Apr 29

Varicose Veins: Treatment Has Become Easier

by Kelsey Dayton

Treating varicose veins used to be brutal and barbaric. It was called vein stripping and it meant a stay in the hospital to control the pain, said Tonda Richards with Dr. Timothy Richards’ office at Rocky Mountain Surgical Solutions in Missoula.

The procedure today takes only minutes and uses only localized anesthetic, Tonda Richards said. A fine wire is threaded into the vein and then a laser light emitted from the wire slowly draws back out the vein. It heats the inside of the vein and causes it to collapse. The body absorbs the vein tissue. If any pieces are left they can either be removed by pulling the tiny pieces out or injecting it with a fluid that causes the rest of the vein to disappear.

By the time a varicose vein presents itself, the body has already compensated and isn’t using that vein, so removing it doesn’t cause any problems, Richards said.

Timothy Richards brought the technique to western Montana about 10 years ago, said Tonda Richards. Now it’s become a standard treatment for varicose veins. The current procedure is done in the office instead of a hospital. Patients are given a light sedative to keep them relaxed instead of full anesthesia. They receive a topical anesthetic so they don’t feel the skin punctures, but they are awake and cognizant the 45 minutes the procedure could take, Richards said. Then they head home. In about six weeks the body absorbs the vein, but some patients feel immediate relief.

Varicose veins are the result of a valve in the veins, which allows blood to flow throughout the body failing. The blood begins to pool causing the veins to expand to the ropey lumps people see in their legs Richards said. It’s not just that people don’t like how they look. They become painful.

“This is not a cosmetic situation,” Richards said of treatment. “(Varicose veins) are a lifestyle altering problem.”

Everyone experience pain differently but it can be a burning or aching sensation. Legs can feel tired and ache. Ankles and feet can swell and itch. They can cause skin ulcers.

“They just hurt,” Richards said.

While varicose veins are more often seen in older adults, the condition can be hereditary and impact even teenagers.

Northwest Montana Surgical Practices in Kalispell has treated patients as young as 16 years old up to a 92-year-old woman.

“And she did just fantastic,” said Jessica Lee, medical assistant. At Northwest Montana Surgical Practices in Kalispell, varicose veins are treated using frequency ablation where a heated catheter goes down the main truck of the vein system feeding all the veins and then a micro phlebotomy removes the excess vein, Lee said. Ultrasound guides the procedure allowing the doctors to see the veins and the catheter. Like the procedure at Rocky Mountain Surgical Center, it only requires a sedative and small increments of topical anesthesia throughout the procedure. It replaced vein stripping not just because it’s more efficient but because it’s so much easier on patients, Lee said.

Varicose veins are incredibly common, she said. At Northwest Montana Surgical Practices, it’s only a small part of what the nine-physician team treats. Two of the doctors are vascular surgeons and treat varicose veins. But it’s a common enough condition that some clinics are able to specialize in just varicose veins Lee said.

Heredity is one thing that can increase chances of developing varicose veins but there are other lifestyle factors that can influence the likelihood, Richards said. They are common in those who have jobs that involve a lot of standing, like a waitress and in those who are overweight. They also can occur in pregnant women.

They usually begin occurring when people are in the 40s or 50 but most people don’t deal with them until they are in the 60s, 70s, or 80s, Richards said. The longer people avoid treating the veins the worse they can get. It’s better to get them treated early, she said. Especially with the low impact procedures that can remove the veins.

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