By: Jean Johnson for Veins1Barbaric Vein Stripping
“Vein stripping is barbaric,” said Fred Keller, M.D., head of Portland’s Dotter Interventional Institute at Oregon Health Sciences University. “I agree,” said interventional radiologist Jeremy Weiss, D.O. with grim emphasis in his voice. “Vein stripping can involve very long incisions and cutting out veins. Sometimes surgeons even ram a stainless steel rod down a vein to help destroy it. Medicine has grown far beyond this kind of technique.”
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| Symptoms of varicose veins can include:
Pain in the legs that feels like a fullness, heaviness, or aching.
Visible, enlarged veins.
Discolored, brown skin at the ankle
Ulcers or open sores resistant to healing near the ankle.
Conservative therapies for varicose veins include:
Avoid excessive standing
Elevate feet when resting
Wear elastic support hose
After years of working in hospital radiology departments, Weiss inaugurated a clinical practice in the summer of 2005 to better serve patients. See Veins1 article “A Personal Approach to Interventional Radiology.” How Interventional Radiology Replaces Surgery
Interventional radiologists execute minimally-invasive procedures using their expertise in the circulation system and all of the other tubular structures within the body. By making a tiny nick in the skin atop a major vessel, they are able to insert a thin catheter and guide it using real time imaging to the source of problems within the body. In this way interventional radiologists are able to treat a range of problems formerly addressed with a scalpel. Weiss explains that strides made in interventional radiology over the past four years have provided varicose veins patients with a new, impressive option. He says that interventional radiologists provide this option instead of plastic or general surgeons because the techniques required use the skill set interventional radiologists have.
Interventional Radiology Treats Varicose Veins
“Endovenous ablation, the new treatment that is markedly different from vein stripping, involves almost no recovery time. Patients can have it done here in the clinic and can walk out of the office afterward,” said Weiss. “The procedure involves injecting patients with a medication, topical laser, or both that help destroy the blood vessel. The larger veins are usually treated by puncturing the greater or lesser saphenous vein, which is usually the problem vein. Then we feed a catheter that has a laser into the vein. When we get it positioned, we seal off the vein – usually the saphenous.” Current data also shows endovenous ablation has a lower complication rate than vein stripping as well, says Weiss who has done well over 100 procedures over the past four years. He also notes that current data shows this approach to treating varicose veins as effective as traditional methods while maintaining lower complication rate.
Symptomatic Varicose Veins Differ from Spider Veins
Weiss explains that he’s talking about large, ropey veins that are more than just unsightly. “Patients who have symptomatic various veins are at risk for true medical complications including fatigue, heaviness, pain, rupture, venous stasis, blood clots and poor healing including non-healing ulcers in the lower extremities,” he said. Weiss notes that spider veins do have not implications for medical problems and thus are normally considered cosmetic issues. Spider veins usually require a different type of treatment, such as injection with medications, called sclerosants or using a laser on the skin surface. Whether symptomatic or spider, endovenous ablation causes most varicose veins to disappear “pretty close to immediately” after treatment. “Even in patients whose veins remain visible,” Weiss said. “The veins will still be decompressed and lie flatter and less prominently than before so they are far less eye-catching. But in the majority of cases, the veins disappear all together along with the associated medical problems.”