Varicose Veins

What are Varicose Veins?

Varicose veins are enlarged, swollen veins that bulge out of the skin. Varicose veins are different in appearance from spider veins, which are tiny dilated capillaries that do not protrude. Both, however, are caused by venous insufficiency, or abnormal backward flow of venous blood.

Symptoms of Varicose Veins

The overwhelming majority of patients with bulging varicose veins have symptoms. Symptoms include pain, aching, fatigue, swelling, leg heaviness, burning, and itching. Medical attention should be sought whenever these symptoms are present. By resting, elevating, or supporting the legs, these symptoms can be relieved for short periods of time. If the venous insufficiency becomes more severe and is left untreated, it can lead to progressively severe problems called venous stasis changes. This results in the overlying skin tissue to be damaged by the pooling of blood. Early symptoms include swelling and skin discoloration. If the condition worsens, it may cause the skin to break down and lead to open sores and ulcers.

Who is Most at Risk?

Anyone can have varicose veins, but certain people are more at risk than others. The condition is most common in females, but 25-33 percent of patients are male. Patients may be any age, but risk increases as one gets older. For females, pregnancy increases the risk of developing varicose veins. Varicose veins also tend to be hereditary and run in families. A previous history of blood clots also increases the risk for developing varicose veins.

Treatment of Varicose Veins

Contact our office at 317-355-5081 for an appointment, or obtain more information by clicking here.

Spider Veins

What are Spider Veins?

Spider veins are the thread-like veins found just under the surface of the skin. They can be red, blue, or purple, and are usually on the thighs and lower legs. Spider veins can sometimes cover large areas of skin, but they are a cosmetic problem only, rarely causing physical symptoms.

Why Do I Have Them?

Risk factors for spider veins include age, heredity, pregnancy, hormonal changes, obesity, and extended periods of standing. At least a third of all women and a smaller percentage of men are believed to display the condition.

Will They Go Away Without Treatment?

No. Once spider veins are established, treatment is necessary for them to be removed.

Will I Need Surgery?

Spider veins are easily treated without surgery. Sclerotherapy can be used to cosmetically treat spider veins, with no down time, or hospitalization. Additional information about sclerotherapy can be found here.

Treatment of Spider Veins

Contact our office at 317-355-5081 for an appointment, or obtain more information here.

Treatment Options

Endovenous Laser Therapy (EVLT)

Endovenous Laser Therapy (EVLT) is an exciting, state-of-the-art, outpatient, non-surgical procedure. It usually takes less than an hour to complete. Patients are given the option of having oral or intravenous conscious sedation for relaxation. General anesthesia is not necessary. After the leg is prepped and draped, and the skin anesthetized, a laser fiber is inserted into the vein through a tiny needle hole using ultrasound guidance. The laser fiber is then activated, sealing the vein closed with heat energy. A bandage is applied to the needle hole, a compression stocking is placed on the leg and the procedure is complete.

What are the Risks?

EVLT has been proven to be remarkably safe. Reported complications, including overlying skin burns, nerve injuries, or blood clots developing in other untreated veins, are extremely rare. The risks are well below 1 percent; we have not seen these complications in our practice to date.

What are the Results?

Reports in the literature (as well as in our experience) have demonstrated a greater than 98 percent success rate.

Do Insurance Companies Cover EVLT?

The overwhelming majority of insurance companies cover EVLT, ambulatory phlebectomy, and sclerotherapy for treatment of symptomatic varicose veins. But not all insurance companies will cover spider vein sclerotherapy. We will submit your information to your insurance company for preapproval prior to your treatment.

Ambulatory Phlebectomy

Ambulatory (micro) phlebectomy is a procedure that removes and disrupts varicose veins through a series of tiny (micro) skin incisions. We can perform this procedure at the same session as an EVLT procedure, or at a separate time.

Who Needs a Phlebectomy?

Ambulatory (micro) phlebectomy is performed on an outpatient basis for patients with large bulging veins. This procedure is done for the large branches off the greater saphenous vein that would be treated with EVLT.

How is the Procedure Done?

After the leg is prepped and draped using sterile technique, the skin around the varicose veins is numbed with local anesthetic. We then remove/disrupt the varicose veins through a series of tiny incisions. The large bulging veins are then removed.

What Can I Expect after the Procedure?

When we’re done, small pressure dressings are applied to the incisions and the patient is instructed to wear a thigh-high compression stocking for two weeks. Long-term results of this safe, effective procedure have been shown in the medical literature (and in our own practice) to be excellent.


What is Sclerotherapy?

Sclerotherapy is an outpatient procedure that involves injecting a sclerosing liquid through a tiny needle into the spider or varicose vein. This solution replaces the blood in the vein and causes irritation and scarring of the walls of the vessel. The body then begins its natural healing process and the vein begins to shrink and disappear. Sclerotherapy is one of the most common treatments for spider and varicose veins and has been in use for more than 75 years.

Who is a Candidate?

Our physicians and staff will evaluate your varicose and spider veins. We will order a preliminary ultrasound (particularly patients with large bulging veins) to see if EVLT or ambulatory phlebectomy needs to be performed before the sclerotherapy. The treatment strategy is discussed in detail with each patient prior to starting therapy.

Describe a Treatment Session

The sclerosing agent is injected into the spider or varicose veins through a tiny needle. Discomfort is minimal and no anesthesia is required. You will need to bring support hose to your appointment.


Do I Need Testing for My Veins?

Our vein specialists always start with an ultrasound examination as part of your treatment plan. Both the deep and superficial veins are carefully evaluated. Ultrasound images give your doctor a detailed image of your veins, enabling us to determine what treatment options are best for you.

How is the Ultrasound Done?

An ultrasound appointment will be scheduled for you at the hospital, to be completed by specially trained technicians with experience in vein studies. The ultrasound is completely painless. A warm gel will be placed on the area they will be imaging, and a wand will be used to take pictures. Exams take one to two hours.

When Do I Get Results?

Your results will be reviewed with you at your next appointment. At that time, a treatment plan will be put into place for your specific care. This office visit gives you the opportunity to ask questions, and be informed of the next steps for your vein treatment.


Compression stockings are specially designed to increase blood circulation and provide graduated pressure on the lower leg, which can help alleviate the symptoms associated with varicose and spider veins. Compression stockings are tightest at the ankles, gradually become less constrictive towards the knees and thighs. Compression stockings are used to compress the veins, and redirect blood flow to the deeper vein system.

Do I Have to Wear Them?

Yes, you will be required to wear compression stockings for two reasons: First,  to see if your symptoms get better. Second, you need them for your procedure and right after your veins are treated for optimal results.

Can I Use Support Hose Instead?

Compression stockings are offered in different strengths and types, and are available by prescription. You will be provided with a prescription at your appointment for the type you will need.

Where Can I Get Them?

Many pharmacies carry compression stockings. Any brand is fine, as long as they are the proper strength and fit. For a list of pharmacies we have used in the past, click here.

Additional questions or concerns? Contact us today.