for varicose vein
varicose veins are
caused by incompetence of the valves
within the superficial veins. As these
valves become more incompetent, blood
backs up (away from the heart) and
causes dilatation of superficial veins.
While these veins are not harmful,
they may lead to swelling, discoloration,
and discomfort in the lower extremities.
Varicose veins typically do not respond
to injection sclerotherapy or lasers.
As they are not terribly dangerous,
treatment is reserved for patients
that are having symptoms. The most
effective therapy for varicose veins
invasive procedure is done at NYU in the
outpatient surgery unit on the 10th floor
of Tisch Hospital. The patient is admitted
early in the day and undergoes surgical
excision which takes approximately 1.5 hours.
The patient is then placed in the recovery
room for approximately one hour and then
is discharged home. Typically, the patient
stays in bed on the day of surgery and is
walking normally the day after surgery.
A tight dressing is applied on the day of
surgery and this is also removed the day
surgery is extremely cosmetic. This performed
with a half inch incision at the level of
the ankle and a one inch incision at the
level of the groin. There are a series of
other microincisions along some of the branches
of the veins on the leg. These incisions
are approximately 1/8 of an inch in length
and heal virtually without scarring.
veins are not treated with surgery. Typically
these are treated with injection sclerotherapy
or laser therapy. Radio frequency ablation
surgery is another technique used for treating
large varicose veins. Vascular surgeons
at New York University currently do not
use radio frequency ablation, as the avulsion
phlebectomy procedure has been a more effective
procedure in the removal of varicose veins.
carry deoxygenated blood. Varicose veins
are knobbly, twisted and darkish-blue in
appearance, and are most commonly found
on the legs. Blood is collected in the superficial
veins of the leg, just below the skin surface,
and delivered to deeper veins that run within
the calf muscles. The muscular action of
the calves helps to pump the blood against
the force of gravity towards the heart.
One-way valves inside the veins prevent
blood from travelling backwards. If these
valves fail to close properly, blood pools
in the superficial veins. Over time, the
affected veins distend with blood (become
‘varicose’). The cause is unknown.
Varicose vein surgery is the removal of
these distended veins. Treatment can be
undergone for therapeutic or cosmetic reasons.
associated with varicose veins
can occur if the faulty valves are located
within the veins that perforate the calf
muscles (deep veins). Associated problems
in the legs.
Skin rashes such as eczema.
Brownish ‘stains’ on the skin
surface, caused by the eruption of capillaries.
Blood clots forming within veins (thrombophlebitis).
Medical issues to consider
The type of surgery required is determined
from a number of tests, including a
physical examination and an ultrasound
scan. You need to discuss a range of
issues with your doctor or surgeon including:
Medical history, since some pre-existing
conditions may influence decisions about
surgery and anaesthetic.
Any medications you take on a regular
basis, including over-the-counter preparations.
Any bad reactions or side effects from
any drugs you have experienced.
Whether or not you are pregnant. Varicose
vein surgery is generally not advised
for women during pregnancy.
Ligation and stripping - the vein is cut
and tied off (ligation). Stripping the
vein involves inserting a slender instrument
into the vein through a small incision.
The vein is then pulled out through a
Phlebectomy - small incisions are made,
and the veins removed with a special hook.
Immediately after the operation
the operation, you can expect:
Firm bandaging on the legs, to reduce
You will be encouraged to walk around
A hospital stay of one or two days.
side effects of surgery
of the common side effects of varicose vein
Swelling, which may take a few weeks to
subside. The feet and ankles are particularly
Scarring, although scars tend to be less
noticeable than varicose veins and fade
Brown staining of the skin may occur,
but tends to fade with time.
The skin and calf muscle may be painful,
swollen and bruised.
Unintentional injuries to nerves may cause
patches of numbness or ‘pins and
patches may recover in time (up to two
years in some cases) or they may be permanent.
Varicose vein surgery is considered to be
safe, but all surgery carries some degree
of risk. Possible complications may include:
Infection, particularly if skin ulcers
Blood clots forming within deep veins
Bleeding or bruising.
of yourself at home
Be guided by your doctor, but general self-care
Allow for one (or perhaps two) weeks
off work following surgery. You will
need to avoid any hard physical exertions
during this time.
Don’t remove your bandages yourself.
Leave bandages for your doctor to remove.
To keep the bandages dry while showering,
wrap your bandaged leg in plastic.
Take at least a half hour walk every
Sunburn can make scars look worse. Avoid
sun exposure if possible for six months.
Wear a compression stocking for as long
as your doctor advises.
Avoid prolonged periods of standing,
or sitting with your legs crossed.
Support stockings may be needed if your
legs continue to ache.
Long term outlook
You will need to have a check-up a few
weeks after surgery and, again, several
months later. About 20 per cent of people
who undergo varicose vein surgery will
develop new crops of varicose veins
Varicose veins are knobbly, twisted and
darkish-blue in appearance, and are most
commonly found on the legs.
Varicose veins are caused by faulty valves
within veins that allow blood to pool.
Treatment options include sclerotherapy
and surgery to remove the veins.
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