Why A 3-Fold Approach Is Most Effective For Treating Varicose Veins

Why A 3-Fold Approach Is Most Effective For Treating Varicose VeinsMany patients with varicose veins are unhappy with the ropy, twisted bulges in their legs. Those blueish bulges form when veins in the leg swell because the one-way valves in the veins fail to keep blood moving upwards toward the heart. However, other people with varicose veins may not have the symptomatic bulging veins, but they do still suffer from swelling, pain, throbbing, or a heavy aching sensation in their legs. This is because much of varicose vein disease is hidden beneath the surface of the legs.

Varicose veins that are visible on the surface of the skin are usually the tip of the iceberg. Other diseased veins that feed into the visible varicose veins lie hidden deeper in the skin. Ultrasound imaging allows us to see the entire network of vein disease beneath the skin. Finding the root source of vein disease allows us to make an accurate diagnosis in order to treat most effectively.

Fortunately, treatment for varicose veins no longer means an overnight hospital stay or an extended recovery process. With today’s treatments, the procedures can now be performed in a vein doctor’s office in about an hour, with little to no downtime. Treatments are designed primarily to relieve discomfort from varicose vein symptoms, but also to make the legs look healthier.


Endovenous Laser Therapy (EVLT) is a safe and effective treatment that closes varicose veins. A tiny optic fiber laser catheter is inserted into the diseased vein through a needle. Laser heat is then used to close the vein, allowing blood to be naturally rerouted to other healthy veins within the leg.

An ambulatory phlebectomy is a procedure designed for larger, visibly bulging veins that remain after EVLT. These veins are typically too twisted for an endovenous catheter to pass through them so must be treated after the EVLT. During an ambulatory phlebectomy, the vein specialist inserts a small phlebectomy hook through a small puncture-like incision, allowing for the removal of the vein in sections.

Ultrasound-guided foam sclerotherapy is ideal for “cleaning up” any remaining vein disease in the legs. It acts like a liquid tool reaching the hidden sources of vein disease, so it can effectively treat large areas of veins in the least amount of time. Ultrasound-guided foam sclerotherapy is a critical part of treatment for most patients with varicose veins to both relieve symptoms from unseen varicose veins and to reduce the recurrence of visible varicose veins.

While one procedure may relieve symptoms, a combination of treatments is often necessary to halt the progression of varicose veins. Oftentimes, a 3-fold approach—EVLT, ambulatory phlebectomy, and ultrasound-guided foam sclerotherapy—is most effective for thoroughly treating varicose vein disease that isn’t visible on the surface of the skin. Taking a proactive, thorough approach can successfully eradicate the varicose veins at the source and reduce the rate of recurrences. If physicians, especially cardiologists and surgeons, are only treating varicose veins with a single treatment, patients will nearly always be dissatisfied with the result either in the near or long term.  

Each of these procedures are completed in-office, typically in under an hour. No general or spinal anesthetic or narcotic pain medications are required. Patients are able to resume their normal activities immediately.

There are many options for the treatment of diseased veins and your best bet depends on the severity of your condition and your desired outcome. The most important aspect to remember is that you don’t need to endure the discomfort your varicose veins are causing any longer.

At East Tennessee Vein Clinic, our outpatient procedures are quick and typically covered by insurance. We treat not only the root cause of your varicose vein disease but also are skilled in treating the branches that others often fail or are unable to treat.

As the first physician dedicated solely to the treatment of vein disease in Tennessee, Dr. Douglass and East Tennessee Vein Clinic lead the region in experience and expertise of varicose veins. We treat veins differently than other clinics precisely because of our comprehensive attention to treating the root cause of each patient’s vein disease. Visit us online at East Tennessee Vein Clinic, or call 866-281-VEIN, or request an appointment online today.

“The service was great. Will be back – Thanks for your kindness.”

- D.J., Gatlinburg, TN