Dr. Joseph L. Vanderlinden, M.D.

Not really. A CT can show large veins, but varicose veins are the result of blood moving the wrong way in the veins. An ultrasound will show blood moving in the veins and demonstrate reflux.

Good question.

So, RF ablation is the process of destroying the function of a varicose vein using heat. The procedure requires that a patient is supine and lying down. The surgeon inserts a needle and wire into the furthest down area of the varicose vein to be ablated. Then, the surgeon injects local anesthetic around the vein. Followed by heat treatment of the entire vein segment. The problems with the procedure begin with needle access to the vein. Sometimes it is difficult to access the vein. This happens rarely. The next issue is with injecting local. It’s possible to inject the vein itself. This can cause cardiac issues. The next is heating the vein. If the catheter is beyond the saphenous vein junction to the femoral vein, then you will heat scar the femoral vein. That can cause femoral vein thrombosis, which may be difficult to treat. Catheter insertion into the artery has been described. Ablation of the artery is a disaster, and generally will require immediate femoral bypass surgery. Next is the likelihood that saphenous vein ablation doesn’t work. This is very uncommon. Next is skin burning. If there isn’t enough local anesthetic to maintain a heat sink between the vein and the skin, the skin may burn. It causes pain and deformity. Lastly is the risk of deep vein thrombosis. It is generally accepted that 1% of people will develop DVT with vein ablation.

This is quite a project. The reason that aortic aneurysms are separated for treatment is this: If the dissection, which typically begins at the ductus arteriosis, goes downward to the distal aorta, the only indication for surgery is poor blood flow to the gut or extremities. The reason that a dissection that goes retrograde to the ascending aorta is repaired, is that the risk of blood dissecting into the pericardium, which is generally deadly.

Daily.

It can be very dangerous.

Not necessarily

It doesn’t. Sorry

Sure it hurts. But it should be no big deal. Be sure to have a surgeon familiar with issues like mesh related neuropathy perform your operation.

Compression hosiery may delay the progression of varicose veins, but it is never curative. Hosiery can help with the discomfort of varicosities.

Nope. The only risk is blood thrombosis which can be spontaneous. It’s just clotting of blood which is very painful. And bleeding if the vein gets too near the skin.

There is really nothing serious about spider veins. They are just the smallest veins involved in the same process as larger varicosities.

I would wear compression hosiery throughout your pregnancy. When you complete breastfeeding, consult a vascular surgeon for a U/S and discussion of treatment.

Compression hosiery do help prevent the progression of varicose veins, but don't necessarily prevent them. I should wear hosiery daily, but I don't because putting them on is not easy. By hosiery, I'm referring to 15-20mmHg compression. I prescribe 20-30mmHg hosiery to my operative patients.

Nerve damage is certainly an issue with vein stripping or with microphlebectomy. But it is usually a minor issue with just sensory damage, causing a small area to be asensate, or it can cause burning to a small area. The discomfort usually lasts only weeks or months.
Only 1 or 2% of patients have neuropathy following vein surgery.
VNUS closure has a notorious history of causing neuropathy in the leg below the knee, it I’ve performed the operation hundreds of times, and had no problem with it.

Most visible veins of the lower body are considered varicose, regardless of size. The underlying pathophysiology is always of valve dysfunction. The valves become incompetent, and blood begins flowing out and down the leg. Blood should generally flow only toward the deep veins and up toward the heart.

Generally, all varicose veins enlarge over time. They are extremely unlikely to improve. It’s due to the anatomy of the veins, that the small valves allow blood to flow backwards.

Laser treatment of varicose veins uses light energy to cause spasm of small blood vessels. Laser light will generally cause your skin to lighten in the treatment areas. Laser therapy may work for the smallest of varicose veins. But for larger veins, the veins disappear for a few days, and usually return. I recommend seeing a vascular surgeon who for an opinion.

Deep vein thrombosis, DVT, is characterized by pain, usually in the leg, left or right, and tenderness behind the knee. But typically, there are no symptoms or signs. This is why it is standard practice to use devices or medications to prevent DVTs in hospital patients.

Vascular surgeons or interventional radiologists can perform vascular radiology to treat venous or arterial disease. Even cardiologists can do interventions.

Good question. The mainstay of treatment for deep vein thrombosis (DVT), is anticoagulation. Blood thinners used are heparin, Eliquis, and Coumadin. Typically for 3-6 months. If a patient cannot be safely anticoagulated (upcoming major surgery, active bleeding), then a large DVT can be managed by using a filter placed in the Vena cava to prevent pulmonary embolism. The best management of a large DVT in a healthy patient is lysis, which uses TPA, a clot busting medication to break up the DVT.