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Philadelphia Comprehensive Vein Center

 


 
 

Dr. Lee Kirksey, a Board Certified vascular surgeon, serves as Clinical Assistant Professor at The University of Pennsylvania School of Medicine and practices at Penn Presbyterian Medical Center in Philadelphia Pennsylvania. Dr Kirksey specializes in minimally invasive treatments like varicose veins and spider veins. Varicose veins and spider veins affect 30% of adults. Dr. Kirksey states that these varicose veins and spider veins occur in men and women although most people think that they're more common in women. It's not just a cosmetic consideration when one is considering vein sclerotherapy or laser vein ablation. "Varicose veins and spider veins may be quite symptomatic with pain, swelling and redness. This can limit people's ability to conduct normal activities working, conducting family life and recreational activities."

Dr. Kirksey as director of Penn Woundcare Center of The University of Pennsylvania Healthcare in Philadelphia describes the various causes of varicose veins and spider veins. Usually, some abnormality with the superficial veins exists. Most commonly a poorly functioning valve. This malfunctioning venous valve allow blood to pool in the leg when one is standing still. That's the reason that most people complain of worsening symptoms when standing stationary. Interestingly, when people with this condition exert themselves with exercises like walking, the symptoms disappear. This is because the muscles of the legs assists the return of blood to the heart under conditions of exertion.

Additional symptoms of venous insufficiency include swelling and heaviness that usually worsens over the course of the day. The symptoms of varicose veins are usually worse as the day progresses and elevation of the legs may palliate some of the discomfort.

Treatment of varicose veins, spider veins and leg discomfort varies depending on the symptoms that are present in the patient. Some people have no symptoms and there motivation is the appearance. Varicose veins and spider veins can be quite unsightly.

 
  For varicose veins, the most important point is to determine is there are any underlying "feeding" vessels which maybe producing the unsightly spider vein areas. This can be determined by a very easy noninvasive ultrasound assessment.

Provided that no underlying cause is found on ultrasound, then treatment options include sclerotherapy, laser ablation and phlebectomy. Sclerotherapy involves the injection of an alcohol or salt solution which creates inflammation with the walls of the vein. The walls of the vein collapse and the small lumen of the blood vessel closes. The vessels in then reabsorbed by the body over time.



Common Question: Doesn't my body need this vessel? What happens when it is removed?

Answer: Most varicose and spider veins are caused by an abnormal superficial vein. The deep veins of the leg perform the majority of drainage and in someone whose veins are performing poorly, the circulation is actually improved when the poorly performing valves are eliminated.

Laser ablation is used for spider veins and varicose veins. My preference is to treat the largest area with injection and to follow that treatment with laser for any leftover areas.

Laser ablation can also be used for the saphenous vein and replaces the historic gold standard of veins stripping.


Common question: There are so many advertisements for varicose vein treatment. How do I know which one to choose.

Answer: Shop around. I would consider varicose veins, injection sclerotherapy and spider vein treatment to be "retail medicine". Sometimes the cheapest provider is not necessarily the best quality. I would suggest that you look for a facility where they do a high volume. It varies from state to state, but in most places injections are done by a supervised nurse or a physician.
 
   
Lee Kirksey, MD FACS - Specializing In Arterial, Venous and Cosmetic Disorders - Phone: 877-642-2644