Varicose Veins

What Are Varicose Veins?

Varicose veins are a very common problem, appearing as twisting, bulging, rope-like cords on the legs. They are the result of problems with the valves within the venous system of the leg. All the veins in the leg contain one-way valves that keep blood flowing from the legs up towards the heart. When the valves become faulty, the blood gets accumulated in the vein, making it enlarged and swollen, called varicose veins. The veins become weak and twisted, and the lumps bulge out from just under the surface of the skin. Varicose veins usually occur in the legs but they can also be formed in other parts of the body.

Treatment Of Varicose Veins

There are no medicines that can cure varicose veins. However, venoactive medicines can help in reducing the pain and swelling as well assist in ulcer healing.
Conservative treatment advice

This includes lifestyle changes, including avoidance of standing, active ankle exercises, control of body weight and keeping legs elevated at night. Compression stockings are often used for symptomatic relief


This procedure is suitable for smaller varicose veins or as an additional treatment in which your vascular specialist will inject a chemical directly in the varicose veins to block them.

Endovenous ablation techniques

These minimally invasive procedures have revolutionized the treatment of varicose veins and are currently considered the treatment of choice for a majority of patients. These are non-surgical methods wherein a very small catheter is introduced in the vein under sonography guidance and the vein is fired by laser or radiofrequency energy. The closed vein will eventually be absorbed within the body. Newer advances include radial laser fiber, introduction of mechanical and chemical ablation (MOCA) for non-thermal treatment of varicose veins as well as the use of GLUE.

Advantages Of Endovenous Techniques


Surgical ligation and removal of the veins was earlier considered the gold standard of treatment but its use has been decreasing since the past decade. Surgery may however be considered for patients with very large varicose veins, which are removed using small incisions. Bruising, numbness and swelling often occur after surgery. Another recent advance is the use of phlebectomy hook, in which large varicosities can be removed from small stab skin incisions using special vein hooks.


How are varicose veins treated?

Not all varicose veins require clinical treatment. In mild cases, home treatment may be all you require to ease symptoms and keep the varicose veins from getting worse.

You can:

Exercise to strengthen the muscles and veins of the legs

Wear compression stockings to improve blood flow and limit vein swelling

Prop up your legs to allow the blood to flow out of the legs easier

Avoid long periods of sitting or standing

What are the minimally-invasive treatments?

To treat more serious varicose vein problems, we offer several effective and minimally invasive solutions; endovenous thermal ablation, ambulatory phlebectomy and ultrasound-guided sclerotherapy. After diagnosis, we will discuss options so you can choose the treatment that best suits your needs. Although effective, no varicose vein treatment, whether surgical or minimally invasive, can prevent new varicose veins from developing in the future.

What is Cyanoacrylate (bioadhesive) Glue Treatment?

Cyanoacrylate glue – a special type of “superglue” – is used to seal off the main veins with incompetent valves, which need to be dealt with when treating varicose veins – usually the long (great) saphenous vein on the inner side of the leg.
Cyanoacrylate glue does the same job as closing veins by endothermal ablation (laser or radiofrequency treatments), which seal the vein off by intense heat) or “stripping” in a surgical operation.

What are the Advantages of glue treatment?

Having glue treatment is similar to endothermal ablation (laser, radiofrequency) but there is no need for the multiple injections of anaesthetic fluid which are required for laser or radiofrequency to prevent heat damage to surrounding tissues, and pain.

No compression bandaging or stockings are required over veins that have been glued, unlike after other kinds of treatment, when bandages and/or stockings are commonly advised for several days. Just 24 hours of compression is used to minimise bruising when veins are removed through tiny incisions (phlebectomies) at the time of glue treatment.

Glue may avoid the minor discomfort that can occur after endothermal treatments like laser and it causes less bruising than surgical stripping.

What is endovenous thermal ablation?

Endovenous thermal ablation (EVTA) is an alternative to surgically removing varicose veins. We use ultrasound to guide a small catheter or laser fiber into the vein. The catheter delivers just enough laser or radiowave heat to cause the vein to close, collapse and seal shut, without affecting nearby tissue. The treated vein is absorbed by the body and disappears within a few months. EVTA not only treats your large varicose veins, but also eliminates many smaller unsightly ones. The procedure is generally performed with just a local anesthetic and takes about 40 minutes. You will be able to walk and resume most normal activity immediately after the procedure, wearing compression stockings for a few weeks, and most people return to work the next day.

What is ambulatory phlebectomy?

Ambulatory phlebectomy is minimally invasive surgery to remove smaller varicose veins just under the skin through tiny incisions in the skin, using a special set of tools. Often, the incisions are so small that after a few months, they completely disappear. The procedure is done under conscious sedation and usually takes one to two hours or less, (If you have an extended network of varicose veins, you may need two or three sessions.) Recovery is quick: you can walk and resume most normal activity immediately, just wearing compression stockings for a couple of weeks.

What is ultrasound-guided sclerotherapy?

Ultrasound-guided sclerotherapy treats large networks of veins just below the surface of the skin and is a gentle and highly effective treatment for spider veins. Using ultrasound, we guide a small needle into the vein and inject a fluid that scars and closes the vein. Within a few weeks, treated varicose veins fade away. While more than one treatment may sometimes be required to fully treat the problem areas, sclerotherapy can be very effective at improving the appearance of your legs.

Medical Treatment


Varicose veins can be treated surgically where the size is large and done under general Anesthetic .If its small then Laser treatments are effective. As follows :
Ligation and stripping

Two incisions are made: one near the patient’s groin at the top of the target vein, and the other farther down the leg, either at the ankle or knee. The top of the vein is tied up and sealed. A thin, flexible wire is threaded through the bottom of the vein and then pulled out, taking the vein with it.


A chemical is injected into small and medium sized varicose vein and a most common treatment for Varicose vein .This scars the vein and block and other veins take over to carry blood

Radiofrequency ablation

A doctor do a small incision either above or below the knee and put a thread with catheter into the vein. A probe is inseted into the catheter and starts emiting Radiofrequency energy which heats up the vein and destroy the walls of Varicose vein. This technique used to be done on Large Varicose Veins

Endovenous laser treatment

A doctor put a catheter into the patient’s vein through which a laser is transmitted to the position at the target vein gradually burning and sealing all of it . This leads to sealing of Vein permanently .

Transilluminated powered phlebectomy

A small incision is done under the skin to pass an endoscopic transilluminator to illuminate the target vein and then cut and remove the target vein through the incision

Dr Ashutosh is the Ist M. Ch Vascular Surgery Qualified doctor practicing in Uttar Pradesh. With the experience of 6+ years, Dr. Ashutosh is the best vascular surgeon in Lucknow

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