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Varicose Veins ยป Procedures

Varicose Veins


Management Protocol

Below are listed three of the procedures we currently use for treating

the problems commonly associated with varicose veins.


Laser Ablation


Laser ablation has for the most part replaced the need for surgery of varicose veins.  It is performed primarily in the office under local sedation.   The entire procedure is performed under ultrasound guidance and in a sterile environment.  A small knick (incision) is made, then through a series of steps a catheter is placed inside the designated vein.  The laser fiber is then placed and confirmed under ultrasound guidance to be in the precise location.


Tumescent (saline and lidocaine) is injected into the skin and subcutaneous (fat) tissue to protect the surrounding tissue, compress the vein that is being treated, and completely eliminate the pain when the laser is fired.   The laser is activated for about two to three minutes depending on the length of the vein segment.


Once the treatment is completed and vein is confirmed closed under ultrasound guidance then we will wrap the legs for compression.  Instructions are given for post procedure protocols.  The entire procedure takes about one hour in the office.  If done at the surgical center under monitored and local anesthesia, it will take about three hours (the procedure itself takes less than an hour).


Radiofrequency is another procedure utilized to close the varicose veins and can be performed if the patient requests this modality.  The procedure is very similar to laser ablation with a few limitations that can be explained in consultation.




Sclerotherapy is done after the larger veins have been treated with laser therapy. Ultrasound guided sclerotherapy is done when the veins are deeper and cannot be seen on the skin surfaces.  Often vein such as tributaries, distal saphenous veins, and larger reticular veins are treated by ultrasound guided sclerotherapy.  If the veins are more superficial, reticular or spider veins, they can be injected without ultrasound guidance.  Most superficial veins will need at least three treatments about a month apart to eliminate the vein.  We use Soledechol, which is the only approved agent to treat varicose veins at this point.


Non-thermal Vera Thena