after your Procedure
  • Wear your thigh high compression stockings for 72 hours (first 3 days).
  • For days 4-11, please wear them only during the day.
  • Schedule a follow up appointment in 2 weeks to ultrasound the treated leg. Recommendations for treatment of additional veins may occur at this time. Please bring shorts and wear loose fitting clothing for this exam.
  • Schedule a follow-up appointment in 3 months to again ultrasound the treated leg.
  • It is normal to have some mild bruising in the area of the insertion sites for treatment of ropy veins and occasionally local anesthesia.
  • You may feel a mild “pulling” feeling in the first 1-2 weeks after the procedure. This is normal. If this becomes uncomfortable please notify Dr. Weitzman for treatment.
  • Call Dr. Weitzman immediately if you experience the following:
    1. Unusual tenderness or redness in your leg.
    2. Unusual redness or warmth in the leg.
    3. Unusual swelling in the leg.
    4. Shortness of breath or chest pain.
    5. Any persistent bleeding.

Complications are rare

The benefits of treating your vein condition far outweigh the risks of continuing to live with this progressive condition. On rare occasions, you can have numbness or tingling in the treated extremity for a short while. Rarely, you can experience superficial phlebitis or even a DVT. Dr. Weitzman is a Board Certified physician who is able to manage and treat any medical complications you may develop.

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Treatment