What are varicose veins?

A varicose vein is a failed vein, the contents of which are stagnant or refluxing. Either way, this blood is out of circulation. The function of your veins is to channel blood back to the heart. The larger veins have valves which direct the flow of blood. When any of these valves fail, blood can accumulate under pressure, engorging and distorting the veins in your leg. Varicose veins appear as either bulging and rope-like, or small and thread-like. They can result in aching, tired and swollen legs; create a burning, throbbing, or itching sensation; and cause muscle cramps and a general restlessness in your legs. Varicose veins are a vascular disorder requiring treatment for medical reasons.

What causes varicose veins?

One clear factor is heredity. Most patients who suffer from varicose veins have a family history of the condition. Another factor is hormonal changes that specifically affect women. Pregnancy or birth control pills further increase your chances of developing vein disorders. Other contributing factors include prolonged standing, being overweight and/or trauma to the leg.

What are spider veins?

Spider veins appear to be hormonally induced and are associated with pregnancy and menstruation. Although spider veins are not usually symptomatic, the accompanying reticular veins, found deeper in the skin, often cause discomfort. Reticular veins are also referred to as “feeder” veins. Many women have a combination of both varicose and spider veins. While they may seek treatment for cosmetic improvement, many female patients are in fact looking for relief from pain. Back to Top

Does vein disease affect women and men equally?

Women account for approximately 85-90% of varicose vein cases that are treated each year, mainly because of the unique additional risk factors for females, including estrogen levels and pregnancy. Women are particularly afflicted with reticular veins. These light blue veins usually appear in a lattice framework, giving a marbled appearance to the skin. They are harmless looking veins, but may be symptomatic. Reticular veins are associated with Restless Leg Syndrome (RLS) in women. When these veins are effectively treated, the discomfort may diminish. 

In men, the pathophysiology is similar, but instead of reticular veins, the culprits are multiple, small-branching varices and “high pressured small vein disease” (hpsvd). The varices, unfortunately, are often mistaken for “cosmetic” telangiectasia (spider veins). The difference is important because the treatment is different. The association between RLS and vein disease has been overlooked, most likely because of the innocent appearance of the reticular veins. Back to Top

What should I look for in a physician?

Varicose vein disease can be very complex and each patient is unique. Therefore, it’s important to find a physician experienced in treating the entire spectrum of vein disease from spider veins, to large ropey varicose veins to leg ulcers. At Pacific Northwest Vein Center, our physicians are board certified general surgeons.  They are experience in treating all aspect of venous disease. They are dedicated to providing individualized treatment plans for each patient that meet your individual needs. They will thoroughly evaluate your health and medical condition, discuss the details of your situation so you feel comfortable and present you with a course of action that works best for you. We recognize that each person and their treatment needs are different. Back to Top

What is the difference between endovenous lasers and surface lasers?

An endovenous laser is used to treat large veins beneath the surface of the skin. Surface lasers treat the lighter, more delicate spider veins that appear close to the skin's surface. Back to Top

What is sclerotherapy?

Sclerotherapy is a microinjection procedure that requires no pain medication or surgery. Abnormal veins are destroyed by injecting a solution called a sclerosant, which irritates the vein wall. It is not simply injecting the sclerosant, but paying attention to the volume, concentration and “exposure time” that makes the difference between success and failure. Back to Top

How does the sclerosant work exactly?

The sclerosant we use is an FDA-approved medication, which intentionally causes injury to the inner vein wall. This injury occurs in a controlled manner, depending on the volume and concentration of the medication used in each site. The medication is inactivated quickly by dilutional effect and interaction with structural components of the vein wall, making the effect localized. The initial injury to the vein wall results in a healing process which causes the vein to literally heal shut over time. This results in shrinkage of the vein, and eventually, complete obliteration of the target vein. Back to Top

Does sclerotherapy cause any damage or side effects?

As with all medical procedures, side effects and complications are possible. This is why it is important to seek treatment from an experienced physician. Allergic reactions are extremely rare and are mild when they do occur. They are somewhat more likely to occur when treating larger varicose veins because the medicine is more concentrated and used in greater volumes. You may develop itching dermatitis (inflammation of the skin) and a mild, temporary increase in pigmentation (staining of the skin) if you have any of the following: darker skin, overly sensitive skin, very dense spider veins, or if your skin is already damaged because your veins have deteriorated too much. Back to Top

What is Endovenous Laser Treatment (ELT)?

Endovenous Laser Treatment (ELT) was FDA-approved in 2002, and extensively reviewed by the physicians of The Pacific Northwest Vein Center to be certain it was safe and effective before introducing it to our patients. ELT is a quick, minimally invasive laser treatment that requires no hospitalization and no complicated surgery. The entire procedure, start to finish, takes about one hour and causes minimal to no pain. Performed under ultrasound guidance, ELT uses laser energy to treat the underlying cause of varicose veins by closing off the vein to any future blood flow. Your body then naturally uses other healthy veins to return blood from the heart. Back to Top

Does Endovenous Laser Treatment (ELT) cause any damage or side effects?

Major complications resulting from ELT are very rare. Various levels of discomfort can occur as well as some bruising, bleeding, numbness in the leg and rarely skin burns. Very rarely (less than 1%), blood clots in the deep veins (Deep Vein Thrombosis) may occur.  People with a history of blood clots in the deep veins (Deep Vein Thrombosis) and inflammation in a small vein near the surface of the skin (thrombophlebitis) may be at greater risk for problems related to varicose vein surgery. Back to Top

How will my blood circulate if I eliminate my varicose veins?

Varicose veins are a burden on your circulation. Because the blood inside them is refluxing (going backwards), correcting the flow can only improve your circulation. In treating varicose veins, we eliminate only the bad veins and safeguard the healthy veins for normal circulation. Ultrasound helps to ensure that treatment is highly selective. Back to Top

Just how serious a problem is recurrence – will they come back?

If you have a chronic vein problem, your chances of recurrence are affected by several factors, the most important of which is the thoroughness of your treatment. Unfortunately, many patients quit treatment too early – usually, once they believe their legs look “good enough.” In fact, remnants of the veins left in the leg can quickly grow into more veins. Back to Top

Is it okay to postpone treatment?

As you probably know, postponing any type of treatment can have its drawbacks. Varicose vein disease is a progressive disease that, if left untreated, will only get worse. When making a decision about your varicose veins, keep in mind that the sooner you get your veins treated, the easier they are to treat and control. Back to Top

Will I need to be hospitalized or take time off from work?

Your entire course of treatment will be at our center which will save you time and money, avoiding a hospital stay. Usually, you can resume most activities shortly after each session. Prior to your treatment, you will receive detailed post operative instructions. Back to Top

How are the doctors at Pacific Northwest Vein Center trained?

All our physicians are board certified general surgeons who have extensive experience in all areas of venous disease. Back to Top

What happens during a physician consultation?

When you come to us, you will complete a patient medical history form that will help the surgeons understand your medical history and current concerns. It is possible that they will require some diagnostic studies, such as an ultra sound to help diagnose the extent of your venous disease.  Once your doctor understands your medical needs, they will discuss and develop a plan of care specific to you. You will meet with our support staff that will assist you with insurance questions, financing and scheduling of your treatment. Back to Top

Will I have to undergo any testing before treatment?

As mentioned before our surgeons may recommend diagnostic tests, including Arterial Doppler and continuous Wave Doppler, Duplex Ultrasound and Light Reflection Rheography. This state-of-the-art technology provides painless and non-invasive testing, and is performed in the physician's office when possible. Again, this will help us diagnosis and treatment your medical condition. Back to Top

Will my insurance pay for this?

In many cases, depending on your coverage and benefits, your insurance company will pay for the procedure. Many insurance companies first require 3-6 months of conservative therapy (use of compression stockings, weight loss, exercise and anti-inflammatory treatment). If the conservative method does not work for you, then your insurance company may pay for surgical therapy.You should also make sure to have a referral from your family doctor for your initial consultation, as it will allow us to bill your insurance for this visit. Back to Top

How long does the procedure take?

That will depend on your individual treatment plan, but a general guideline is about an hour.
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What if I just want treatment for some small spider veins?

We have special packages available for spider treatment only. Since you are still having a medical procedure, we do require a consultation prior to start of treatment with our surgeon. We do not bill insurance companies for this type of treatment since it is considered cosmetic in nature. On average, you will need about 3 sessions. Back to Top

If I am pregnant will you treat my veins?

No. Most pregnancy related varicose veins will resolve on their own within 6- 8 weeks after you deliver. We would suggest waiting until you are two months post-partum.  If you still have venous insufficiency, make an appointment to see one of our surgeons. Back to Top

What is ICAVL Accreditation?

The process begins with a comprehensive self-evaluation by laboratory staff. Completion of the application for accreditation requires information on all aspects of laboratory operation as well as the submission of actual case studies for review. After a laboratory submits the application to the Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL), the application undergoes a confidential peer-review by the ICAVL's trained reviewers, including physicians, technologists and sonographers, before a final decision is made by the Board of Directors.

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