Midwest Vein Care is the go-to destination for reliable diagnosis and treatment of spider veins and varicose veins in St. Louis, Missouri. Our prices are significantly lower than all of our competitors in the area without sacrificing quality of care. The treatment of venous disease begins with a medical history and examination of the circulation.
The smallest cosmetic veins that appear in the skin are called spider veins; we treat them with sclerotherapy. For larger varices, treatment with laser ablation or radiofrequency ablation is comfortable and has no downtime. Our experience in vein treatment and our meticulous approach to patient care have allowed our patient base to grow significantly over the years. We have also developed lasting referral relationships with partner professionals in dermatology, interventional radiology and plastic surgery thanks to our ability to provide a variety of excellent medical and cosmetic venous treatment and cosmetic services to our patients.
Endovenous ablation procedures are considered experimental and investigational for the treatment of affluent and accessory varicose veins other than the accessory saphenous vein. Varicose veins are a common condition, present in 20 to 25% of women and 10 to 15% of men in Western adult populations. In most people, varicose veins cause no symptoms other than bad cosmetics. Varicose vein surgery is one of the most commonly performed cosmetic procedures in the United States.
Most varicose veins do not require medical treatment, but in some cases, circulation may be hampered enough to cause foot and ankle swelling, discomfort, a tingling sensation, or a feeling of heaviness. For most people with varicose veins, all they need is to wear specially tight elastic tights. Tights should be carefully adjusted to the person, providing the most pressure on the lowest part of the leg. Tights should be put on when you wake up in the morning, preferably before you get out of bed.
Exercise, such as walking or biking, also helps promote better circulation from the lower body. Resting with your legs elevated will help promote circulation; on the contrary, sitting with your legs crossed can aggravate the condition. Authorities have recommended 6 or more months as a reasonable length for a trial (conservative management). An editorialist noted that the brief follow-up of subjects assigned to surgery may result in an underestimation of the costs and an exaggeration of the benefits of surgery.
By the third year, only 40% of the subjects assigned to surgery were evaluated; however, most recurrences are diagnosed after 3 years of age. Focusing on the short term can lead to underestimating the cost and overestimating the benefit; prospective comparisons of durability of up to 5 years or more are rare, and yet at this time the recurrence rate can reach 50%. In patients with varicose veins, leg pain may be associated with superficial thrombophlebitis or venous leg ulcers. When evaluating the role of varicose vein surgery in treating these conditions, the effectiveness of varicose vein surgery must be compared with conservative treatment.
If the patient suffers from superficial thrombophlebitis, conservative treatment is indicated. According to available guidelines, uncomplicated superficial thrombophlebitis is usually treated symptomatically with heat, simple analgesics, non-steroidal anti-inflammatory drugs (NSAIDs) and compression stockings; treatment should continue until symptoms have completely disappeared (usually 2 to 6 weeks for them to go away). The most serious thrombophlebitis should be treated with bed rest with elevation of the limb and application of warm, moist compresses. According to a systematic review of the evidence, pentoxifylline has also been shown to be effective for the treatment of venous leg ulcers; compression has been shown to prevent venous leg ulcers as well.
The effectiveness of venous surgery for prevention or treatment of venous ulcers is unknown. According to established guidelines, eliminating primary and secondary sources of reflux is essential for successful treatment; these sources are usually a nearby perforator or major junction that causes a redirected venous return through veins with intact valves. Venous reflux can be caused manually by compressing and releasing calf muscle using Valsava maneuver or by releasing pneumatic tourniquet; if saphenophemoral reflux lasts longer than 500 ms., then diameter of large saphenous veins (GSV) is recorded 2.5 cm away from saphenophemoral junction. Vein size has been correlated with presence of significant saphenous reflux as compatible GSV adjusts its luminal size to level of transmural pressure; it has been demonstrated that measurement its diameter reflects severity hemodynamic compromise in limbs with GSV reflux.
In cohort study Navarro et al., authors discovered that GSV diameter proved relatively accurate measure hemodynamic deterioration clinical severity model saphenophemoral junction GSV incompetence predicting not only absence abnormal reflux but also presence critical venous incompetence; GSV 5.5 mm less predicted absence abnormal reflux sensitivity 78%, specificity 87%, positive negative predictive values 78% accuracy 82%. The TriVex (transilluminated electrical phlebectomy) system is an alternative method for performing ambulatory phlebectomy; this involves endoscopic resection ablation superficial veins using illuminator electrical venous rejector small electrical surgical device; veins marked magic marker; improve visualization veins bright light inserted leg small incision motorized vein rejector which motorized oscillating end inserted cut dislodge veins.
