Varicose Vein Treatment in Philadelphia, PA

What Are Varicose Veins?

Varicose veins are enlarged, blue or green squiggly veins that protrude from the surface of the skin. Varicose veins are larger than spider veins, approximately the size of a garden worm. They are often painful and unsightly, and usually develop in the legs. In extreme cases, varicose veins are debilitating and affect mobility.

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Causes of Varicose Veins

Veins have an important function in our body – they carry the blood pumped by the heart to bring oxygen to all parts of the body. They have valves that ensure blood is flowing in the correct direction. When the valve is broken, blood is not flowing back out of the vein quickly enough and piles up in the vein. As a result, the vein expands, bulges and is damaged. This can cause ulcers on the leg or ankle.

Varicose veins are mostly genetic but tend to affect women more due to changing hormones and pregnancy. Obesity is also a risk factor for varicose veins.

Varicose Vein Treatments

In the past, a phlebectomy, a painful “vein stripping” surgery would be needed to physically remove the vein segments with bad valves. Fortunately, there are a number of non-invasive, nonsurgical treatments to remove varicose veins.

Endovenous Laser Ablation (EVLA)

EVLA (also known as endovenous laser therapy) is a safe and effective technique that uses a laser to treat large veins under the surface of the skin. The procedure involves making a tiny freckle-size incision and inserting a catheter containing a laser fiber directly into the varicose vein. Ultrasound is used as a guide for improved accuracy. Local anesthetic is administered through the length of the vein. Then, laser energy is released as the laser is slowly pulled back through the catheter. The laser energy damages the vein walls and they collapse, sealing shut the bad vein segments. Blood flow is redirected to healthy veins and the diseased veins eventually shrink and fade away.

The procedure is done in the office and takes less than 30 minutes. You can return to normal activities (including work) the following day. Exercise can be resumed in one week.

Ultrasound-guided Foam Sclerotherapy

Ultrasound-guided foam sclerotherapy is frequently used for patients who have extensive varicose veins and is done as an additional therapy after endovenous laser ablation. This technique uses a longer needle for placement in a vein beneath the skin surface to get rid of a “root vein” with a bad valve.

Multiple injections are usually performed in a single 20-30 minute session. The needles are extremely small and although they are “pinchy,” they are not painful due to their micro size. After the injections, a compression stocking is worn over the injected leg for one week to help compress the injected veins. Normal activities are allowed with the exception of halting exercise for two days.  

Frequently Asked Varicose Vein Questions

The first step is an ultrasound examination in our office to look at the direction of blood flow within the veins in the leg. Most times, tracking the source of the varicose veins beneath the skin surface shows a root vein that has developed bad valves. Bad valves can develop within several different veins in the leg.

The first line of therapy is to wear good compression stockings to alleviate some of the leg discomfort from varicose veins, although this will not fix the problem. Most insurers will require 3-6 months of medical compression wear without substantial alleviation of symptoms, to qualify the patient for approval for endovenous laser ablation. 

The EVLA procedure makes the leg work more efficiently. After the bad vein segment is lasered, the flow is diverted into much larger veins that are working well, relieving the back pressure in the system. The leg will feel better and lighter, without the accompanying leg heaviness, fatigue and other symptoms.

The larger, external veins will typically decrease in size from 30-70% from EVLA alone, although they likely still will be visible. Often, sclerotherapy is performed as a “clean up” procedure after EVLA. Sclerotherapy is often considered cosmetic, and not covered by medical insurance. However, ultrasound-guided sclerotherapy may be covered, which is aimed at internal veins valve problems.

Absolutely. We have many patients who have suffered with venous stasis ulcers chronically for several years and improve dramatically after the causative bad valve is identified and addressed. In most circumstances, the ulcer will heal within 6-8 weeks of treatment if properly diagnosed.

The varicose vein treatment is performed as an outpatient procedure in the Lumen Center office in Bryn Mawr, PA.

"I had the pleasure of having the sclerotherapy and laser vein procedure. The office has a well-educated, professional staff. Dr. Kwak also is very professional. He is compassionate and explained everything during the procedure. Taking care of my veins was the very best thing I’ve ever done. Dr. Kwak gave me my life back and I highly recommend him."
Bridget S.

The Recovery Process

The recovery process for varicose vein treatment is very short. Most people can return to normal activities the next day and exercise in one week after EVLA.

Lumen Center patients are carefully monitored post-procedure and at regular checkpoints for up to a year. 

Is Varicose Vein Treatment Right for You?

The first step is to schedule a free vein screening with Dr. Kwak to discuss your goals, concerns and questions. He’ll start by providing an ultrasound examination, determine if you are a good candidate and review what you can realistically expect. We’re here to help guide you every step of the way.