Minimally Invasive Varicose Veins
Surgery (MIVS)
Varicose Veins
Varicose veins are an enlargement of veins that result
from pooling of blood which force the vein walls outward. Heredity
factors play an important role in their development. Other factors that
contribute include pregnancy, hormonal therapy including post-menopausal
hormones and birth control pills. Prolonged standing or sitting, obesity
and aging are additional causes.
Symptoms include discomfort in the legs especially at
the end of the day. This can include heaviness, tiredness, aching and
swelling. If symptoms persist for a long period of time it can result in
phlebitis, skin changes, ulcerations and bleeding.
Treatment Options
- Conservative Treatment
- Graduated compression stockings which are tighter at the ankle than
the calf or thigh can alleviate some symptoms but will not rid your
legs of varicose veins. This option is good for women who are
pregnant.
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- Surgical and Other Treatment Options
- Compression Sclerotherapy
- Sclerotherapy is an office based procedure in which a sclerosing
solution is injected into the veins using tiny needles. This makes
the vein disappear and may require multiple treatments in order to
close the veins completely. This is excellent for spider veins.
- Ambulatory Phlebectomny
- Phlebectomy or removal of varicose veins is a minor surgical
procedure to remove larger varicose veins. Tiny incisions are used
resulting in barely visible scars and is performed on an outpatient
basis.
- Surgical Stripping and Ligation
- People with large varicose veins may have incompetent valves in
the greater saphenous vein
 . This vein runs from your ankle to the
groin wh ere it meets the main vein of your leg, the femoral vein.
The valves allow blood to pass up the vein to your heart and should
prevent blood from pooling in the vein or flowing in reverse
fashion. When this occurs a greater pressure is exerted causing this
vein and its branches to bulge thus causing varicose veins. This
results in venous insufficiency and worsening of varicose veins.
Ultrasound is needed to document this and if diagnosed removal of
the saphenous vein from the knee to the groin will alleviate this
problem. This procedure requires general or spinal anesthesia and
results in longer recovery and more bruising and discomfort then
less invasive procedures.
EVLT™ (Endovenous Laser Treatment of the
Saphenous Vein)
This is a new minimally invasive laser procedure that can be
performed instead of vein stripping as described above. The procedure is
relatively short and less painful than vein stripping. It can be
performed under local anesthesia and the post-operative recovery time is
less than a stripping procedure.
During this procedure a laser fiber is passed into the saphenous vein
through a 2-3 mm incision. Laser energy is delivered to the vein wall
causing it to close off. Little or no scarring is seen.
Normal activity and walking is encouraged immediately afterwards and
compression stockings are also worn for one week post-operative. Some
bruising and soreness can occur for 7-10 days after treatment and
usually requires only Tylenol or Advil type of medication for relief.
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