The Bailey Cosmetic Surgery & Vein Centre´ is the only center in mid-Missouri to offer the entire complement of state-of-the-art vein care procedures. These procedures are always performed in the office under local anesthesia. Dr. Bailey was the first physician in Missouri to use the revolutionary 1320nm Cool Touch YAG laser for the treatment of varicose veins. The benefit of this device over the more commonly used Diode lasers is a marked reduction in post-procedure pain and bruising.
Varicose Veins Treatment (Venous Insufficiency)
State-of-the-art vein care is minimally invasive. There is no downtime and the procedures are office-based. The modern treatment modalities include:
- Endovenous Laser Ablation (EVLT)
- Endovenous Radiofrequency Ablation
- Ultrasound Guided Sclerotherapy
- European Microphlebectomy
- Radiofrequency Perforator Closure
- Visual Sclerotherapy
- Surface Laser
The goal of all of these procedures is to close off abnormal veins and redirect blood into healthier deeper veins. Vein stripping is no longer necessary and is a historical operation.
Venous Stasis Leg Ulcers
Venous stasis leg ulcers are wounds that develop on the lower legs from untreated venous insufficiency. The back flow of blood in the veins due to incompetent valves leads to venous hypertension and eventually capillary damage and inflammation in the tissues. Skin changes commonly occur before the development of leg ulcers and may present as an eczema-like rash, or red, brown, or purple skin on the lower legs.
VenaSeal is a method of treatment for venous insufficiency in which a medical adhesive is placed within the vein under ultrasound guidance to permanently seal off the refluxing vein. VenaSeal does not use a heat source and therefore does not require the use of tumescent anesthesia to numb the local tissue. The “medical glue” remains permanently inside the vein, eliminating the backflow of blood and relieving symptoms of venous insufficiency.
Frequently Asked Questions
A. Varicose veins are dilated, tortuous veins that usually occur in the legs, but may occur in other areas of the body. They are one manifestation of a common condition known as venous insufficiency. The underlying cause of this is the improper function of the one-way valves within the veins (this is unrelated to heart valves). The valvular insufficiency results in high pressure within the veins and is one of the reasons for the dilated and tortuous varicose appearance of some veins. Not all patients with venous insufficiency have varicose veins; however, they will still have the symptoms of high pressure within the veins. Venous insufficiency looks different for each patient. Some will have normal looking legs, or experience leg swelling that is worse at the end of the day, while others will see brown skin discoloration or spider veins at the ankle. This all depends on your lifestyle and the progression of venous insufficiency. If you see or feel any signs of venous insufficiency, it is always encouraged that you have a diagnostic ultrasound.
A. Venous ultrasound is a sophisticated and painless imaging modality that allows your physician to visualize normal and abnormal blood flow in your veins.
A. Venous Insufficiency is a very common condition that affects women more commonly than men. Other risk factors include a history of blood clots, leg trauma, multiple childbirths, obesity and prolonged sitting or standing. It is estimated that 80 million Americans are affected by venous insufficiency. Approximately 40% of women in their 40’s and 50’s are affected. By age 70, approximately 70% of women are affected. Men in their 40’s and 50’s are affected about 15-20% of the time. Generally, venous insufficiency progresses with age.
A. The symptoms vary from person to person but can include the following:
- Leg aching, heaviness and tiredness that is worse at the end of the day
- Leg swelling that is worse at the end of the day
- Leg cramps at night
- Restless legs
- Blood clots
- Eczema type skin rash on lower legs
- Leg ulcers
- Spontaneous bleeding
- Occasionally patients experience a burning or numbness in their legs
A. Laser or radiofrequency techniques may be used to close refluxing veins within the lower extremity under local anesthesia. Both technologies produce thermal energy (heat) to seal veins shut. These procedures are minimally invasive and there is no downtime. Through a 1 mm puncture site, a laser fiber or the radiofrequency catheter is inserted into the vein under ultrasound guidance. Once the laser fiber or radiofrequency device is positioned appropriately within the vein, the vein is surrounded with additional local anesthesia. When turned on, both devices apply heat to the inside of the vein, which instantly seals the vein shut as the device is pulled back.
This procedure takes 20-30 minutes in the office and the patient is left with the 1 mm puncture site that heals very quickly. The patient can return to normal activity immediately and will be advised to take oral anti-inflammatory medicine such as Ibuprofen for 5 to 7 days after the procedure. Both laser and radiofrequency procedures are extremely effective and are often performed in conjunction with micro phlebectomy and/or ultrasound-guided sclerotherapy.
A. According to a study by Clint Hayes, M.D. published in the Journal of Phlebology, almost 40% of patients with restless leg syndrome also have venous insufficiency. When their venous insufficiency was treated, symptoms were improved by 80%. Approximately 30% of the patients had no improvement, however.
A. NO. Some patients may just have leg swelling that is worse at the end of the day. This chronic leg swelling leads to the development of a brown skin color near the ankle over time. This is known as hemosiderin staining.
A. There are many reasons why people develop chronic leg swelling. Venous insufficiency is a very common underlying cause. Untreated this can damage the lymphatic system of the legs which further exacerbates the leg swelling. Ultimately the skin becomes damaged and a condition known as stasis dermatitis occurs. In this situation the skin becomes brown in color and can develop an open ulcer or even become infected. Other things that can lead to chronic leg swelling include blood clots, heart failure and some blood pressure medicines.
A. Venous Insufficiency can be treated but the patient cannot be cured of the genetic propensity to develop reflux. Therefore as the patient ages, it is possible that reflux or venous insufficiency will develop in other veins.