Varicose Veins

Carmen Laronn, MD

Varicose are blue, green, or purple enlarged “rope like” veins bulging under the skin mostly seen in the lower extremities. They may cause pain, swelling, burning, throbbing and leg cramps. Untreated this condition may lead to complications like ulcerations, bleeding, dermatitis, and thrombophlebitis. Approximately 30% of women and 15% of men may develop varicose veins in their lifetime.

Treatments:
Sclerotherapy
Sclerotherapy is a non-surgical technique that is used to close medium sized veins, spider veins or broken capillaries. These veins are common on the thighs or leg but may also be seen on the face or body.

How It Works
A tiny needle is used to introduce the sclerosing agent into the vein. The agent displaces the blood in the vein and irritates the inside lining into itself. Your body then absorbs it and it disappears. A typical treatment takes from 20–40 minutes and includes multiple injections. There are a number of different “sclerosing agents” that can be used in many different concentrations that vary on the type of vein.

A couple of treatments may be needed for best results. Most veins are completely gone in two weeks to two months.

Costs & Recovery Time
Because the needles used are so tiny, there is little discomfort involved and there is only 2–3 weeks recovery time needed. Costs range from $100–$265 depending on the number of areas involved, the size and the number of veins.

Micro Foam Sclerotherapy
This is a type of sclerotherapy where the sclerosing agent is mechanically foamed before injected. The advantage of this technique over regular sclerotherapy is that less concentrated solutions can be used due to the increased efficiency.

How It Works
The patented system changes the physical properties of the sclerosing agents making them more effective in targeting the affected segments of the troublesome leg veins. This results in less bruising and quicker recovery.

Costs & Recovery Time
Cost is $285 per treatment and recovery time is even quicker due to the increased efficiency of the process.

Duplex Guided Sclerotherapy
Duplex guided sclerotherapy is a technique the physician can use to more accurately control your procedure. It can be used with both regular sclerotherapy and with microfoam sclerotherapy.

How it works
The duplex ultrasonic imaging is a tool the physician uses to guide the treatment along the vein being treated. Since the physician can see your vein more clearly with this imaging method, treatments done this way are more effective and less follow-up treatment is needed.

This procedure is especially useful for the deeper non-visible veins or varicose veins. When it is combined with Duplex imaging techniques, studies reported by The American College of Phlebology have shown a dramatic increase in effectiveness over traditional methods.

Costs & Recovery Time
Your physician will usually recommend the wearing of graduated compression stockings for 14 days after your treatment. The cost is $550 per treatment and the total recovery time is 3 weeks to 3 months depending on the size of the vein treated. Multiple treatments may be needed.

Vascular Lasers
“Light that treats” Non-invasive, state of the art technology uses pulses of light to eliminate varicose and spider veins on the body, face and extremities without injections or surgery. This patented technology allows your physician to customize treatment specifically for the size and depth of the veins as well as for your skin type. This flexible interactive approach cannot be achieved by any other non-invasive method currently available.

How They Work
Vascular laser treatments are done with a non-invasive medical system that uses intense pulsed light therapy to reduce or eliminate skin redness, spider veins, sun damage, age spots, brown spots and more. It can treat the full face, neck, chest and even the hands. It treats both vascular and pigmented lesions. Vascular lesions are abnormal blood vessels close to the skin’s surface that give the skin a reddish color. Pigmented lesions are brown spots caused by an excess of melanin (the dark pigment in the skin).

The light energy causes the tiny spider or other veins that cause redness of the skin to shrink and be absorbed by your body. The intensity and area these treatments cover can be controlled by your physician. The redness from rosacea can be reduced as much as 80%.

For clustered wide spread areas, these treatments are done in a series of 3–6 treatments. One to 3 treatments are usually needed for isolated areas.

Costs & Recovery Time
You will see results after your second or third treatment and usually have no downtime. This is one of the so called “lunchtime” procedures — it can take 30 minutes or less and you go right back to work. Costs range from $250–$550 depending on the size of the area treated per session.

Endovenous Laser (EVLT) Treatment
EVLT is a varicose vein treatment that replaces surgical vein stripping. In clinics that have the Sonosite ultrasound equipment to diagnose the problem in advance of treatment, the treatment can be directed specifically to the cause of the problem instead of treating unnecessary areas. The Laronn Clinique is the only center in Denver with the $35,000 sonogram equipment and the $40,000 EVLT laser.

How It Works
The procedure is done in the office under local anesthesia after vein mapping. A laser fiver is inserted into the damaged vein to be treated. Pulses of light are delivered into the vein that causes it to collapse and seal shut as the laser fiber is slowly removed. Your doctor will advise you which treatment is most appropriate for your situation (as long as the office has several capabilities). The complete treatment takes one hour. The results are immediate and full recover takes 2–3 weeks.

Costs & Recovery Time
Most people are able to return to normal activities immediately though your doctor will probably have you walk, wear compression stockings and avoid vigorous exercise for a couple weeks. You should also avoid long periods of standing for two weeks. The cost of this treatment is usually around $2,900.

Ambulatory Phlebectomy
Vein stripping has been a standard practice for decades for dealing with large, bulging varicose veins. Many surgeons still use this outdated mode that requires general or spinal anesthesia in a hospital setting. Stripping usually requires large, multiple incisions leaving unsightly scars. Post operative recovery is painful and recuperation includes prolonged bed rest and time out of work.

Ambulatory phlebectomy is a micro surgical treatment performed in your doctor’s office. It removes large varicose veins and is non-invasive, non-traumatic so is much preferred to the traditional “vein stripping”.

How It Works
This treatment method removes the troublesome vein by making tiny incisions in the skin. The incisions are so tiny that stitches are generally not necessary. The procedure is usually done with local anesthesia in your doctor’s office. It is frequently used in combination with sclerotherapy to enhance the overall results. Most patients see their results immediately.

Costs & Recovery Time
Most people are able to return to normal activities immediately though your doctor will probably have you walk, wear a compression bandage or stockings and avoid vigorous exercise for a couple weeks. You should also avoid long periods of standing for two weeks.

At 6 weeks after the procedure, a follow up is done to determine if troublesome veins remain that should be treated with sclerotherapy or lasers.

The cost of this treatment depends on how many veins are removed if both legs are treated any may range from $2,500–$5,000.

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