Varicose Veins 101

Varicose Veins – Overview

• Half of all Americans over 50 suffer from the pain and swelling of large, “ropey” varicose veins.
• Many individuals are familiar with varicose veins, but only a small number truly grasp their root cause or the risk of them becoming a significant health issue. If you suffer from severe varicose veins, it can affect the skin’s nourishment and result in discomfort and swelling.
• Additional health complications that may arise include eczema, inflammation, and even ulceration in the lower leg. Therefore, it is crucial to address vein issues promptly.
• Fortunately, the diagnosis and treatment of varicose veins is a procedure that is typically covered by most insurance plans.

What causes varicose veins?

• The veins in your legs resemble a tree, with the trunk at the bottom dividing upward into various branches and leaves.
  • Blood flows from the leaves, known as superficial venous capillaries, into the branches (small tributary leg veins), and then finally into the trunk (larger saphenous veins). Eventually this blood returns to your heart.
  • Normally, there is a one-way valve allowing blood to flow from the saphenous vein into your deep veins (femoral vein). If this valve is not functioning properly, blood flows back into the saphenous vein, which then influences all of the superficial veins extending all the way down to the ankle.
• Varicose veins are a sign of venous reflux or “leaky valves” and is broadly known as the condition called Chronic Venous Insufficiency (CVI) which is a result of failing valves that inhibit the blood in your legs from returning to the heart as it normally should.
• Varicose veins represent the distended tributaries or “branches” coming off larger malfunctioning veins (“trunks”). They are most common in the calves, but can be seen anywhere in the lower leg, depending on what “feeder vein” is not functioning properly.

What are risk factors for varicose veins?

• Genetics
• Hormones
• Pregnancy
• Occupational (prolonged sitting/standing)

How does Varicose Vein Disease (Chronic Venous Insufficiency) present?

• Symptoms:
  • heaviness
  • aching
  • swelling
  • throbbing
  • itching
  • pain
  • burning
  • tiredness
  • numbness
  • cramping
  
  Visible clinical findings, ranging from the following (C1-C6):

Next Steps:

Our Approach:

The goal is to treat the underlying medical problem first, then to treat what is left, and finally any cosmetic issues. If there is no underlying problem, the cosmetic issue may be addressed directly.

The Diagnosis and Treatments for Varicose Vein Disease Are Covered By Most Insurance Plans!

Medicare and most commercial insurance companies cover the diagnosis and evaluation of varicose veins and chronic venous insufficiency.

Treatment coverage by Medicare and other insurance depends on an in office evaluation by our vein care specialist and what we find on your ultrasound exam of your legs. 93% of our medical patients have their treatments covered by insurance. Medicare and most insurance companies may first require you to try conservative treatments including the use of compression hose, prior to approving laser ablation treatment and other minimally-invasive procedures.

Our vein care specialists will happily walk you through a full benefit estimate prior to treatment.

Our Medical Protocol:

Vein Treatment Consultation

• Meet your Vein Care Specialist and receive a comprehensive medical and cosmetic vein evaluation.
• An ultrasound exam will be recommended if your issue is medical.

Ultrasound of Your Leg Veins

• An ultrasound exam of your legs is performed to evaluate your vein size and determine if you any leaky vein valves (reflux).

Ultrasound Follow Up Appointment

• Your custom vein map report is reviewed with your Vein Care Specialist.
• Conservative management and minimally-invasive treatment is discussed if your report is positive for vein disease.

Conservative Treatment – click to learn more

• Most insurance companies require a conservative trial of compression hose and other measures.
• Your treatment will not be covered by insurance without a conservative treatment lasting anywhere from 3-6 weeks (depending on your insurance provider).

Vein Treatment

• Endovenous Thermal Ablation and Ultrasound-Guided Foam Sclerotherapy (UGS) are performed following your compression trial. 
• Most patients need 1-2 thermal ablations and 2 UGS to complete treatment of one leg.
• You will need to wear a medical-graded, custom-fitted compression hose continuously for 1-2 weeks following each treatment. (This will be placed in the office after each treatment)
• There is NO downtime. You return to normal activities immediately following each treatment.
• Treatments are virtually pain free. 

Treatment Follow Up

• A follow-up ultrasound exam of your legs will be completed to document closure of your treated veins.

Click here to learn more about our medical evaluation and treatments

Our Cosmetic Protocol:

“What about my spider veins?”

Spider veins are small, red, purple, or blue veins located just beneath the skin’s surface. These veins become visible because they are swollen with stagnant blood. While spider veins are smaller than varicose veins, they can be more noticeable due to their position just below the skin and their darker color, which makes them stand out. Additionally, spider veins are more prevalent in women than in men.

Although not typically a serious health issue, their appearance can indicate various vein disorders. Spider veins may also cause itching, minor discomfort, and pain.

Common causes of spider veins include:

• Genetics
• Gender
• Pregnancy
• Hormonal changes
• Aging
• Occupations that involve prolonged standing or sitting
• Obesity
• Injury

Most insurance companies consider treatment for these visible veins to be strictly cosmetic and do not cover treatment for spider and/or reticular veins.

The treatment options for spider veins include:

• Sclerotherapy: Used to treat both varicose and spider veins using an injectable.
• Vascular Laser: This is a 100% non-invasive treatment that allows your vein doctor to eliminate veins from the outside without incisions or injections.

Click here to learn more about our cosmetic treatments