Varicose Veins

Nearly thirty percent of adults will develop varicose veins in their lifetime, making this a very common vein condition. For many individuals, these veins are merely a cosmetic concern and aren’t dangerous to their health. But for some, these veins may become uncomfortable or itchy, or even cause swelling in the legs. Occasionally, varicose veins can lead to more serious complications.

Varicose Veins FAQs

A varicose vein is an enlarged and twisted vein that is usually visible below the skin. These veins most commonly appear in the legs, where standing and walking can increase the pressure in those veins over time.

The farther away the vein is from your heart, the more your body must work to return that blood to the heart. Over time, through gravity or through pressure from standing and walking, the valves that help pump that blood back up to the heart can become damaged or weakened.

That causes the blood to pool back in the vein, and those veins will respond to that increase in blood by stretching or twisting to accommodate it.

You may be at risk for varicose veins or spider veins if you have the following characteristics:

  • Age
  • Sex – Women are more likely to develop varicose veins.
  • Pregnancy – The strain of pregnancy can increase the likelihood of developing varicose veins.
  • Family history
  • Obesity
  • Inactivity

Some people may never need to treat varicose veins for anything other than cosmetic reasons. However, for those experiencing unpleasant symptoms, like itchiness, aching or swelling, it’s recommended that they see a doctor to ensure they aren’t at risk for complications. While complications from varicose veins are rare, they can include the development of ulcers, blood clots or bleeding from burst veins. The development of any of these conditions requires prompt medical attention.

  • Pain
  • Aching
  • Swelling
  • Heaviness or tiredness
  • Itching
  • Cramping
  • Restlessness
  • Wounds/ recurrent cellulitis
  • Chronic skin changes of discoloration, skin thickening/hardening, and dry flakey skin in the lower calf/ankle region

As a first step to overcoming varicose veins, new patients will start wearing medical grade compression hose (20-30mmhg). You must wear these to the top of the calf/knee from waking up until going to bed consistently for a minimum of 3 months prior to possible intervention. During this time, you should elevate legs when sitting and perform daily aerobic activity (i.e.: walking or recumbent bike).

The next step is seeing a nurse practitioner who specializes in vascular care to discuss symptoms and have a lower extremity evaluation. If recommended, you will get a venous duplex to assess for reflux and measurements of veins. This is different than a DVT ultrasound and is completed at our office. The nurse practitioner will call with results and further follow up plans. If a procedure/intervention is the best path forward, you will meet the USA vascular surgeon to discuss your treatment plan and submit to insurance for approval of procedure.

Once insurance approves planned intervention (a process that can take 6+ weeks), our office will call you to schedule your date/time. All procedures are completed here at our office and are same-day procedures. You will need a driver as you will be sedated for the procedure. Afterward, you will need to continue compression for 2-4 weeks post procedure based on your discharge instructions. You will also have another ultrasound approximately three days post operatively to assess the successfulness of the procedure and any extension of DVT. You will then follow up with the nurse practitioner 7-10 days post operatively to check the healing progress. The final post operative check will be in 6-8 weeks with your surgeon.
Note this is the standard procedure barring no complications.

Your surgeon will determine which of the following procedures is best for you based on the exam and ultrasound results. Note a procedure/intervention is not recommended for asymptomatic patients.

  • Radiofrequency Ablation (RFA) or Endovenous Laser Treatment (EVLT): This is typically used to seal/close the great or small saphenous veins and some perforator veins.
  • Varithena: this is an injectable foam that again collapses and seals off the malfunctioning vein. Typically used for smaller veins, perforators, or tributaries
  • Micro phlebectomy: Small, micro incisions are created to remove large varicosities.
  • Sclerotherapy: This is a cosmetic procedure completed for spider veins. Insurance does not cover this unless the patient has a history of bleeding spider veins. The cost is $300.00 per 30-minute session. How many sessions depends on patient satisfaction. We recommend 1 month between sessions. This does not require the above-mentioned steps. Only requires new patient visit for evaluation prior to scheduling sclerotherapy appointment.

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Treating Varicose Veins

Typically, varicose veins can be diagnosed through a simple physical exam. Sometimes your provider may recommend a venous doppler ultrasound to rule out any blood clots in the veins. This is a noninvasive diagnostic.

The type of treatment your provider recommends will depend on where your varicose veins are, how large they are and any other complications you may be experiencing. Your provider may recommend any of the following treatments:

  • Home care – Your provider may recommend simply adjusting your home habits by increasing your exercise, elevating your legs or wearing compression stockings.
  • Sclerotherapy – During this in-office procedure, one of our providers will inject a solution into your leg that will close off the vein, rerouting the blood through healthier veins. Eventually, the closed off vein will fade away.
  • Laser treatments – Sometimes, varicose veins can be closed by using a laser light on the skin itself to close off the vein.
  • Endovenous laser therapy or radiofrequency ablation – A minimally-invasive treatment, your provider will thread a small laser fiber or a catheter into the vein and then use a laser or radiofrequency devise to close off the vein from the inside.
  • Vein surgery – Also called vein litigation, varicose vein surgery involves making a few small incisions to reach and then tie off the vein to close it. Sometimes, our surgeons may also remove the vein entirely through a process called vein stripping.

Request an Appointment for the USA Vein Center

At this time, USA only accepts online appointment requests for the USA Vein Center. If you would like to schedule an appointment for other consultations or procedures, please call us at 423-267-0466. 

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16 Specialty Services From Over
30 Skilled Surgeons

Today our network extends to more than 6 cities in the region. Search our network of surgeons and nurse practitioners by specialty or location.

16 Specialty Services From Over
30 Skilled Surgeons

Today our network extends to more than 6 cities in the region. Search our network of surgeons and nurse practitioners by specialty or location.