Varicose Vein Treatment Options: Understanding Causes & Treatment

Dr. Malvehy specializes exclusively in the diagnosis and treatment of vein disease, including varicose veins, and is consistently rated one of the best vein doctors in the San Francisco Bay Area. Varicose vein treatment is customized by Dr. Malvehy during the initial consultation and may include a combination of laser vein treatment (also called EndoVenous Laser Ablation or EVLA), ultrasound guided foam chemical ablation, and minimally invasive varicose vein removal.

Current varicose vein treatments are all performed in the office using only local anesthesia. Patients can drive themselves to and from their treatment visit and have little to no downtime afterwards. Depending on the size, location, and nature of your particular varicose veins, Dr. Malvehy may be able to perform most or all of your treatment in a single visit.

Varicose Vein Treatment Options

Hi, I’m Dr. Albert Malvehy, an East Bay vein specialist, also known as Dr. Vein Eraser, and today I’m going to talk a little bit about varicose veins and what your treatment options are for varicose veins.

This is a common question that we get as you can imagine, being a varicose vein treatment clinic. People will come in, and the first step in getting your varicose veins treated
is understanding what’s causing them. And so that involves having an ultrasound done. So this is our handy ultrasound machine. It has to be powered off at the moment, but patients will come in and have an ultrasound done in the office so that we can understand where the varicose veins are coming from.

I’m going to come over to this screen over here. So varicose veins often result from one of the superficial veins, not the deep veins, where you might have heard of someone having a deep blood clot from having these veins are a little bit closer to the skin surface. They’re called Saphenous. They aren’t functioning properly. And we need to understand exactly which one is not functioning so we can treat them.

The body is compensated for veins that aren’t working long before people have shown up to our front door. And so my work as a vein doctor is very simple. Stop the backwards flow or stop the bad things  from working at all and let the other ones work in peace. There are a lot of different ways to treat the varicose veins or stop those bad veins from working and let the body absorb them. One of the first treatments is vein stripping, where a surgery is done to make decisions in the legs and actually remove some of those superficial veins that I just pointed to on the chart there that was done generally in the operating room, generally under general anesthesia.

So the person is fully asleep and the veins are physically removed from the body using incisions. That procedure has fallen out of favor with newer technology, which is what we use here in the office. So now with the advent of office based varicose vein treatments, there are things including laser treatment, radio frequency treatment, glues, and foams. The answer of what is best for you depends on what your anatomy is and what your surgeon is most comfortable using. In our office, we’ve used all these different modalities to treat people.

Essentially, whenever we do a Varicose vein treatment, I’m going to use this vein as an example. This is the great Saphenous in his vein. Most of the treatment is actually targeted at treating this root vein. Here this Saphenous vein. Also, I called it a superficial vein a moment ago.

I’m getting it to stop working. And one of the ways that can be done is we can place a little thin laser into the vein and cauterize it or burn it. Burning can also be done with something called a radio frequency catheter or RF technology. Glue can be placed in here just like super glue. So a small IV or catheter can be placed in here and the vein can be plugged up with a glue that’s like super glue. That’s called Dena seal.

Finally foams is an injection where a medication is injected in there, it sort of looks like shaving cream that’s injected and it causes the veins to dry up. So come on over here. So if we look at people who have people who have varicose veins, if we look at this before picture, for example, this person had a Saphenous vein that was not functioning properly and then they had bulging varicose veins that sort of came out of the bottom because all the pressure to the superficial vein was not working, was going down to the floor causing these varicose veins to come up. Okay, so this person has a laser treatment done through the thigh through the part that actually looks normal but that’s where the root of the problem was and we saw that on ultrasound and then also a little bit of foam injected here.

This is done three or four months later after those veins have dried up. So in terms of varicose veins treatment options, there are older surgical treatment options, we don’t really use those anymore. Everything is now done in the office and the most common ones are laser radio frequency glues and foams. All right, tune in for another topic some other day. See you next time.

Dr. Albert Malvehy

Dr. Albert Malvehy

M. Albert Malvehy, MD, RVT, dABVLM is a top-rated East Bay vein doctor serving the East Bay and greater San Francisco, California area. One of the few physicians in the country who devotes his practice exclusively to vein disease, Dr. Malvehy performs over 500 major varicose vein treatments using laser vein treatment and 1,000 spider vein treatments with sclerotherapy every year.

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