Varicose veins are not surface deep. The root of the problem begins a few centimeters beneath the surface of the skin. Healthy veins have valves that shut and keep the blood moving up towards the heart. When these valves fail the blood pools in the vein and pressure builds up. Over time branches of the vein swell leading to varicose veins at the surface. But other symptoms associated with leaky (incompetent) veins can include: swelling, pain, cramping, restless legs, skin discoloration, bleeding and ulcers.
Proper treatment does not begin at the surface but addresses the root cause. Varithena is an FDA approved vein treatment (mix of CO2 gas and Polidocanol a medical detergent) that is injected into the vein with leaky valves under ultrasound guidance. This leads to the leaky vein with diseased valves healing shut. The blood reroutes up healthy veins and the branch varicose veins shrink with time. Over time symptoms of swelling, pain, cramping can also improve. We apply compression to keep the medication in the diseased vein and apply a compression wrap afterwards.
The day of the procedure you can eat your regular diet and take your regular medications. You come into the office and lay down on the exam table. We clean the skin with alcohol and numb it with lidocaine. We access the vein under ultrasound guidance with a tiny needle and inject the Varithena. We wrap the leg with a compression wrap which stays on for 2 days. There is no heavy exercise for those 2 days after the procedure (no activity more strenuous than walking). After two days the wrap comes off and you can resume all normal activities. The entire process takes 30 minutes.
You will likely have some aching after the procedure for a few days. This is usually mild. Advil or other NSAIDs (anti-inflammatories) help if you are not allergic or do not have other contraindications to NSAIDs.
You will return for a follow up ultrasound approximately 1 week after the procedure.