Dr. Gabriel Lasala, MD, FACC was the first cardiovascular interventional specialist to perform non-surgical treatment of varicose veins with laser and sclerotherapy on the Northshore. Venous therapy is performed at the Harrison St. Clinic in Covington by Dr. Lasala.
Millions of people in the United States have varicose veins. Some seek treatment for cosmetic improvement. Some seek relief from pain, swelling and other medical problems. Venous insufficiency is a progressive disease that can lead to serious debilitating health issues later in life if left untreated.
Arteries take nutrient rich blood from the heart to the cells, muscles and organs. Through the veins, the blood, laden with waste products, is transported to the detoxification centers of the body and back to the heart.
The blood in the legs must flow uphill. The venous circulation depends on calf and thigh muscle contraction to pump blood. This is why walking helps circulation. Leg veins have small valves that prevent blood from returning down the leg under gravity.
Veins can be superficial or deep. There are two main superficial or surface veins the greater saphenous vein in the groin and the short saphenous vein behind the knee. They have thin walls and one-way valves, and are surrounded by soft tissue. The deep veins course through the muscle. These carry more than 80% of the blood flow from the legs. The perforators connect the superficial to the deep veins in the calf and the thigh.
When the valves don't function efficiently, blood accumulates or “refluxes” down the leg. This accumulation increases the pressure in the veins causing congestion and the veins become progressively enlarged with a blue ropey like appearance. The increased pressure causes symptoms as pain, heaviness, cramping, and restlessness in the leg. Sever varicose veins can compromise the nutrition of the skin and lead to eczema, inflammation, or even ulceration of the legs.
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Heredity is the number one contributing factor causing varicose and spider veins. Hormonal factors including puberty, pregnancy, menopause, the use of birth control pills, estrogen and progesterone affect the disease. Other predisposing factors include aging, standing occupations, obesity, and leg injury.
When the diseased vein is obliterated or sealed shut, blood is forced through competent, stronger veins in the deep system. Relieving the vessel of this extra pressure will relieve the symptoms of discomfort.
There are two general treatment options: conservative measures, such as compression stockings and corrective measures such as sclerotherapy, laser treatments, and surgery.
This is an in-office treatment. Using ultrasound guidance, the doctor injects a medication that irritates the lining of the vein causing it to collapse and seal shut. Depending on the type and size of the vein, you may need from one to complete the treatment. Normal activities may be resumed. Compression stockings are applied and must be worn for several days up to several weeks after the treatment.
This is an in office treatment. A small laser fiber is inserted into the damaged vein by way of a needle stick. Local anesthetic called tumenescent is administered along the length of the vein to be treated. This creates insulation around the vein. Pulses of laser light are delivered inside the vein, which causes the vein to collapse and seal shut. Compression stockings are applied and worn for several weeks after treatment. Normal activities may be resumed.
This is a hospital procedure. Surgical options include ligation (tying off a vein) or stripping (removal of a long segment of a vein by pulling it out with a special instrument). Local or general anesthesia is used. Most patients are discharged the same day.
The type of treatment your physician recommends will be based on careful assessment of your symptoms and medical conditions and finding of the ultrasound scan that demonstrate the location and size of the diseased vein.
The results from any of the above treatments are very good. However, several points must be stressed:
- Treatment is not effective in every patient. Some get less than perfect results. Perfection cannot be guaranteed
- Treatment is rarely completed in one or even two sessions
- Recovery from treatment is not immediate. There is usually persistent tenderness or lumpiness of the vein that can last for weeks
- Pigmentation is a source of real concern. Occasionally it may persist. It may take up to two years to fade.
Serious complications are very rare but nonetheless can occur and lead to problems. However, varicose veins are left untreated can lead to serious problems such as phlebitis, skin ulceration, permanent nerve damage in the feet and legs and the formation of blood clots in the legs.
Tchefuncte Cardiovascular Associates is leading the way in premier cardiovascular care in Southeast Louisiana. We are a professional team of specialists who have mastered vital medical procedures. With a focus on harnessing the latest technological advances, TCA passionately treats patients with expert diagnosis and treatment. We make the process with dealing with any procedure less stressful and more comfortable for you and your loved ones.
EVLT® Treatment for Varicose Veins