Varicose Vein Treatment: What Are My Options?

At East Tennessee Vein Clinic, we have a wide variety of treatment options for your varicose veins. The most powerful tool at our disposal is the diagnostic ultrasound, which allows us to map your legs. The process takes about 30 minutes, and the information and pictures can be used to obtain insurance approval for your treatment.  

Varicose vein treatment is a multi-step process

You will most likely need a combination of our treatments in order to tackle every element of your varicose veins. The following are the various treatments that we offer at East Tennessee Vein Clinic

Endovenous thermal ablation

The first step in treatment is frequently endovenous thermal ablation . This treatment tackles the hidden “root source” of varicose veins that are visible with a catheter placed inside your failed saphenous vein. The saphenous vein is a large, shallow vein in the leg. 

As the catheter is withdrawn the vein is sealed shut by heating the vein with either a laser (endovenous laser ablation i.e. EVLT) or a microwave (Closure-Fast i.e. RFA). The procedure usually lasts 10-14 minutes and is performed under local anesthetic. Nitrous oxide (laughing gas) is used to make you more comfortable during the procedure. 

This treatment is safe and effective. 99% of first-time endovenous thermal ablation treatments are successful. 

After this procedure, most patients will have ultrasound guided foam sclerotherapy and a few will have microphlebectomy.

Ambulatory phlebectomy/Microphlebectomy

Microphlebectomy is for patients with very large and prominently bulging veins. Some patients will benefit from this.  After giving nitrous oxide to make you comfortable and local anesthetic administered directly over the bulging veins, a needle puncture is made next to the bulging veins through which a small “knitting hook” device extracts the vein. You will not feel pain with this once the anesthetic is administered.

This procedure only requires local anesthesia and most patients will be finished in under an hour.  Not every patient will need this treatment but when it is used the improvement of the appearance of the veins as well as improvement of symptoms is often quite dramatic.  

Ultrasound guided sclerotherapy

Ultrasound guided sclerotherapy, the final step in treatment, is important for symptom relief. It also prevents recurrence of other visible varicose veins. It treats even large varicose veins without surgery and involves a foamed sclerosant to be injected into the veins, which causes them to close down. Over time, the veins narrow to a fibrous thread which is not visible.  Most patients will have 2-3 sessions of ultrasound guided sclerotherapy.  In a great many patients this is all the treatment they will require.

Varithena is a particular kind of ultrasound guided foam sclerotherapy which enables treatment with two sessions.

Other varicose vein treatment options at East Tennessee Vein Clinic

While the above treatment plans are the most commonly used, we also offer a few others. 

Venaseal is a non-thermal based treatment which allows the treatment of the saphenous vein with literally a single needle prick and through which we deliver a small amount of specially formulated medical adhesive to close the vein.  This is essentially a form of medical “super glue”. 

Finally, reticular and cosmetic sclerotherapy are used most often on spider veins and veins on the face or legs. Sclerotherapy for spider veins that are cosmetic in nature are typically not considered a medical necessity, and so aren’t typically covered by insurance. Despite that, our patients find the cost of treatment surprisingly affordable.  

Recovery time for varicose vein treatments 

All of our procedures at East Tennessee Vein Clinic are outpatient, and patients are expected to return to their most of their customary activities immediately. You can drive yourself to your appointment and drive home with no need of assistance. You can return to work, and are encouraged to take a daily 20 minute walk. 

The short recovery time is one of the tremendous advantages of the procedures East Tennessee Vein Clinic offers our patients. At East Tennessee Vein Clinic treating veins is all our doctors do and is a true specialty clinic, not a sideline for a part time vein doctor.  Our doctors will provide you with what steps you should take for optimal healing! 


If you’re ready to schedule an appointment and get rid of your varicose veins, schedule a consultation today

“Dr. Douglass and his staff are excellent!!”

- K. W., Fairfield Glade, TN