Varicose Vein Treatment Boise, Idaho
Dr. Williams has many years of experience in treating varicose vein disease. He was the Director of the Saint Alphonsus Vein Clinic from 2012 to 2018, he was the Director of the Saltzer Vein Clinic from 2004 until 2012. He continues to do vein work in his own private practice but now most procedures are performed in the operating room instead of a clinic. Dr. Williams has been performing endovenous ablation procedures since 2004.
We provide both surgical as well as catheter based treatments. Most patients with venous insufficiency do have symptoms of varicose veins and many of those people realize that the pain in their legs is from varicose veins. However, some of our patients have pain in their legs or restless legs at night and suffer from venous insufficiency, but do not have large, bulging varicose veins that can be easily seen. We usually see a patient initially in consultation for a formal examination and find out from the patient exactly where their symptoms are located as well as the character of the symptoms. In order to evaluate the patient's legs for venous insufficiency we need to obtain a specialized ultrasound. If the ultrasound shows venous insufficiency, then the patient's varicose vein treatment is usually covered by insurance and / or Medicare.
Most often the treatment of venous insufficiency involves endovenous ablation. We use a very small catheter, the size of a spaghetti noodle, which goes inside the vein and welds it shut from the inside. This treatment usually takes one hour to treat one leg and is associated with decreased or complete resolution of vein pain and a significant decrease in visible varicose veins.
Identifying & Treating Varicose Veins
Varicose veins are enlarged veins that may have a gnarled appearance at the skin surface. They often appear dark blue or purple in color and may be visible through the skin. Varicose veins typically occur in the legs and feet due to gravity from standing and walking. The condition is common in older individuals and my develop in women more often than men due to pregnancy. Although varicose veins are unsightly, small ones are not usually harmful. However, they may cause significant pain and discomfort. In some cases, they may lead to other serious conditions and circulatory problems including clots and pooling of oxygen depleted, iron rich blood containing toxins.
Varicose Vein Diagnosis
The provider will first perform a physical examination of your legs in order to pursue a diagnosis. Signs of swelling, skin color changes, ulcerations or other breaks in the skin, presence of varicosities and other venous abnormalities help establish the different diagnoses which could be causing the problem. You will be asked to describe any pain or discomfort you are experiencing. Your physician may recommend diagnostic tests such as a Duplex ultrasound to get a better look at the veins and to see if there is any leakage from the valves, blockage, or abnormal flow. A handheld probe will be passed over the affected area which examines with sound waves and without radiation or pain. A computer will convert the sound waves into a picture that can display the flow of blood in the arteries and veins. This will evaluate for venous insufficiency where vein valves are found to be incompetent and allow the blood to fall back down the legs with gravity. This is the problem that leads to varicose veins.
Varicose Vein Treatment
Treatment for mild to moderate varicose veins usually includes self-care to keep the condition from worsening. Elevating your legs for at least 15minutes three times a day will help to take pressure off the veins. Your doctor may recommend wearing compression stockings. These stockings put pressure on the legs which helps the blood to move more efficiently through the veins back towards the heart. This results in better circulation and may relieve many of the symptoms.
Treatment for More Serious Varicose Veins
In some instances, varicose veins may require further treatment. These treatments are known as interventions. They range from small procedures for tiny spider veins to treatments performed through catheters placed inside the larger veins.
Small treatments may include sclerotherapy which is a procedure that involves injecting a solution into small veins which closes them and allows them to fade. The same procedure can now be done with a foam solution to close larger veins. External beam laser procedures are also done for small veins. These modalities are usually deemed cosmetic by medicare and insurance companies and patients usually pay out of pocket.
Even if you are considering cosmetic treatment for small veins, it is a good idea to first get the duplex ultrasound done so that venous insufficiency can be ruled out as the cause of varicose or spider veins. If a patient does have venous insufficiency proven by ultrasound then medicare and insurance companies will usually pay for procedures to correct that condition.
Endovenous ablation is a safe and very effective alternative for closing varicose veins. In this procedure, heat from an electrode inside the catheter is focused on the affected veins. This usually takes less than an hour. It is important to understand that not everyone is a candidate for this procedure, so speak to your physician to see if it is an option for you.
Ligation and phlebectomy procedures are surgical procedures used to treat large veins. These involve tying off the vein and/or removing it through tiny surgical incisions. This is still sometimes required for some patients.
Preparing for Your Varicose Vein Appointment
There are no special preparations to make before seeing your doctor. However, you should have a list of your symptoms, any medications you may be taking and a history of family illnesses. Blood thinners are usually stopped for a few days to prevent bleeding during or after the procedure.
Lifestyle Changes After Varicose Vein Treatment
If your varicose veins are mild to moderate your physician may suggest some lifestyle changes to prevent the condition from worsening. Avoid sitting or standing for long periods of time. Avoid crossing your legs since this position can affect circulation. Elevate your legs periodically to increase circulation. Avoid wearing high-heeled shoes when possible. Walking increases blood circulation so speak to your physician about developing a regular exercise routine that is appropriate for you.
What to Expect After Varicose Vein Treatment
Patients who require endovenous ablation or phlebectomy usually have their treatment and return to work in 3 days. We follow up with the patient to ensure the treatment was a success and the patient was satisfied with the outcome.