Varicose vein treatment can cure pain, unsightly lines

Published 10:51 am Monday, February 18, 2008

Varicose veins were bringing Karrol Bruso down.

Though normally an energetic person, Bruso found herself dreading getting out of bed in the morning because of her aching, tired legs.

Her long hours running the Quiznos in Mill Creek Town Center, working on her feet almost all day, didn’t help.

“I stand a lot for my job,” she said. “It was painful.”

Though the look of Bruso’s bumpy, blue varicose veins bothered her, especially when she wore skirts and shorts, it was pain that brought her to the Radia Vein Center in Mill Creek, now in its third year of operation.

There, like many patients before her, she found treatment that brought her legs back to life.

Her doctor, Mark Papenhausen, 38, one of five vascular surgeons at Radia, treated one leg at a time.

Bruso, 49, noticed an improvement almost right away in her right leg, which seemed to be energetically racing ahead of her untreated left leg.

“My left leg felt like there were weights on it,” she said. “There was such a difference.”

Varicose veins affect about 15 percent of men and about 25 percent of women, according to the Mayo Foundation for Medical Education and Research.

Thanks to advances in technology, however, treatment is getting easier for doctors and patients, including many in Snohomish County.

Papenhausen fixed Bruso’s veins with two treatments that are typically covered by insurance, especially if symptoms include pain.

He started with endovenous laser ablation, an attractive alternative to the longtime standard treatment for varicose veins known as stripping, Papenhausen said.

Stripping usually requires a hospital-based surgery with general anesthesia as well as weeks of recovery instead of a few days.

Laser ablation involves inserting a laser fiber catheter into a large vein, known as the greater saphenous vein, on the inside of the leg. On its way out, the laser fiber delivers pulses of laser light, causing the vein to collapse and seal shut, allowing better-functioning veins deeper in the leg to take over.

“It’s fascinating,” Bruso said. “It’s wonderful.”

Bruso was back at her demanding workplace, despite some tenderness in her legs, after about three days.

“It’s really cool,” she said, adding that she tells her friends not to be afraid of treatment. “I say, ‘Don’t worry. Go do it.’”

Bruso, a particularly laid-back and enthusiastic patient, said the second procedure Papenhausen did — called ambulatory phlebectomy — was even more interesting.

In a phlebectomy, doctors remove small varicose veins though a series of tiny punctures.

Bruso watched as Papenhausen removed the enlarged, veins, which looked like angel hair pasta, from her legs, using a crochet-like hook.

“I had lumpy bumpies,” she said of her doctor’s affectionate term for enlarged and unsightly vein branches. “It looked like little marbles.”

Most recently, Bruso also had a third type of vein treatment called sclerotherapy to remove her spider veins, which are smaller blue or red veins.

Though some spider veins in the legs can cause pain, most pose only cosmetic problems and are not covered by insurance.

Sclerotherapy sessions typically cost $350 for 30 minutes with the number of treatments varying from patient to patient.

To remove Bruso’s spider veins, Papenhausen injected each one with a detergent-like solution, Sotradecol, which causes the veins to seal shut and eventually disappear.

Once the solution enters the vein, it seems to magically disappear. Then it turns red, a color that will fade as the vein heals.

While the long-term success rates for vein procedures are high, spider veins can continue to emerge in new places.

“People who have spider veins can get more,” Papenhausen said. “But it’s usually years down the road.”

Though scarring and the back-to-work recovery time is minimal for many vein-related procedures, Papenhausen recommends planning treatments at least two months before a big event such as a wedding.

“It’s a healing process,” he said. “They’re going to look ugly and red and inflamed.”

Patients who have sclerotherapy for spider veins or phlebectomy treatments for varicose veins should avoid sun exposure for a month before and after the procedures. Scarred tissue can react to sunlight with permanent darkening or hyperpigmentation, making fall and winter better times for treatment.

Sunscreen, Papenhausen said, is a good idea after any vein procedure near the skin surface.

Bruso is thrilled with her results.

Though the mosquito-bite feeling of the tiny needle going into her skin for sclerotherapy injections didn’t feel good, she said it was easier to endure than Novocaine at the dentist.

She’s also excited to have more presentable legs at her daughter’s wedding.

“I won’t have model legs,” she said. “But I won’t have blue legs.”

Reporter Sarah Jackson: 425-339-3037 or sjackson@heraldnet.com

Resources

Radia Vein Center 15224 Main St., Suite 303 Mill Creek 425-740-2180 www.radiaveincenter.com

Society of Vascular Surgery 800-258-7188 www.vascularweb.org