5 Steps to Treating Bulging Veins in Your Legs

Updated on: November 28, 2018

If you've noticed colorful squiggly lines on your legs or sudden bulging veins in your legs, arms and hands, you are certainly not alone. Over 80 million Americans have varicose veins or spider veins.

New treatments are minimally invasive and are done right in your doctor's office. Learn the 5 steps of having your bulging veins treated.

Step 1: Initial consultation

Everyone's vein condition is unique and requires a thorough evaluation prior to starting a treatment plan. Your doctor will start with a vein screening to evaluate your condition. This allows the physician to recommend a customized treatment protocol for varicose veins, spider veins or both. You'll want to be sure that you are offered all the latest and most up-to-date treatments available for vein conditions, and that your surgeon has successfully treated many patients before you.

This takes the guesswork out of how your veins need to be treated and you should receive a full explanation of which procedures are considered cosmetic and which procedures are fully covered by your insurance carrier.

Step 2: Ultrasound evaluation/interpretation

Ultrasound imaging is the single most important tool used to diagnose your vein problems and recommend the appropriate therapy. It is a mandatory initial step for every patient. No advice regarding leg vein treatment should be given without this simple, painless and non-invasive test.

In addition, the person performing and interpreting the test should have the appropriate credentials. Your sonographer should hold the RVT (Registered Vascular Technician) certification, which is the gold-standard for persons performing your exam.

The physician who evaluates the ultrasound exam should be a qualified vein specialist, who holds an RVT, RPVI or RPhS certification. This ensures that they have a deep and broad knowledge of your venous system, and that will yield the most accurate assessment of the underlying cause of your vein disease.

Step 3: Discussion of comprehensive treatment plan

Vein-dedicated facilities treat the root of the problem rather than just the surface abnormalities. No two patients are alike and all require a customized approach, which should be comprehensive and clearly explained.

Your doctor should be knowledgeable and able to answer any questions that you may have. Vein specialists are usually board certified in general surgery, but also, more importantly, in vascular surgery and phlebology.

They should also hold the title of being a Diplomate of the American Board of Phlebology (ABPh) and be a Fellow of the American College of Surgeons (FACS). To find out more about your doctor's credentials, visit the American Board of Surgery or the American College of Phlebology.

You don't want to be in a position of having this important work done to your body without the ability to ask questions freely and be completely satisfied with the answers you receive. Also, make sure your doctor is the one performing your procedure. Some doctors delegate various follow-up treatments to ancillary personnel. Whether or not they are qualified, they may not be aware of your entire case and what exactly has been done up to that point. This can lead to poor follow-up and disjointed care.

Step 4: Treatment options

Treatment options vary. Most patients shy away from treatment as they are most familiar with outdated stripping procedures that were painful and came with a prolonged convalescence. Recent advances in vein treatment now offer patients an easier alternative:

  • Varicose veins: Most patients will have underlying venous insufficiency detected on ultrasound examination. Endovenous Laser Therapy (EVLT) or Endovenous Laser Ablation (EVLA) and/or VNUS Closure should be available to correct this.
  • Spider veins: VeinGogh and/or Veinwave technology coupled with a combination of ultrasound-guided foam sclerotherapy and VeinLite sclerotherapy containing FDA approved medications including both Asclera and Sotradecol. Saline injections are relatively dated, not currently approved by the FDA for sclerotherapy, can be painful and may lead to increased complications.

Step 5: Post-treatment evaluation

During your post-treatment evaluation, your treated veins will be evaluated and the physician will determine if additional procedures are needed. Once your varicose veins have been successfully treated, you can begin treatment for your spider veins, if necessary. If present, it is important to treat the underlying varicose veins first, to ensure the most optimal results.

For more information, contact Dr. Schwartz at the North Shore Vein Center to schedule your free vein screening: 516-869-VEIN (8346) or visit our site.

*Additional diagnostic ultrasound testing may be required, which will be billed to your insurance carrier.

By Mark Schwartz, MD, FACS, ABPh, RPVI

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