FREQUENTLY ASKED VEIN QUESTIONS

The most significant risk factor is a family history of varicose veins.
Other risk factors include pregnancies, obesity, spending a lot of time on your feet, and previous deep vein blood clots (DVT).

Because of genetic factors, vein disease and reflux cannot be prevented. You can take certain measures to control the symptoms of vein disease, including:

• Compression stockings
• Exercise
• Maintain a healthy body weight
• Avoid prolonged standing or sitting
• Periodically elevate your legs above your heart

Symptoms can range widely, including:

• spider veins
• Varicose Veins
• Painful legs, cramping in your legs
• Tired or fatigued legs or restlegs at night
• Heaviness and swelling
• Edema
• change of skin colour, including reddening or brown pigmentation of skin especially around your ankles
• Leg ulcers and sores

Individual veins can be successfully treated; however, vein disease cannot be permanently cured.

Treated veins will no longer be varicose, but vein disease is a life-long condition, and over time, new varicose veins form.

After a period of time, additional maintenance procedures will be required as new varicose veins develop.

The risk of new veins forming is largely genetic and variable between patients. Some patients require regular repeat treatments, some patients do not require any further treatments.

No. We use the newest minimally invasive treatments available.

Most of the treatments we offer can be performed in our office.

Most patients are able to resume their normal activities immediately after treatment.

In 2012 the Ontario government stopped providing insurance coverage for most vein patients. Currently, severe vein disease is covered by OHIP if you are experiencing complications from your vein disease. Our doctors can help determine if you qualify for OHIP covered care.

Cosmetic spider veins and varicose veins are not covered by insurance.

Removal of varicose veins or spider veins is a multi-visit process. Remember, you probably have had noticeable veins for many years, sometimes even decades, and will require a few weeks to months after treatment for them to go away.

We make sure you have had a thorough expert consultation and assessment and that you are fully informed about treatment options.

Every person requires different treatments, but you should plan ahead! If you have a special trip or want to wear a new outfit with your “new legs,” visit our offices at least three months in advance.

With the removal of varicose or spider veins, circulation actually improves.

Varicose veins are not suitable for heart bypass so you have no reason to keep your varicose veins.

Endovenous surgery is a well established non-surgical procedure to treat varicose veins.

With endovenous therapy, there is no need to remove the leaking saphenous vein. Instead, the vein is sealed closed from the inside of the vein using a small catheter inserted through a small puncture in the thigh. All steps are performed under ultrasound guidance to assure perfect positioning of the catheter. Once the vein is closed, it then shrivels and is absorbed by the body. By closing the saphenous vein, blood is diverted to normal veins with competently functioning valves. The circulation is improved, and symptoms are alleviated.

Endovenous treatment does not require hospitalization and is performed in our office.

Vein stripping has been performed for many years and is safe but is an invasive procedure. An incision is made at the groin and the calf and the vein is removed or ‘stripped’ from the body using a rod, by pulling it out from one incision to the other. Vein stripping is performed in a hospital under general anesthesia. It can be painful and requires a considerable recovery time.

Endovenous surgery such as laser or the newer techniques (Venaseal and Clarivein) are non-surgical, minimally invasive and virtually pain-free way to treat varicose veins

There is now good clinical evidence showing recurrent varicose vein disease is actually less after endovenous surgery therapy than the traditional stripping procedure.

There are many reasons people seek help for spider and varicose veins.

Often, they are embarrassed by the appearance of their legs, or their veins are painful.

Some people have more severe symptoms, such as swelling, itchiness, heaviness, and even skin colour changes or ulceration.

Wearing compression stockings and elevating the legs can provide temporary relief, but do not reverse any of the varicose vein changes.

Some varicose veins that develop during pregnancy will return to normal after delivery, therefore, we recommend that all women wait at least three months after delivery before having varicose veins treated.

We do not recommend vein treatment while breastfeeding.

Because vein disease is progressive and some changes are permanent, it is reasonable to consider treatment between pregnancies, before permanent changes develop. It is usually easier to treat mild disease than severe disease.

We recommend an ultrasound for all of our patients at a vascular lab. Most ultrasounds of the legs only look if there is a blood clot in the deep veins.

Our vascular labs look for blood clots as well as how the valves are functioning and provide a much more detailed assessment of your veins.

Our team of technologists are expert in vascular ultrasound. If there is an emergent finding, they call us directly so we can treat you immediately.

Everyone has 3 systems of veins in the legs: the deep veins, the superficial veins, and perforartor veins that connect the deep and superficial system

Deep veins which carry the majority of blood from the legs to the heart, about 95% of blood.

The superficial veins have two main systems, the greater saphenous vein (GSV) and the short saphenous vein (SSV). There are many other superficial branches that have other names.

The vascular lab technologist that is an expert at vein ultrasound will perform maneuvers during your study to test if the valves are working.

If the vales are working, blood does not fall backwards or reflux toward the feet during testing. If the valves do not work, this shows up as reflux or ‘leaking valves’ on the ultrasound.

In general, most people with varicose veins will have superficial reflux. If one of the main superficial veins are refluxing such as the greater or short saphenous vein (GSV or SSV) we recommend treatment of these veins to have a better longterm outcome.

Sometimes if the saphenous veins are competent, if you have small superficial veins such as a tributary or a branch off the GSV or SSV, these can be treated only with sclerotherapy.   If you have GSV or SSV reflux and you leave these untreated, there is a high chance your varicose veins will come back quickly.

Sometimes the valves of the deep veins do not work and the ultrasound will show “deep system reflux”. This means that even if we fix the superficial veins, you are at higher risk of recurrent symptoms and may require ongoing compression therapy even if your superficial veins are treated.

In patients with deep reflux, we pay particular attention to the outflow veins, or the veins in the pelvic. If there is any concern about a blockage in these veins, we may arrange additional testing such as a CT or MRI to evaluate if these veins are blocking the vein outflow from the leg. These are typically after a DVT (deep vein blood clot) from years ago and require specialized treatment plans.

Veins can be treated all year. Because we want you to have the best outcome possible, we advise caution about vein treatments during summer.

For most vein treatments, you will be required to stay out of direct sunlight for 2 weeks. However depending on the severity of your vein disease, some patients will rarely require up to 2 months of avoiding directly sunlight to the treated vein.

You will also be required to wear compression stockings for 2 weeks. Because of these reasons, we find most people choose to get treatment in the fall, winter, or spring.

A vascular lab is where highly specialized ultrasounds are performed to evaluate your vascular health. It is noninvasive, completely safe, and painless.

Our vascular lab offers complete vascular ultrasound by skilled RVT technologists. Our Medical Directors are RPVI certified, ensuring the highest standard in vascular ultrasound interpretation.