Inject Veins or Remove Veins? Which?
Written by Dallas Vein Specialists on June 14, 2010
Patients frequently are confused about why some leg veins are injected and some are removed. When I evaluate veins from spider veins to large varicosities, there are several considerations going through my mind in addition to the source or cause of the vein problem.
SCLEROTHERAPY is the injection of veins with chemicals that damage the inside of the veins. This causes veins to occlude with clot and then be removed by the body’s own inflammatory process over a period of weeks to months. While it is true that superficial veins of all sizes may be injected, application of sclerotherapy to some veins is not advisable. Rather some should be removed using minimally invasive techniques.
For spider veins, the small, 0.1-1.0mm, red to blue veins in the top layer of the skin, injection of a chemical sclerosant (sclerotherapy) with a small needle is the best treatment and usually achieves good results with the veins disappearing over 1-3 months. For veins that are larger and bulge beyond the surface of the skin, injection with a sclerosant chemical will convert a soft collapsible vein to a firm, non-collapsible clotted vein that will usually become tender and inflamed. Because these veins are many times larger than spider veins, it will take much longer for the body to “absorb” the damaged vein filled with clot. During this time it will also be unsightly and frequently “hyperpigment”, which refers to the dark brownish skin discoloration over and around the clotted vein. This is really the result of iron in the clot migrating and staining the skin. Such skin discoloration may be cosmetically undesirable and may take months to years to fade and may even remain permanently. At present there are no dependable treatments to reverse or speed resolution of the discoloration of the skin.
Thus for varicose veins, larger veins that lie deeper than the surface of the skin and appear to bulge, a better treatment is removal. By removing the vein a prolonged resolution of the clot and the associated inflammation, tenderness, firmness, lumpiness, and skin discoloration are avoided. The veins are removed using a minimally invasive technique in which small incisions are made at intervals over the veins under local anesthesia. Made by an experienced vein surgeon the wounds are barely larger than needle punctures, require no sutures, and heal within 1-3 weeks. This procedure, called MICROPHLEBECTOMY or AMBULATORY PHLEBECTOMY, achieves excellent cosmetic results.
At Dallas Vein Specialists we tailor treatment to the patient’s needs. We use modern minimally invasive methods to achieve the symptom relief and excellent cosmetic outcomes with minimal discomfort and with rapid return to usual daily activities.