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​Vein Care Services

Varicose Veins and Venous Inefficiency

Learn more about varicose veins and venous inefficiency, two of the most common types of venous disease.

Varicose Veins

Varicose veins occur when a valve or valves become damaged and do not function properly, allowing blood to flow backward, toward the feet. Blood then pools in surface veins which become large, dilated and tortuous, or varicose veins. If there is enough blood pooling in these varicose veins, some of it can be pushed into the surrounding tissue. The tissue can become so saturated with un-oxygenated blood that it cannot accept oxygenated blood. This causes tissue breakdown, also known as ulcers.

Deep veins are the major veins in the legs which run deep in the middle of the leg with an artery. These carry approximately 95 percent of the blood flow out of the leg.

Superficial veins run closer to the skin and carry approximately 5 percent of the blood flow. The two main superficial veins in the legs are the greater saphenous and lesser saphenous veins. Problems in these two veins are the most common cause of varicose veins.

Varicose veins can result in a condition called venous inefficiency, where the flow of blood through the veins is inadequate, causing blood to pool in the legs.

Three Main Causes of Venous Insufficiency

  • Blockage in a vein (blood clot)
  • Inactive "muscle pump" in the legs
  • Damage to the valves within the veins

Risk Factors for Venous Disease

For women: pregnancy, childbirth, genetics, obesity, inactivity, aging and injury.
For men: genetics, injury, obesity, inactivity and aging.

Stasis Changes

Skin changes can become evident in someone with venous insufficiency. Stasis refers to the blood not moving. Stasis changes include brownish discoloration and skin changes in the lower leg and ulceration. The ulcers can become infected, leading to an infection in the surrounding tissue, called cellulitis.


An ultrasound study that specifically evaluates how blood is flowing in the leg veins and tests the integrity of the valves is done to determine the best treatment options. This test is non-invasive, with no injections or dyes, and is done at our outpatient laboratory. It can take up to 90 minutes.

Treatment Options

The various treatments we offer all serve the same purpose:

  • Eliminate the problem veins and the source of the problem
  • Help prevent future venous stasis problems
  • Help you and your legs feel better, so that you can lead a healthy, active lifestyle

Sclerotherapy involves injecting a medication into the smaller spider veins using a tiny needle. This medication irritates the inner wall of the spider veins, causing them to collapse, and eventually disappear. This procedure takes about 30 minutes and can be done in several stages. Sclerotherapy can also be done with ultrasound guidance to improve treatment of larger veins. Sclerotherapy remains a superior option for treatment of spider veins.

Endovenous Laser Ablation, or "laser," is a minimally invasive procedure that uses a small wire with a laser tip to close the vein from the inside. The procedure is done in the office with a local anesthetic, and takes only about an hour. Results are excellent and there is no lengthy recovery time; therefore, you should start to see results right away.

VNUS (Closure) uses a small wire with a tip that delivers radio-frequency energy to the vein wall, sealing it from the inside. This procedure can be done in the office or operating room in conjunction with other operative vein procedures. The VNUS itself is minimally invasive with a very short recovery period.

Ambulatory Phlebectomy involves removing varicose veins through a number of small incisions. This is usually done in conjunction with the laser procedure. This combination allows treatment and elimination of the cause of the varicose veins as well as the varicose veins themselves.

Trivex is a surgical technique for varicose vein removal. Using this technique, a larger number of varicose veins can be removed, with a smaller number of incisions than with standard Ambulatory Phlebectomy.

Vein Stripping is an outpatient surgical technique to remove varicose veins which is performed in the hospital. Most patients require general or regional anesthesia.

This information is for educational purposes only and is not a substitute for medical evaluation. We recommend you discuss health issues with a physician.

Call us today for more information at 509-928-6454 or email us at [email protected].