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George M. Hariz, M.D., F.A.C.S.

Varicose and Spider Vein Treatments

Treatment of Varicose and Spider Veins can help prevent complications such as bleeding, clot formation, inflammation, and damage to the skin that can lead to skin ulceration and infection. Treating the veins can also reduce or eliminate the swelling, pain, night cramps, and itching caused by varicose and spider veins. The treatment prevents bleeding in the skin or hemorrhages from ruptured varicose veins. Additionally benefits include: aesthetic improvements, relief from heaviness in the legs, and a sense of well-being.

Following an initial vein screening your physician will be able to determine an individualized treatment plan which may include one or more treatments utilizing the therapies outlined below.

Endovenous Closure (Laser/RF)

Endovenous Closure (Laser/RF) is the primary therapy used for the treatment of varicose veins. This is a minimally invasive, painless, in-office procedure done under local anesthesia. A sterile fiber is inserted into the vein via needle and positioned with ultrasound guidance. The energy delivered will seal the defective vein. The procedure is very safe, usually painless, and requires less than one hour to perform. Endovenous Closure (Laser/RF) uses no incisions, leaves no scars, and is approved by most insurance companies, including Medicare.

Endovenous Closure (Laser/RF) deals with the underlying cause of varicose veins, which is incompetence of the Greater Saphenous Veins. This procedure closes off the vein permanently while leaving it in place. Using targeted energy, endovenous closure seals the vein shut, helping you look and feel better faster. This eliminates the bulging of the vein at its source. The blood from the faulty veins will be diverted to many normal veins in the leg.

Endovenous Closure (Laser/RF) has a 98% success rate with excellent long-term results. Less than 1% of patients develop deep vein thrombosis (DVT) from the laser. In a small number of cases, numbness has been known to occur, and on very rare occasions can be permanent. It is important to understand that not all patients suffering from varicose veins are suitable candidates for endovenous laser treatment. Compared to many more invasive procedures, Endovenous Closure (Laser/RF) is an effective alternative.

Ambulatory Phlebectomy

Also known as Microphlebectomy, Ambulatory Phlebectomy is another treatment commonly used for the treatment of varicose veins. This procedure uses tiny incisions in the skin to remove the varicose vein after which stitches are usually not required. Rare complications include short term skin color change, infection, pain, and tiny red spider veins. This procedure is minimally invasive and performed through a small puncture. It permits the removal of all larger varicose veins as an office procedure performed under local anesthesia.


Sclerotherapy is the primary method of eliminating spider veins and can also be use in conjunction with the other treatments for varicose veins. A solution called a sclerosing agent is injected into the veins. This solution causes irritation to the inner lining of the vein resulting in closure of the vein. The number of treatments needed differs from patient to patient, depending on the extent of the problem. An average of two to four treatments is required in most cases to achieve a 70%-80% clearing. The treatment sessions are done at four to six week intervals to achieve optimal results. Successfully treated veins will disappear after the initial series of recommended treatments are completed. Patients with a history of spider veins may have a tendency to develop new veins, and thus a yearly touch up is recommended.

Conservative Therapy

There are some forms of conservative therapy that can provide relief to a degree. In some cases elevating the legs, wearing graduated compression stockings, or using anti-inflammatory medications such as ibuprofen or aspirin has been shown to help relieve swelling or pain; and in some cases improve circulation in legs affected by varicose veins. It may be suggested or in some cases required by insurance companies to manage the symptoms for as period of time with conservative therapy prior to other venous procedures. Before starting any therapies it is advised to see your physician to see which treatment path would be best for you.

Post Treatment

Many patients experience immediate relief from symptoms and experience little to no post-operative pain. Walking is encouraged after the procedure and minor bruising and soreness can be treated with over-the-counter, non-aspirin, pain medication. We recommend wearing compression stockings on the schedule provided by your physician. A Venous Doppler examination will be conducted at one week, one month and one year thereafter.

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