Veins and arteries make up the complex vascular system in your body. Dr. Goodman is specifically trained to treat all vascular diseases such as varicose veins, venous insufficiency and arterial disease in a comprehensive manner for your optimal result.
General Questions
Varicose Veins: Did you know...
Your calf muscles are your Second Heart
What is the prevalence and causes of varicose veins?
What are the symptoms of varicose veins?
What happens if I don't treat my varicose veins?
What is venous insufficiency?
What is the goal of treatment?
EVLT and VNUS Closure Treatments for Varicose Veins Questions
What is the difference between the EVLT and VNUS Closure technique?
Is everyone a candidate for the EVLT or VNUS Closure procedure?
Does it hurt?
What is tumescent anesthesia?
How big is the incision?
Will there be bruising and swelling?
What are the post treatment limitations and expectations?
Will I miss work or other activities?
When will I see results?
How safe is the procedure?
May I travel?
Does endovenous ablation work?
Spider Veins Questions
What is the difference between varicose and spider veins?
Does injection sclerotherapy or surface laser therapy hurt?
How many treatments are needed?
Do I have to wear compression stockings?
What are the complications of sclerotherapy and surface laser treatment?
May I travel after the procedure?
Varicose veins are enlarged, weakened and damaged superficial veins that have lost the ability to effectively carry blood back to the heart. Varicose disease results in the stretching of the vein wall and the malfunction of the valves inside the vein that normally prevent blood from pooling or falling back down the leg. This is called venous reflux. When venous reflux occurs, pressure builds-up causing the blood to find a superficial place to go. When this occurs, tremendous pressure builds in the deep vein system causing the excess blood to find an alternative place to go. Varicose veins and spider veins are the visual symptoms of the progression of the disease.
Symptoms of varicose veins and venous insufficiency include:
- itchiness
- achiness
- heaviness
- exercise intolerance
- restless leg syndrome
- night cramps
- pain along the vein path
- swelling
- skin changes
- ulcers
The Second Heart is a system of muscles, veins and valves all working together to help get the venous blood from your foot, up your leg and to your heart. The venous system is a passive system, under less pressure that the arterial system. Your calf muscle is your second heart. As you walk, the calf muscle essentially massages the deep vein system, forcing the blood higher up the legs.
Failure of the calf pump and any of its components is associated with virtually all the symptoms of venous congestion and venous reflux.
Walking is integral to preventing venous congestion and is crucial to the post treatment protocol and successful resolution of your symptoms.
Approximately 80 million people in the United States suffer from some form of vein disease. Heredity is the most important factor in the development varicose veins.
Advancing age increases the prevalence of varicose veins from 41% of women in their forties to 72% of women in their sixties. The prevalence of varicosities in men increase from 24% in their forties to 43% in their sixties.
Women are more susceptible to this problem because of cyclical circulating hormones (progesterone). This causes the vein walls and valves to soften and dilate. Pregnancy is also an important factor as the weight of the uterus causes pressure in the pelvic area, increasing the pressure in the leg veins. Pregnancy hormones also contribute, causing the veins and the valves to soften.
Other predisposing factors include occupations requiring prolonged standing, obesity, excessive heat and disorders of the lower leg (flat feet, deep vein thrombosis).
Common complaints range from general leg fatigue and heaviness, itching, burning, and aching to swelling, and throbbing pain. Often patients experience cramping and restless leg syndrome. Women may experience worsening symptoms during their menstrual cycle, hormone therapy, and pregnancy.
*Not all symptomatic patients will complain of pain as their symptoms may be subtle and gradual. After treatment, they are surprised to realize how much chronic discomfort they accepted as normal.
Over time, complaints may progress to rashes, discoloration, phlebitis, ulceration and bleeding.
There are many adverse consequences of untreated varicose veins, and the severity will vary from person to person. Their symptoms
of fatigue, aching and pain may increase. One can get swelling, skin color changes, thickening of the skin, and up to 20% of patients can develop leg ulcers. Spontaneous bleeding, superficial thrombophlebitis and a potentially life-threatening condition called deep vein thrombosis can develop.
Venous insufficiency is the term used to describe vein disease of the leg. It is a disorder affecting millions of Americans, as it increases the blood pressure in the leg veins, and over time, can cause leg swelling and the symptoms relating to those itchy, achy, tired and painful legs. It can progress to varicose and spider veins, skin color changes and ulcers.
Prior to starting your specific treatment plan, your personal goals are discussed with Dr. Goodman.
Our ultimate goal is to help you maintain an active and healthy lifestyle.
back to top 
The EVLT procedure uses light energy to seal off the vein. The VNUS Closure system uses radiofrequency to heat the wall of the vein to seal it shut. Both procedures are performed in the office using local anesthesia. You are able to walk out of the office and may drive yourself home as long as you are not medicated.
The applicability of minimally invasive techniques such as EVLT or Closure
is primarily dependent upon your anatomy and other factors. We always try to do the least invasive procedure that is appropriate for your disease process. An individual
treatment plan will be specifically designed for you.
Patients are offered a mild sedative for the office procedure if they feel the need. Generous amounts of local "tumescent" anesthesia are given into the tissues surrounding the vein to numb the area. Patients do not feel pain when the vein is treated.
Tumescent anesthesia is a special numbing medication that is administered into the tissues surrounding vein with ultrasound guidance. Not only does this provide anesthesia to the area, but the pressure from the fluid reduces the diameter of the vein, thus optimizing the contact of the fiber with the vein wall. This ensures the maximal delivery of energy to the vein wall.
The ELAS and VNUS Closure procedures usually require a nick in the skin the size of a freckle.
Bruising and local swelling in the surrounding tissues is possible and will resolve in a few days.
Reasonable activities may be resumed the day of treatment. Walking is encouraged at least once per hour for ten minutes while awake. A post procedure thigh high compression stocking is worn overnight and may be taken off in the morning to shower. Either this stocking or your pre-treatment compression stocking must be worn during the day but can be removed at night for sleeping. This is done for 7-14 days.
No baths, hot tubs, or heavy lifting are allowed for one week.
A follow-up appointment will be scheduled for you.
Most patients resume near normal activities that day, and may return to work within 24-48 hours after the procedure. Your specific situation will be discussed with you.
In general, most patients feel the absence of achiness and heaviness in their leg in the first few days following the procedure. Some patients see their bulging varicosities drastically reduced 1 to 6 weeks following the procedure. This is influenced by the severity of the disease process and the compliance with the post treatment regime.
As with any medical intervention, potential complications exist but are extremely rare. They will be discussed at length with you before treatment.
Long trips are discouraged for 1 week following treatment.
Yes. The procedure has a success rate of 98%.
back to top
Varicose veins are large bulging veins. Spider veins are small purple, red or blue veins just below the skin surface.
Sclerotherapy utilizes extremely small needles to administer the sclerosing medication. Mild tenderness is sometimes experienced during administration. The surface laser procedure requires temporary cooling of the skin prior to treatment. You may feel warmth at the treated area. Chilled aloe gel is applied after the procedure.
The treatment protocol is tailored individually and varies depending on the severity of the disease and your ultimate goal. Only a thorough evaluation and discussion will answer this question honestly.
Compression stockings are critically important after injection sclerotherapy. They must be worn to keep the vein compressed. They may be removed at night. They are not needed after surface laser treatment.
Surface laser therapy may discolor darker skin tones, including tanned skin. Our laser utilizes a special wavelength resulting in a more effective treatment of darker skin types.
Adverse reactions to sclerotherapy are very rare. They may include a brownish discoloration appearing within a few weeks after treatment. This is an indication of extreme irritation and may resolve in 1-12 months. Other very rare complications are ulceration, phlebitis, nerve injury and allergic reactions.
Regardless of treatment, the spider veins will initially look worse before they look better.
Lengthy travel is discouraged for 1 week following sclerotherapy treatment. There is no restriction to travel following cosmetic laser treatment.
back to top |
