Removing Varicose Veins

Are you embarrassed by the way your legs look in shorts or skirts? Many women try to hide varicose and spider veins, but thanks to advances in vascular treatment, many are learning to love their legs again. Joining me now is Dr. Jeffrey Goldblatt to talk about advanced treatment options that are designed to make you look and absolutely feel better. Welcome, it's great to have you with us. Thank you. Well, tell me more about circulatory centers and your mission. Well, basically circulatory centers is a corporate group of multiple offices doing the standard sort of present treatments for varicose veins. That's all they do is they want to make veins go away, make people's legs look nicer and feel better. Absolutely, we know a lot of people don't feel good when they see these veins. Basically, what are some of the main reasons people go to circulatory centers for treatment? Well, basically they want to either get rid of what they see, which is varicose veins or spider veins, or they're having symptoms of discomfort, various many different type of symptoms that can occur with varicose veins. How do varicose veins and spider veins develop? It's basically a valve problem. If you think of the normal function of your blood stream is to pump blood out of your heart and it the heart has a pumping mechanism, the vein has a valve mechanism, and if the valves fail as the blood returns to the heart, it creates kind of a back pressure and the back pressure can be exerted into the spider veins or varicose veins and it's called reflux and that's what we check for. So sort of blocking the blood flow? Not blocking it, just reducing the effectiveness of it as it flows forward. It goes forward and then goes back a little bit and then forward again. Do most women, I guess, are there more women who who have this type of issue versus men? There's more women than men. Why is that? Pregnancy. That's basically the reason? Basically, yeah. But men do also have varicose veins and spider veins. It's a congenital thing. It's a valve defect and it happens to young girls too, but pregnancy seems to be the culprit for most women. Oh goodness, okay, something for me to look forward to. Okay, let's take a look at a picture right here and I believe this is the one with varicose veins and let's just see. There it is and you can see that the vein is is bulging out. Would you consider this a major problem here or is that a minor one here? That looks fairly major. It depends on your how you interpret major though. I mean, basically you have a cosmetic major one and then you have a symptom logic, symptoms that are major. So that's the before picture, then the after picture it looks much better. Right. What happened there? Well, two things. One, you have to diagnose what's causing those veins to stick out and once you know what it is, then you do treatment. One cause may be, I call it like a Christmas tree where you have a trunk and branches. We examine the trunk with our ultrasound machine looking for this reflux. The branches are what you see and if we see reflux, we can seal off the vessel that's causing the reflux and in many cases the veins disappear. They don't dissolve, they just disappear. A second situation is there's no reflux visible to us, but still the varicose veins are visible to you and cause symptoms and for that we can do something called a phlebectomy, which is to actually remove them. It's quite different than the old-fashioned strippings that you heard. In fact, let's take a look at the next picture and we can really see a more severe case here. Let's talk about that phlebectomy in regards to this patient because it appears this is what the patient had done. No, not necessarily. Again, if you can stop the blood from flowing slightly backwards, the reflux, then what happens in many, many cases is the veins start to disappear. They'll look like your leg normally looks if you're lying down and you have a leg up in the air because veins, the pressure that's exerted by veins are related to gravity so there's no venous pressure if you're flat, but if you have your legs down then you can see them bulge out. I want to talk more about vein stripping. I mean, in the years past those were something you didn't want to hear because I know that most people probably thought that was a very painful procedure. And it was. Yes, and so now what do you have? Well, what you have now is the vein that was stripped out years ago was usually called the saphenous vein and it went from your groin to your ankle. The other vein was what they call the short saphenous and that was from the back of your knee to your ankle and we would actually make a cut and put a wire inside that vein and it would go down to wherever the exit was and then you would actually tie the ends off and take it out. Then what was left over you had marked and then you make multiple cuts over these veins and I'm sure people have seen older people on the beaches with these big cuts, it looks like a ladder. That was what they call the ligation, so it's a stripping and ligation. And now they, what do they do now? Now we do the reflux study and if the vein that we used to strip out has reflux we insert either a laser fiber or a radio frequency fiber inside the vein with local anesthesia and we're able to heat up the vein so it just shrivels up and closes. It's called, we call it a closure procedure. Once you do that then there's no reflux down that large trunk so those branches in many cases start to disappear. Most of the time they don't go away immediately but if you give them time they'll go away. I understand that this is covered by insurance? As long as you're having symptoms and it's not cosmetic, it usually is. And can this be done as an outpatient service? Yes, we do, or should we say I do 95% of everything as an outpatient. And what about how long, what about recovery? The recovery is very limited. I mean when we do this it's called an endovenous laser ablation which I happen to do but we just ask the patient to be not as active for a week. I recommend that they do no running, biking, jogging, heavy lifting, just for a week. And that's to let this seal and to put no unusual venous pressure on what we just sealed off. When you do all this is there the risk of it coming back? Tiny. Tiny? Tiny. We've only been doing these ablations in the United States for about 10 years. Europe is ahead of us. Everything is done in Europe before we get approval from the FDA. Absolutely. And they've been doing longer but basically a very tiny percentage, maybe what we call, it opens up again, maybe less than 1%. All right, now for more information on circulatory centers go to veinhealth.com or call this 800 line 800-350-2163. There are three locations, one in Old Lyme, Norwich, and Colchester. Dr. Goldblatt, thanks for being here. You're welcome. Wonderful information. Thank you.