Frequently Asked Questions

General Phlebology Questions

What is Phlebology?

Phlebology is the medical specialty that deals with veins and vein-related disorders.

What is a Phlebologist?

A Phlebologist is a specialized physician who diagnoses and treats vein disorders.

What are Varicose Veins?

Varicose veins are veins that become unusually swollen and enlarged, usually due to faulty valves within the veins. They can appear bluish, protrude from the skin's surface, and often have a winding or worm-like appearance.

What Causes Varicose Veins?

The enlargement of veins and valve malfunction is caused by an increase in vein diameter. Common causes include genetic factors, hormonal changes (especially high levels of progesterone in females), pregnancies, obesity, hormone replacement therapy, oral contraceptives, and prolonged standing. Approximately 75% of individuals with varicose veins are women, and 25% are men.

Can Varicose Veins Be Cured?

Varicose veins can be effectively treated, but they cannot be permanently cured. Treating abnormal veins doesn't eliminate the underlying tendency to develop varicose veins, so maintenance treatments may be required after the initial treatment.

How Does Blood Return to the Heart After Abnormal Veins Are Treated or Removed?

The reverse flow of blood in varicose veins, especially in the great saphenous vein (GSV) and the small saphenous vein (SSV), interferes with normal venous return. Removing these areas of abnormal circulation improves blood circulation in the treated limb, reducing symptoms like tiredness and heaviness.

What is a Skin Ulcer?

A skin ulcer, specifically a venous stasis ulcer, is caused by a venous reflux disorder. Early signs include darkened skin around the ankle, which can progress to a leathery or waxy appearance. Untreated, it may lead to skin breakdown and bleeding.

Treatment Methods

What is a Duplex Ultrasound Examination?

A duplex ultrasound allows your phlebologist to visualize vein anatomy and assess blood flow beneath the skin. This information aids in diagnosing your specific vein issue and planning treatment.

What is Sclerotherapy?

Sclerotherapy treats varicose veins by injecting them with chemicals that cause vein destruction. Many patients who choose this treatment for cosmetic reasons also experience improved leg comfort.

What New Treatment Options Exist for Abnormal Blood Flow in Major Vein Trunks Besides Stripping?

To control backward blood flow in large veins, the source of visible varicosities must be sealed or removed. This can be achieved using energy sources like lasers, radiofrequency, electrical energy, or ultrasound-guided sclerotherapy injections.

What is Ultrasound-Guided Sclerotherapy?

Ultrasound-guided sclerotherapy involves injecting veins that are below the skin's surface. This technique uses ultrasound imaging to safely guide the injections.

Is Sclerotherapy Safe?

Most patients do not experience complications, but some may develop skin pigment changes or skin burns. Serious complications like deep vein blood clots or arterial injection are rare.

What are Laser and Radiofrequency Vein Sealing?

Laser or radiofrequency energy can seal abnormal superficial trunk veins. These treatments involve applying heat to the great or small saphenous veins. Ultrasound-guided injections may also be used to seal these veins.

What Are My Vein Treatment Options?

Treatment programs aim to address visible varicose veins and underlying abnormal veins. If only varicose veins are present, treatment may involve surgical removal (micro-incision phlebectomy) or chemical injections (sclerotherapy).

Why Can't I Just Treat the Branches if the Main Superficial Trunk Is Abnormal?

For long-lasting treatment of visible veins, the underlying source that may not be visible must also be controlled. Some insurance carriers require treatment of the main trunk before or simultaneously with branch varicosities.

Why Do Doctors Recommend Gradient Compression Stockings?

Properly fitted gradient compression stockings can temporarily alleviate the effects of vein disease, reduce discomfort, and prevent skin damage. Some insurance companies require a trial of stocking use before approving definitive therapy.