Why Doctors Recommend Sclerotherapy

Among treatments for spider and varicose veins, sclerotherapy has remained popular for decades.  Vein doctors continue to recommend this procedure to address medical and cosmetic concerns by eliminating these unwanted blood vessels.

Why Vascular Surgeons Advise This Procedure

This technique stands somewhere in the middle of types of vascular treatment.  It remains the primary treatment for spider veins and is also a varicose vein treatment under certain circumstances.

On the one end of the spectrum are conservative treatments such as losing weight and wearing compression stockings.  At the other end is vein surgery.  The use of sclerosing agents falls between these two.  According the Mayo Clinic, it represents a fairly safe procedure with few complications.

Since vascular surgeons administer this treatment at a vein clinic on an outpatient basis, the procedure is much more convenient for patients than surgery is.  Compared to vein surgery, it is a minimally invasive option.

Injections used solve both cosmetic and health problems.  They improve a patient’s appearance by getting rid of spider and varicose veins.  They can also reduce symptoms like swelling, burning, aching, and cramping.  The procedure might be done alone or in combination with other treatments.

The University of Wisconsin Health indicates that the most common reasons why doctors recommend this procedure include:

  • Spider veins or small varicose veins not causing serious problems
  • Small varicose veins that return after vein stripping
  • Some larger varicose veins

At an initial consultation, a vein doctor will determine whether a patient is a good candidate for use of a sclerosant.  Among issues that disqualify an individual are pregnancy or recent delivery.

How This Vein Treatment Works

Vein doctors perform this procedure using a very fine needle to inject a special substance known as a sclerosant or sclerosing agent into a targeted vein.  Sclerosants are either liquids or foam.  Many practitioners today use a technique that combines ultrasound to locate deeper problem veins with sclerosants injected by catheters, usually when problem vessels are in the legs.

The University of Wisconsin Health reports that injecting the sclerosant into each targeted vein takes between 5 and 30 minutes.  The time required depends on how many blood vessels need treatment and how large they are.

The sclerosing agent irritates the walls of the vein, causing them to stick to each other.  Eventually, the vessel closes off and is no longer visible.  Healthy nearby veins assume the workload of the eliminated vessel.

After treatment, patients wear compression stockings for a specified period.  The procedure works well for around 80 percent of those who undergo it.  Sometimes patients require multiple sessions to achieve desired results.

It is important for individuals considering this option to realize that no treatment for spider or varicose veins can prevent new vessels from forming.  Because of this, many patients return periodically for additional treatment.


Conservative Varicose Vein Treatments From a Vein Clinic

For some patients, varicose veins are simply a cosmetic problem.  For others, these unsightly blood vessels are also painful and sometimes linked to other medical problems.  Treatment options available from a vein clinic include lifestyle change recommendations and medical and surgical procedures.  Many individuals begin their treatment with conservative measures.

Conservative Treatment Choices

As many as 60 percent of Americans suffer from varicose veins, the University of Maryland Medical Center reports.  When they visit vein doctors, known as vascular surgeons, sometimes the initial treatment recommendation is a conservative one.  Lifestyle changes such as these cited by PubMed Health are often the first option for dealing with varicose veins and enable some patients to avoid medical or surgical procedures:

  • Getting more physical activity.  Getting the legs moving improves circulation and muscle tone.  It encourages blood to move through veins.
  • Shedding excess weight.  Being obese or even overweight can hinder blood flow.  Losing weight reduces pressure on veins.
  • Avoiding tight clothing.  Apparel that is tight around the legs, waist, or groin can cause varicose veins to get worse.
  • Avoiding extended periods of sitting or standing.  It is important to take an occasional break and to avoid crossing the legs while seated.
  • Elevating the legs.  Whenever possible, placing the legs above heart level and keeping them raised while sleeping, sitting, or resting is helpful.
  • Avoiding high heels.  Avoiding shoes with high heels and wearing those with lower heels helps tone muscles in the calf that help circulation.
  • Wearing compression stockings.  Three types are available, each with a different level of pressure.  Support pantyhose provide the least pressure.  Over-the-counter (OTC) compression stockings provide slightly more.  Prescription hose offer the greatest amount of pressure and require a patient fitting.  OTC and prescription hose are available at many pharmacies and at medical supply stores.

Other Varicose Vein Treatment Options

When conservative measures cannot control problems associated with varicose veins, physicians are able to offer alternatives.  Medical procedures include sclerotherapy to destroy a small varicose vein, laser surgery to case a vein to fade, and endovenous ablation to close off a varicose vessel with lasers or radio waves.

Vascular specialists typically reserve surgery for severe cases.  During endoscopic surgery, a device on the end of a camera closes a targeted vein.  To remove vessels closest to the skin’s surface, a physician might choose to perform an ambulatory phlebectomy.  For decades, vein stripping and ligation was the standard treatment for varicose veins.  Fortunately, doctors perform it today only for the severest cases.

It is important to realize that no treatment can prevent the formation of new varicose veins.  However, the Mayo Clinic suggests that making lifestyle changes such as getting more exercise, eliminating extra pounds, following a healthy diet, choosing the right shoes and clothing, and positioning legs correctly can help prevent new vessels.

Thrombolytic and Other Therapies for Deep Vein Thrombosis

If you have deep vein thrombosis, or DVT, it means you have a blood clot that is forming deep within one of your veins. While this is more common in a leg vein, it can also occur in a pelvis.

The blood clot can cause your leg to swell up and lead to discomfort of the area. The blood clot is also dangerous because it has the potential to block proper blood flow in that vein. It is vital to get treated for this condition.

Here is information about the primary therapy, thrombolytic therapy, as well as some other treatment options to consider.

Thrombotic Vein Treatment

The thrombolysis procedure is one of the main thrombolytic therapies available for this condition. In this catheter-directed procedure,a tube is used to send medication into the vein by using imaging and a catheter placed in the vein in order to break up the blood clot.

The medication can dissolve the blood clot and remove the blockage within the vein. Thrombolytic Therapy for DVT is  a non-invasive procedure, so often less uncomfortable and with fewer side effects than surgery.

Preparing for the procedure typically involves stopping certain blood thinners and medications for safety purposes and having a place to relax at home after returning home from the procedure.

Blood Thinners and Anticoagulants

Your doctor might also suggest other treatments, such as taking a blood thinner or anticoagulant, to help with your deep vein thrombosis. These drugs can help keep the blood clot at its current size instead of growing, and eventually leading to a reduction of the size of the blood clot over time. Blood thinners and/or anticoagulants  may be given before or after the thrombolytic therapy for the vein condition.

Compression stockings

Compression stocking also provide a simple treatment option for this vein condition. They work by reducing swelling of the leg that is affected by the blood clotting. They are tall stocking, typically reaching up to the knees. Compression stockings are also highly recommended for people to wear who are prone to DVT blood clots when flying in an airplan . You may also be asked to wear them after you have had the thrombolysis procedure.


In addition to the thrombolysis procedure, there are other surgical procedures that can help with this condition. For example, you can get a cava filter, which is a device that helps to capture blood clots before they move into your veins or to other parts of your body. Your doctor may also recommend getting a venous thrombectomy, which is surgery to cut out the blood clot.

If you believe you have deep vein thrombosis and want to discuss your treatment options, please contact us here at the St. Louis Vein & Endovascular at (314) 272-4150.

Vein Doctor Discuss Sclerotherapy

Sclerotherapy is the most common treatment for varicose veins and spider veins, according to the Office on Women’s Health. Varicose veins and spider veins are enlarged, red- or blue-colored veins that appear on your thighs, the backs of your calves, or on the inside of your leg. Sclerotherapy is a minimally invasive outpatient procedure that effectively treats varicose veins and spider veins.

Vein doctors, also known as vascular surgeons, often perform sclerotherapy for cosmetic reasons. Varicose veins and spider veins can ruin the smooth, youthful appearance of skin. Vascular surgeons sometimes perform sclerotherapy to relieve symptoms associated with diseased veins, such as aching, swelling, burning, and night cramps.

How Sclerotherapy Works

Vein doctors perform sclerotherapy by using a needle to inject a chemical agent, known as a sclerosant, which irritates the inner lining of the varicose vein or spider vein. The irritation causes the vein to scar and eventually close, so it no longer carries blood. The body reroutes blood to other veins. In time, the treated vein breaks apart and is absorbed by nearby tissue.

After Vein Treatment

You can get up and walk around immediately after sclerotherapy – in fact, your vein doctor will probably recommend that you walk and move as much as possible to reduce the risk for blood clots. You will need someone to drive you home, however.

You will need to wear compression stockings for about two weeks after the procedure. These stockings apply pressure to the veins in your legs to keep blood circulating. Avoid strenuous exercise for the first two weeks after surgery.

Treated veins fade within a few weeks, although it may take up to a month to realize the full results of the vein treatment. Multiple treatments are sometimes necessary, especially for very large or stubborn varicose veins. Vein surgeons typically suggest repeating treatment every four to six weeks.

Sclerotherapy is not appropriate for some patients. Doctors suggest that women who are pregnant or are breastfeeding wait to undergo the procedure, for example.

All surgical procedures, even minimally invasive ones like sclerotherapy, carry some risk for complications. The procedure is relatively safe and is associated with few complications. Possible side effects include red, raised patches or bruising at the injection site, which usually go away soon after treatment. Brown lines, spots, or groups of tiny blood vessels may develop near the treatment site; these too should disappear shortly after treatment. A lump of clotted blood may develop in a treated vein. While this is not dangerous, it does require the attention of your vein surgeon.

Your vein doctor can perform sclerotherapy at your local vein clinic. The procedure does not require anesthesia. Sclerotherapy usually takes less than an hour.

To learn if sclerotherapy is right for you, make an appointment with your local vein clinic. Your vein doctor can help you decide if this type of spider vein or varicose vein treatment is right for you.

Causes of Venous Disease

The causes of venous disease (or vein disease) can range from minor problems like spider veins to serious varicose veins and circulatory problems. In many cases, relatively simple treatments can relieve symptoms and help patients resume their normal activities. Vein doctors like cardiologist Raffi Krikorian, MD, of the St. Louis Vein & Endovascular, offer a variety of vein treatments for conditions like varicose veins and venous insufficiency.

Causes of Venous Disease

Veins are part of the circulatory system; they are the blood vessels that return blood to the heart. Healthy veins have small flaps of tissue, called valves, that drop into place after each beat of the heart to prevent the back-flow of blood. Muscle movements help return the blood to the heart, as the pressure in the veins isn’t as high as that in the arteries, which run from the heart and lungs to the tissues.

Venous or vein diseases generally fall into one of three major categories: venous insufficiency, varicose veins and phlebitis or blood clots. They may also include genetic malformations, but those are less common. Venous insufficiency occurs when the valves in the veins stop working properly and allow blood to flow backward. As the blood pools in the veins, they become distended and varicose veins develop. Venous insufficiency and varicose veins may result in leg ulcers from poor circulation. Phlebitis is an inflammation of the walls of the veins that can result in blood clots; it can be caused by venous insufficiency or varicose veins.

Venous diseases have a genetic component; it’s not uncommon for venous insufficiency and varicose veins to run in families. Venous insufficiency and varicose veins are more likely to occur with age; women age 40 to 49 and men age 70 to 79 are most at risk. Pregnancy and smoking affect the circulatory system and can result in venous insufficiency. People who spend long hours on their feet or who are obese or inactive are also at higher risk of developing vein diseases.

Once venous disease occurs, patients may display a variety of symptoms. Swelling in the feet and ankles is common, especially when standing for long periods. Pain when standing that improves when you raise your legs is another common sign. Leg cramps, aching or throbbing, itching, thickening skin on the legs and ankles, or skin that becomes discolored in those areas are also signs of venous disease. Some patients complain of a feeling of tightness around the calves.

If you have signs of venous disease or venous insufficiency, or varicose veins, you can find vein treatment at the vein clinic at St. Louis Vein & Endovascular. Dr. Krikorian is skilled in a variety of treatments, including sclerotherapy, ambulatory phlebectomy, radiofrequency closure and endovenous vein ablation treatment. Contact us today to schedule an appointment.

How a Vein Doctor Can Help You

For some people, spider veins and varicose veins are merely a cosmetic issue. They don’t look good, but they also don’t cause any medical problems. For others, varicose veins can cause symptoms and complications, ranging from burning and aching to bleeding and restless legs. Fortunately, a vein doctor can help people dealing with varicose veins and other vein problems. From determining the cause of your problem to performing varicose vein treatment, vein doctors are looking out for your well being.

What a Vein Doctor Can Do

Diagnose Your Condition

The first step to treatment is getting an accurate diagnosis from a doctor. Vascular surgeons diagnose varicose veins and other forms of venous disease by first looking at the legs, checking for signs of swelling and bulging veins. The doctor will most likely ask you to describe your symptoms and will usually ask if you have any burning or pain.

Since some vein problems are deeper than others and can’t be detected by the naked eye, vein doctors often use ultrasound imaging to look for blood clots or weakened valves and to evaluate how the blood is flowing through your veins.

Recommend the Best Treatment

After vein doctors have diagnosed your condition, the next step is for them to recommend the most appropriate treatment. Treatment depends on the severity of your vein issue and on what you would like to get from  it. For example, if you are dealing with small spider veins, treatment with sclerotherapy might work best.  Depending on the location of your varicose veins, a treatment such as ovarian vein embolization might be required.  Ovarian vein embolization is usually performed when a person is suffering from pelvic congestion syndrome, which occurs when varicose veins form in the uterus or ovaries.

The right treatment for you also depends on how long you can commit to recovery. Many vein treatments don’t require much downtime and allow you to return to work the next day. Depending on the vein treatment, you might need to go in for several sessions before you get the results you want.

Help You Make Lifestyle Changes

Along with performing necessary treatments, the doctors at a vein clinic can recommend lifestyle changes to keep your vein problems from becoming worse. For example, adding exercises to your daily routine can help keep varicose veins in check. Exercise improves blood flow and strengthens your muscles so that they are better able to push blood back up to the heart. Losing weight, if you are overweight, can also help keep your vein problems from becoming worse.

Dr. Raffi Krikorian offers a variety of vein treatments at St. Louis Vein & Endovascular in St. Louis. To learn more about your options and to learn more about how a vein doctor can help you, call (314) 272-4150 for a consultation today.

The Most Recent Spider Vein Treatment Options

Spider veins might be small, but for someone bothered by their appearance, the impact on self-confidence is often significant.  Vascular surgeons have used various therapies involving injections, lasers, and heat to get rid of these unwanted blood vessels.  Fortunately, spider vein treatment options today are more convenient than ever.

What Exactly Are Spider Veins?

They are are small red or blue blood vessels that most often form on the legs or face.  While some consider them a kind of varicose veins, others say they are similar but distinctive.

These abnormal vessels form when pressure in a vein enlarges it.  Typically smaller than varicose veins, they are usually closer to the surface of the skin.  Their name comes from their weblike appearance.

The Cleveland Clinic reports that between 30 to 50 percent of American adults develop spider or varicose veins.

How Do Vein Doctors Currently Treat Them?

Today vascular surgeons perform outpatient treatments for spider veins in a vein clinic.  The two most common options used are sclerotherapy and VeinGogh Ohmic Thermolysis.

Sclerotherapy for spider veins

Overall, healthcare providers still consider sclerotherapy the gold standard for getting rid of spider veins.  According to Stony Brook Medicine, surgeons also use this minimally invasive procedure as a varicose vein treatment.  Although it usually does not eliminate all a patient’s spider veins in one session, most individuals see an improvement of 50 to 90 percent after a treatment.  Many require four to six treatments for optimal results.

Sclerotherapy involves injecting a specially manufactured substance directly into each targeted spider vein.  The injected solution or foam sclerosant irritates a vein’s walls, causing them to become sticky and eventually close.  After destruction of the vein, the vessel disappears, and neighboring veins take over its workload.

Many physicians today prefer using ultrasound guided sclerotherapy.  The Cleveland Clinic reports that this involves injecting a foaming agent that has been mixed with a sclerosant.  Ultrasound technology allows the surgeon to guide the injection into veins that are not easy to see on the skin’s surface.  Doctors sometimes combine ultrasound technology with other procedures to remove spider veins such as radiofrequency ablation.

VeinGogh Ohmic Thermolysis

Physicians also use this procedure to treat vascular problems such as cherry hemangiomas, rosacea, and skin tags.  Considered an alternative to light-based treatments, it utilizes a thin, insulated probe.  Heat transferred through the probe coagulates spider veins.

VeinGogh is appropriate for veins up to 0.3 mm, such as those found on the face.  For larger vessels, vein doctors often use the procedure with sclerotherapy.

Results from this treatment are immediate.  Most patients require up to three procedures for the best possible outcome.

When considering treatment options, it is important to realize that no procedure will prevent the formation of new spider veins.  For that reason, many patients return for periodic treatment.


Help! How Can I Choose a Vein Clinic?

Vein disease can be an indicator of a more serious problem, so it is important to get help if you have it. Even if your vein disease is not a serious health problem, varicose veins and spider veins can interfere with your daily life. They can prevent you from feeling comfortable in shorts, skirts, and short sleeves, or cause your legs to ache when you are walking.

Once you decide to get help for your vein disease, the next step is to choose a vein clinic for your care. This can be a tough decision if many clinics are in your area, but you can narrow your options by checking for some specific aspects. These are some tips when choosing a vein clinic.

Focus on the vein specialist.

The vein specialist is in charge of your treatment, so you want to be sure you are under the care of a top doctor. Look for a board certified doctor such as a board certified cardiologist and a fellow of the American College of Cardiology. Other experience can include interventional cardiology training in the form of fellowships and residencies.

Think about other services.

Some vein clinics are part of larger facilities that offer additional services. If you need any of these services, you might want to choose a vein clinic that is housed in the same building. That way, you can get all of your treatments done in one place and make life simpler. Some of the possible options include cosmetic treatments such as Botox, dermal fillers, chemical peels, facial skin rejuvenation, and waxing.

Ask for proof of results.

Your vein clinic should be able to provide evidence of satisfied patients. You may be able to see before and after photos of patients who have had varicose and spider veins removed, for example. You could also ask to talk to patients who can describe their experiences and results for you.

Consider logistics.

Real life comes into play when selecting a vein clinic for your treatment. You cannot base your decision solely on the quality of the doctor and the comfort of the vein clinic. Instead, you need to consider factors such as location. A clinic near you is easier to get to and less of a hassle when attending your scheduled appointments.

Financing is also important. Check to see if the vein clinic accepts your insurance coverage or financing options that make payment more manageable for you. Some clinics offer specials for vein treatment or other cosmetic procedures. Taking advantage of these specials can be a reason for choosing one vein clinic over another.

Go with your gut.

Sometimes, you can gather all the available information and still not have a clear cut favorite choice. At that point, you can use your intuition to choose a clinic. Consider which location and vein doctors make you feel most comfortable and confident. That vein clinic may be the best one for you.

Should I Have Professional Vein Treatment?

If you are suffering from the symptoms of varicose veins or spider veins, you may wonder whether your condition is serious enough to warrant professional vein treatment. To determine whether you should schedule an appointment with a vein specialist, ask yourself the questions below.

1. What are my symptoms?

Patients with spider veins may notice small, web-like veins on their hands, face, neck and legs. These veins are not raised above the skin’s surface and they rarely cause discomfort. Patients with varicose veins, however, will see larger, swollen veins that seem to be twisted and gnarled. These veins may be raised or deep. They also tend to cause other symptoms, such as pain, cramping, tingling and weakness.

If you are experiencing any of the symptoms above, you may benefit from professional vein treatment.

2. Can I handle this on my own?

In some cases, patients are able to relieve the symptoms of abnormal veins with at-home treatments. For example, if you are suffering from painful varicose veins, you may be able to improve your condition by wearing compression stockings, avoiding long periods of sitting or standing and elevating your legs as much as possible. However, for many patients, these conservative measures are not enough. If you have already tried at-home treatment with no success, or if you don’t believe you would benefit from at-home treatment, it may be time to make an appointment at a vein clinic.

3. Am I comfortable with the idea of professional treatment?

Professional treatment can dramatically improve the appearance of abnormal veins, as well as any accompanying symptoms. Various treatment options are available for patients with abnormal veins, including sclerotherapy, ambulatory phlebectomy, laser therapy and more. Depending on the type of treatment you choose, injections and/or surgery may be required. Although these procedures carry very little risk and require only limited recovery time, they are still more invasive than at-home therapy.

If you are ready to try a minimally-invasive treatment to resolve symptoms of varicose veins or spider veins, making an appointment with a vein doctor is the most appropriate course of action. To learn more about your vein treatment options, contact the St. Louis Vein & Endovascular today.



What to Expect from a Visit to a Vein Specialist

Your first visit to a vein specialist can be a nerve-wracking experience. Here is some information to help you prepare for your appointment.

About Vein Specialists

A vein specialist is a physician who is trained to evaluate and diagnose vein condition. Vein specialists are also capable of administering various treatments to patients with vein disease in order to improve their symptoms.

The Exam

During you first visit to a vein specialist, the doctor will examine your abnormal veins. To make this part of the appointment as easy as possible, be sure to wear loose fitting clothing that will allow your doctor to access the affected veins without difficulty. Your doctor will also ask you questions about your symptoms, as well as any at-home treatments you have tried. Be prepared to answer these questions in as much detail as possible.


Once the doctor has completed the exam and reviewed your medical history, he or she will diagnose your condition. Depending on the circumstances, you may be diagnosed with spider veins, varicose veins or both. If the doctor suspects another issue or complication, further testing may be recommended before you decide on a course of treatment.


A vein specialist will offer a range of treatments to meet the needs of various patients. Here at the St. Louis Vein & Endovascular, for example, we offer multiple treatments for both spider veins and varicose veins. Some of the treatments you may consider for these conditions include:

  • Sclerotherapy – During sclerotherapy, a special solution is injected into spider veins or varicose veins. This solution irritates the walls of the vein and causes them to collapse. It may be performed with or without the help of ultrasound guidance.
  • Endovenous Laser Ablation – Endovenous laser ablation treats abnormal veins with laser energy, which seals them off and diverts blood into healthier blood vessels. This treatment is appropriate even for varicose veins located deep within the skin.
  • Ambulatory Phlebectomy – Ambulatory phlebectomy is a surgical procedure used to remove superficial varicose veins from the body entirely.
  • Radiofrequency Ablation – Radiofrequency ablation involves the administration of radiofrequency energy into the interior of the vein with a small catheter.
  • VeinGoghOhmic Thermolysis – VeinGoghOhmic Thermolysis is a superficial laser treatment designed to improve the appearance of spider veins.

Make an Appointment

If you are interested in visiting a vein specialist, please contact the St. Louis Vein & Endovascular today to make an appointment.

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