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September 9, 2009 > Women's Center Evening Lecture Series: Advances in Treatment for Varicose Veins

Women's Center Evening Lecture Series: Advances in Treatment for Varicose Veins

When most people think of varicose veins, they envision the enlarged blue or purplish veins you may see bulging out of someone's leg. While it's true that varicose veins do occur most commonly in the legs, any vein may become varicose - meaning swollen and twisted. For example, another fairly common site for varicose veins in women is in the pelvis (the lower abdomen and groin).

"When the ovarian veins that drain the ovaries and part of the uterus of blood fail to work properly, blood can pool up in the pelvis, causing pelvic pain that is sometimes known as pelvic congestion syndrome," explains Dr. Bruce Lin, an interventional radiologist at Washington Hospital. "Fortunately, modern treatments for varicose veins in the pelvis and the legs are highly successful."

To help women learn more about the causes and treatment of varicose veins in the legs and pelvis, Dr. Lin will give a presentation at the Washington Women's Center located at 2500 Mowry Avenue in Fremont on Tuesday, September 15 from 7 to 8 p.m. The session is part of the Washington Women's Center's Evening Lecture Series for Women.

"In veins that work properly, the blood flows only in one direction and is prevented from flowing backward by valves," Dr. Lin notes. "When the valves are defective, or damaged by blood clots or trauma, the blood starts to flow backward and engorge the veins. As the blood pools in the veins, the walls of the veins stretch, and the veins grow larger and swollen, often causing pain and discomfort."

Risk Factors

A number of other risk factors may contribute to varicose veins. "Heredity plays a role, so if you have family members with varicose veins, your risk increases," says Dr. Lin. "Age, of course, is another factor, since aging naturally causes wear and tear on the valves in the veins. Being overweight or obese may contribute to the problem, since the extra weight puts more pressure on your veins. In addition, people who have to stand or sit in the same position for long periods of time while they work may be more prone to developing varicose veins, so it's good to move around and change positions frequently."

Laser Treatments for Varicose Veins

Recent treatments for varicose veins in the legs have improved dramatically, too. Getting rid of these unsightly and often painful veins traditionally involved surgery to "strip" the veins - a painful procedure that required general anesthesia and a lengthy recovery period. Now, however, most physicians treat varicose veins with two newer technologies - radio frequency and lasers.

"I believe that laser treatments work better at shutting down varicose veins, and that is what we use here at Washington Hospital," Dr. Lin says. "Specifically, we use the EndoVenous Laser Treatment, called EVLT. This minimally invasive, non-surgical procedure uses laser technology to seal the varicose vein safely and effectively."

Varicose veins in the leg generally involve the "greater saphenous vein" in the leg, which is the main vein just underneath the skin that goes from the groin to the ankle. This vein connects to veins deep below the surface at the skin, known as the deep vein system. When the saphenous vein is collapsed in this laser procedure, the deep veins take over its function.

"We insert a miniature probe with a laser into the incompetent saphenous vein through a freckle-sized nick in the groin," Dr. Lin explains. "Then we use ultrasound to guide the laser into the incompetent vein and inject a local anesthetic. The vein is then compressed on the fiber tip of the laser. As we guide the laser back out slowly inside the vein, it seals shut by the laser energy. The blood flow naturally diverts to the veins that are deeper below the skin."

The relief from the pain of varicose veins with this procedure is very quick, and there is a significant change in the appearance of formerly ugly varicose veins, Dr. Lin claims. The entire procedure, which is generally covered by insurance since varicose veins can be debilitating, takes about 30 to 45 minutes. It does not require general anesthesia, and the patient is able to walk out of the office and recover quickly using only over-the-counter pain relievers to minimize minor discomfort. And, because there is no incision as there would be in surgery, there is no post-operative scarring.

"We usually ask our patients to wear compression stockings for a few weeks after the procedure to minimize bruising and swelling and to help ensure that the vein doesn't re-open, Dr. Lin adds."

Almost any patient with varicose veins can gain relief with the EVLT procedure from the pain, swelling and leg heaviness that varicose veins can cause. One group of people who should not have the EVLT procedure includes those who have an incompetent deep venous system.

"In a very few cases, we may also need to perform an outpatient 'ambulatory phlebectomy' when side branches of the saphenous vein are very large with trapped pools of blood that form knots," he adds. "In those cases, we insert a very small blade and hook through an opening the size of a pen tip into the vein and twist it out. This procedure is also minimally invasive, however, and is much less complicated and painful than surgical stripping."

To learn more about new treatment options for varicose veins, attend the upcoming lecture on Tuesday, September 15 from 7 to 8 p.m. at the Washington Women's Center Conference Room located at 2500 Mowry Avenue (Washington West) Suite 145, in Fremont. To register to attend, visit or call (800) 963-7070.

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