The purpose of treatment for varicose veins is to: relieve pain and discomfort, improve the appearance of the legs, and prevent bleeding from varicose veins. Treatment may be conservative or involve endovascular or surgical intervention.
Diagnostic Tests
Tests are done to identify treatment options. The basic tests may
include blood work, urinalysis, chest x-ray, and electrocardiogram.
Some added tests for selected patients may include the following:
Treatment
By using the test results and a simple exam, the doctor can identify varicose veins and recommend treatment.
Treatment may include:
If needed, two other treatments may be suggested:
Endovenous Laser Ablation
The Procedure
Taking Care after Endovenous Laser Ablation
Activity
During the first 24 hours, no:
After 24 hours, you may resume your normal activities. Exercise aids recovery because the movement of the leg muscles helps blood return to the heart. In most cases, patients are able to drive a car and continue working.
Medications
Take pain medicine as directed.
Bruising and mild tenderness are normal the first week after the laser
procedure. Patients also describe a sense of tightness and pulling in
the treated leg for about three to four days after treatment. This is
normal and will slowly pass.
Most often patients may resume all their routine medicines. Ask your doctor if you have questions or concerns about your medication.
Bathing & Wound Care
After the procedure, a compression stocking and dressings are applied.
Do not remove for 24 hours. Then the stocking and dressing may be
removed for showering. To prevent infection, do not take a tub bath for
one week. There may be small bandages placed directly on the incisions;
allow these to fall off on their own.
Compression Stockings
To have the best outcome, it is important to wear the full-leg compression stockings for about three weeks after the procedure.
Vein Stripping
Vein stripping surgery may be recommended which consists of tying off and removing the varicose veins just under the skin.
Preoperative Concerns
Risk
There is some risk with every operation. The risk varies with each
person, and the type of surgery. After surgery, bruising, discoloration
and swelling of the leg(s) may be present. Numbness of the inner part
of the lower leg may occur. This numbness will disappear over time.
This is rarely a serious problem. Your surgeon will discuss with you
the benefits and risks involved in your surgery.
Postponement
Surgery is sometimes postponed because of another patient needing
emergency surgery, or if you develop a fever, sore throat or cold. You
will be told of any delay as soon as possible. Surgery is to be
postponed only when absolutely necessary.
Research Studies
Northwestern Memorial Hospital is affiliated with Northwestern
University Medical School, which is involved in a variety of research
studies. If you are asked to take part in one of these studies, the
decision is yours. Please ask your doctor if you have any questions.
Surgery
During surgery, several short incisions are made along the leg to
remove the veins. When the varicose veins are tied off and/or removed,
blood flows through the deep veins and back to the heart. This surgery
may be done under general or spinal anesthesia usually on an outpatient
basis. This depends upon the extent of varicose veins.
Taking Care after Surgery
Activity
Recovery from surgery varies with each person and the type of surgery.
Avoid vigorous aerobic exercises for 2 weeks. Let your leg be your
guide to your activity. Return to your normal life at a gradual but
regular pace. You may climb stairs. Walking, cycling, and swimming are
good because the movement of leg muscles helps blood return to the
heart. Sitting with your legs hanging down for long periods of time can
cause pooling of blood in the lower legs. Raise your legs on a
footstool when sitting. You may cross your legs. Elevate your legs
above the level of the heart when possible. There is no restriction on
sexual activity after surgery.
Driving
You may drive
a car when you are free of pain and are able to move your legs
normally. Do not drive after taking narcotic pain medicine or sleeping
pills.
Work
Depending on your job and its demands, you may return to work when you feel up to it.
Medications
Take any needed medicines as directed by your doctor. Your doctor,
nurse or pharmacist will give you specific medication instructions.
They will be happy to answer any questions you may have. Prescriptions
can be filled either here at the hospital or at a pharmacy near your
home. Tell the nurse before you leave the hospital, which you prefer.
Bathing
Showering is allowed two days after surgery. Tub baths are not allowed
for 1 week after surgery. Clean the incisions gently with mild soap and
water and dry well.
Wound Care
No special incision
care is required. If oozing from any incision occurs, cover the wound
with a dry gauze pad or bandage. Bruising, discoloration, and lumpiness
are normal and will disappear in time. Most stitches are internal and
will be absorbed. They do not need to be removed. If stitches are
external, your doctor will give you a date for their removal.
Elastic Support
Leg swelling after surgery is normal. Firm support is needed to
decrease such swelling. Pressure from an elastic bandage helps the leg
muscles to propel blood toward the heart, thus decreasing fluid
build-up in the legs. Wear a four-inch elastic bandage on the affected
leg whenever you are out of bed.
Apply the elastic wrap before getting up to avoid leg swelling. Wrap the bandage snugly from the toes to just below the knee. Overlap the edges of the bandages. The bandage may be removed at night. Your nurse will show you how to apply the bandage correctly before you are discharged from the hospital. Elastic bandages are to be worn for about two weeks. If you continue to have swelling or discomfort, wear them for support. If you are in doubt, ask when you return for your medical check-up.
Elastic bandages can be washed with mild soap and water and can be reused. Extra bandages can be purchased at most drug stores.
You can also wear an elastic compression stocking. They can be purchased in most drug stores or in specialty stocking shops and may require a prescription.
Replace stockings or bandages when they become "stretched out."
Diet
Eating a balanced diet can help keep you healthy and even improve your
health. A diet high in fiber aids regular bowel movements and avoids
straining while defecating. Straining puts pressure on leg veins.
Obesity or excess body weight can lead to varicose veins. If needed, a
dietitian can help you plan a weight reduction program. Dietary
guidelines have been included in this folder.
Preventive Measures
To help prevent varicose veins, follow these basic guidelines.
Smoking
No Smoking!
Nicotine in cigarettes narrows the arteries, decreasing blood flow to
the legs and contributes to blood clotting in the veins. Smoking
increases blood pressure and heart rate. Contact the Northwestern
Memorial Wellness Institute's smoking cessation program at (312) 926-2069 for more information.
Medical Follow-up
Notify your doctor if any of the following occur:
Regular medical check-ups are suggested. Make an appointment to see your doctor within two or three weeks after discharge from the hospital. If you have any questions before that time, do not hesitate to call your doctor or nurse.
Review Date: 02/05
