Using special “Farbduplex” vascular ultrasound, it is painless and easy to visualize the integrity of veins, the valves within them, and flow of blood. Larger varicose veins have leaky incompetent valves that do not close properly. This leads to backflow of blood away, rather than toward, the heart (stasis) and a subsequent increase in pressure within the vessels that can be measured. This then in turn leads to small veins popping up on the ankles; to swelling of the calves and lower extremities; eventually to a hardening of the skin of the lower leg and to eczemas.
Elegant procedures have evolved in recent years that avoid skin incision for access to diseased veins. With less forceful manipulation, therefore less destruction, of superficial and subcutaneous tissues, much better results can he expected with respect to both cosmesis and side-effects.
For example, 2 different techniques: Endovenous Obliteration (EVO) and Microfoam Sclerosis, can be used to remedy blood stasis and leaky valves. Or, using a thin catheter introduced into the vein by way of a tiny incision, radio wave or laser energy – VNUS closure and EVLT respectively – will shrivel varicosities.
After a while the vein resorbs, leaving no scars. Pain is practically nil and the procedures can generally be done in an outpatient setting.
For the Microfoam approach, air or gas froth is injected which scleroses, or damages, the wall of the vein, rendering it “hors de combat” The vein then hardens for a time: to good effect and little, if any, secondary effect or complications. The procedure is done in an outpatient setting, without anesthesia.