What are the Nonsurgical Procedures for Varicose Veins

Various nonsurgical procedures can be used to treat varicose veins. Varicose veins are swollen, twisted veins that are visible under the skin. They occur most often in the legs. These veins may appear blue and bulging.

Varicose veins are caused by damage to the valves in veins. All veins have a valve that makes blood flow in only one direction. If a valve gets weak or damaged, blood can pool and cause varicose veins.

You may need a procedure to treat your varicose veins if they are causing symptoms or complications, or if lifestyle changes have not helped. These procedures can reduce pain, aching, and the risk of bleeding and blood clots. They can also improve the way the affected area looks (cosmetic appearance).

The three common nonsurgical procedures are:

• Sclerotherapy. A chemical is injected to close off a vein.
• Laser treatment. Light energy is applied to close off the vein.
• Radiofrequency vein ablation. Electrical energy is used to produce heat that closes off the vein.

Your health care provider will discuss the method that is best for you based on your condition.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Damage to nearby nerves, tissues, or veins.
• Skin irritation, sores, or dark spots.
• Numbness.
• Clotting.
• Infection.
• Allergic reactions to medicines.
• Scarring.
• Leg swelling.
• Need for additional treatments.
• Bruising.

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• You may have an exam or testing. This can include a tests to:
  • Check for clots and check blood flow using sound waves (Doppler ultrasound).
  • Observe how blood flows through your veins by injecting a dye that outlines your veins on X-rays (angiogram). This test is used in rare cases.

What happens during the procedure?

One of the following procedures will be performed:

Sclerotherapy

This procedure is often used for small to medium veins.

• A chemical (sclerosant) that irritates the lining of the vein will be injected into the vein. This will cause the varicose vein to be closed off. Sclerosants in different amounts and strengths can be used, depending on the size and location of the vein.
• All of the varicose vein sites will be injected. You may need more than one treatment because new varicose veins may develop, or more than one injection may be needed for each varicose vein.

Laser treatment

There are two ways that lasers are used to treat varicose veins:

• Light energy from a laser may be directed onto the vein through the skin.
• A needle may be used to pass a thin laser catheter into the vein to cause it to close.

You may need more than one treatment if the vein re-opens. In some cases, laser treatment may be combined with sclerotherapy.

Radiofrequency vein ablation

• You will be given a medicine that numbs the area (local anesthetic).
• A small incision will be made near the varicose vein.
• A thin tube (catheter) will be threaded into your vein.
• The tip of the catheter will deploy electrodes.
• The electrodes will deliver electrical energy to produce heat that closes off the vein.

What happens after the procedure?

• A bandage (dressing) may be used to cover the injection site or incisions.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• Return to your normal activities as told by your health care provider.

Summary

• Varicose veins are swollen, twisted veins that are visible under the skin. They occur most often in the legs.
• Various procedures can be used to treat varicose veins. You may need a procedure to treat your varicose veins if they are causing symptoms or complications, or if lifestyle changes have not helped.
• Your health care provider will discuss the method that is best for you based on your condition.

Nonsurgical Procedures for Varicose Veins, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Swelling.
• Bruising.
• Soreness.
• Mild skin discoloration.
• Slight bleeding at the incision sites.

Follow these instructions at home:

Incision or puncture site care

• Follow instructions from your health care provider about how to take care of your incision or puncture site. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave skin glue or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision or puncture area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers.
• Wear loose-fitting clothing.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Get regular daily exercise. Walk or ride a stationary bike daily or as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a fever.
• You have redness, swelling, or pain around your incision or puncture site.
• You have fluid or blood coming from your incision or puncture site.
• Your incision or puncture site feels warm to the touch.
• You have pus or a bad smell coming from your incision or puncture site.
• You develop a cough.

Get help right away if:

• You pass out.
• You have very bad pain in your leg.
• You have leg pain that gets worse when you walk.
• You have redness or swelling in your leg that is getting worse.
• You have trouble breathing.
• You cough up blood.

Summary

• After the procedure, it is common to have swelling, bruising, soreness, or mild skin discoloration.
• Follow instructions from your health care provider about how to take care of your incision or puncture site.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.