MultiCare Health System

Varicose Veins

What are varicose veins and what causes them?
Varicose veins are diseased blood vessels that have become permanently dilated (enlarged), and can no longer efficiently carry blood back to the heart. There are quite a few causes including heredity, pregnancy, estrogen medications, prolonged standing or sitting, sedentary lifestyle and injury to the legs.

Can varicose veins affect my health in a negative way?
Yes, left untreated, varicose veins can cause pain, swelling, inflammation, skin ulcers and blood clots.

What are spider veins?
Unsightly and embarrassing spider veins are the tiny relatives of varicose veins. Like varicose veins, spider veins are also caused by heredity, pregnancy, estrogen medications, prolonged standing or sitting, sedentary lifestyle, and injury to the legs. But unlike varicose veins, spider veins are not dangerous and are simply enlarged venules (tiny veins).

Is an evaluation necessary?
When traveling downward to the legs, blood flows easily through the arteries. But when blood flows back up the legs to the heart through the veins, gravity makes this job more difficult. Fortunately, our veins are equipped with one-way valves that fight gravity and direct blood toward the heart. When these valves are healthy, they open and close normally providing blood with a foothold to climb up the leg. When these valves weaken, blood will flow back down the leg. This backwards flow of blood is called “venous reflux."

Diseased veins—from the largest varicose vein to the smallest spider vein—are usually caused by reflux through weakened valves. Over time, the pressure from this reflux causes the veins on the skin surface to overstretch and bulge. In order for your veins to be treated properly, the exact location of the venous reflux first needs to be identified. This is accomplished by an advanced ultrasound imaging test called a Venous Duplex Scan, which creates a “map” of the veins by pinpointing the location of the damaged valves. This important test is painless, non-invasive, takes about one hour to perform, and is covered by Medicare and most health insurance plans.

What is Endovenous Laser Treatment?
For those suffering from varicose and spider veins, the problem often originates in the greater saphenous vein—the main blood vessel that runs from the ankle to the groin. Tributary veins empty blood into the saphenous vein, which carries blood to the deep veins and ultimately back to the heart. When the valves of the saphenous vein stop functioning, blood backups into the tributary veins causing them to become varicose.

There's now a safe, comfortable and cost-effective treatment called Endovenous Laser Treatment. With this new procedure, under ultrasound guidance, a slender catheter is inserted into the saphenous vein at the knee through a tiny needle stick in the skin. A fiber-optic laser is then inserted into the diseased vein. The laser energy collapses the vein causing it to contract and close, allowing blood to be rerouted to healthy veins. There is virtually no discomfort afterwards and no downtime.

What is Sclerotherapy?
Sclerotherapy eliminates unsightly and embarrassing spider veins of the legs. Using an extremely fine and nearly painless needle, the treatment involves injecting a small amount of a sclerosing solution into the affected veins. It usually takes three to five sessions to provide the most effective results. Treated veins gradually disappear over three to six months. Because blood flow is shifted to healthy veins, sclerotherapy can improve the circulation in the legs. And despite all the advancements in laser technology, sclerotherapy still remains the overwhelming choice of doctors and patients for spider vein treatment.

What is Transilluminated Sclerotherapy™?
Spider veins can be caused by pressure from blood leaking from connecting reticular veins (superficial blue-green veins). In order to obtain better and longer-lasting results, it is important to locate and treat these superficial feeder veins. Dr. Kim uses an advanced device called the Veinlite to locate these often hard-to-find veins. The Veinlite transilluminates the skin making it translucent so the reticular veins can be easily seen. Sclerotherapy is then used to eliminate these reticular veins, thereby making the treatment of the overlying spider veins more effective.

What is Ultrasound-Guided Sclerotherapy?
This advanced technique is used to eliminate non-saphenous varicose veins that usually require surgery. The key to the success of this treatment comes from using Duplex ultrasound to first locate the leaking deeper veins that are feeding into and causing the surface spider and varicose veins. Duplex ultrasound then helps to accurately guide injections of a strong sclerosing medication into these diseased veins causing them to safely collapse and close.

Don’t I need these veins? What happens to my circulation if I get rid of them?
Varicose veins and spider veins are part of the superficial vein system. This system returns only five to ten percent of the blood flow back to the heart. Varicose veins and spider veins are diseased and defective veins that are no longer working. Getting rid of them is not harmful. In fact, when they are eliminated, the legs usually feel lighter and more energetic due to the improved circulation. This is because blood flow has been rerouted to stronger and healthier veins.

Does it hurt and are there side effects?
Our skill and experience make the treatments virtually pain-free. We use FDA-approved medications. Side effects are possible with any procedure or medication but, compared to traditional hospital surgery for veins, serious side effects are rare with our advanced techniques.

Do the veins ever come back?
Patients can enjoy healthier, more attractive, pain-free legs. The treated veins do not come back. However, varicose vein disease can sometimes be a chronic condition, no treatment—not even surgery—can stop new veins from forming in the future. Because the initial treatment was so thorough, any new veins tend to be less severe and are more easily dealt with. Simple touch-up treatment can help eliminate problem veins.

How do I get started?
Call our office at 253-876-7997 to schedule an appointment.