Venous insufficiency syndrome or venous reflux causes large, bluish varicose veins to appear on the legs causing pain, leg heaviness and fatigue, swollen limbs and an unsightly appearance. The condition usually occurs in the largest superficial vein in the leg, the greater saphenous vein, causing its leaky valves to allow back-flow of blood from the groin area into the lower leg. In healthy legs, valves open and close to assist the return of blood to the heart. Varicose veins are more than cosmetic, with longstanding disease resulting in chronic health problems.

Endovenous Ablation for venous reflux

Until a few years ago, the only option for removing bulging, leg varicose veins was painful stripping surgery requiring hospitalization, scarring, general anesthesia and significant post-surgery conditions. Nowadays, endovenous ablation techniques have almost put an end to these painful surgical procedures. Endovenous ablation refers to the minimally invasive Ultrasound-guided procedure, whereby varicose veins are entered into and shut down from inside the veins by means of a heat generating radio-frequency catheter or laser fiber.

 Laser Vein Treatment

Currently, the VNUS™ closure procedure and  Laser Vein Treatment are the only two systems that are approved by the FDA for endovenous varicose vein treatments. The former uses a radiofrequency generating electrode , whereas the latter uses a laser fiber to thermally ablate the veins. According to most recent studies, patients who have undergone varicose vein treatment with endovenous laser ablation have reported superior quality of life compared to vein stripping patients two years following treatment.

Interestingly, the varicose veins that are the root cause of the venous insufficiency and therefore targeted for endovenous ablation may not be the same bulging varicose veins for which patients may have originally sought medical attention. Patients are often surprised to learn that a huge bulging vein network on a calf may have its origin at the groin level or back of the knee, where the largest superficial veins communicate directly with the deep vein system. Varicose vein treatment with endovenous ablation targets these main superficial veins rather than the visible branch varicosities that are obvious to the patient. Once treated with an endovenous ablation procedure successfully, these main superficial veins stop the source of back flow of blood to the bulging varicose branches, resulting in dramatic visible improvement within a few weeks, as these veins adjust back to normal pressure conditions. Some of these residual veins may need additional treatments for the best cosmetic outcome with either sclerotherapy (for spider vein removal) or foam sclerotherapy (for reticular vein treatment).

The two most important, superficial veins that are treated with the endovenous ablation procedure are the Great Saphenous Vein (GSV) and the Small Saphenous Vein (SSV). The GSV is by far the most commonly treated one. It extends from the inside of the ankle to the level of the groin, where it joins the deep vein system. The SSV is much shorter and runs in the back of the calf area. It should be noted that shorter communicating veins called perforators, may present as additional and secondary sources of venous reflux. These may need to be identified and treated separately.

Vein Therapy Insurance Coverage

Varicose vein therapy due to symptoms are covered by Medicare and most private insurance policies based on medical necessity. The result is a fast and comfortable varicose vein closure with a smooth recovery experience on the road to healthier legs.

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