FAQ Varicose Veins


Varicose veins can cause unhealthy changes in your circulatory system.  The venous system is an important part of your circulation and can affect your overall health and may lead to unsightly spider and varicose veins in your legs.  If you have varicose veins, treatments are now easier and require less recovery and minimal surgery.  Newer advancement in laser technology, ultrasound, and foam sclerotherapy can make the treatment of spider and varicose veins much less invasive than previous generation.  Old fashioned vein stripping is now less commonly performed in favor or endovenous procedures that employ laser or radiofrequency energy.  Following questions and answers will help you understand vein disease and vein problems.  Our Los Angeles vein clinic is directed by board certified vein surgeon Dr. Raffy Karamanoukian, an expert in the field of vein procedures.
Are bulging varicose veins a problem? Varicose veins can occur on any part of the feet, ankles, legs, and thighs.  Varicose veins represent cooling of blood within abnormal veins located underneath the skin.  The most common cause of bulging varicose veins is as a result of incompetent and poorly functioning vein valves.  Once vein valves begin to function improperly, blood return back to the heart is slowed and blood begins to pull within superficial veins of the legs and thighs.  If you have varicose veins and they continue to bulge with standing or physical activity, these may be early warning sign of a condition known as venous insufficiency.  The patients who have venous disease may ultimately develop symptoms associated with abnormal veins including leg pain, discomfort, leg swelling, clots in the legs, venous ulcers, restless legs, and leg cramping. 
If my varicose veins begin to bulge, does this mean that the veins are getting worse? Not all varicose veins bulge.  Usually, the venous circulation is gravity dependent and standing upright or sitting for long periods of time may worsen the function of the valves in your veins, leading to bulging varicose veins.  Some patients who are highly active and lead a healthy lifestyle may develop lead a healthy lifestyle may develop bulging veins as a result of normal activity, whereas others may develop bulging varicose veins as a result of steadily worsening varicose veins.  During your initial consultation with board certified vein surgeon Dr. Raffy Karamanoukian a complete vein mapping will be performed in order to determine whether your bulging varicose veins represent an early warning sign for venous insufficiency, or whether the bulging veins represent a normal process.
What are some common complaints with the patients who have venous insufficiency? Venous insufficiency and vein disease can arise overtime, but most commonly occurs with advance age.  The most common symptoms associated with venous disease include leg swelling, leg pain and discomfort, aching legs, early muscle fatigue, swelling in the legs, edema, changes in skin color, sock marks, restless legs, itching, and burning.
Does pregnancy make my varicose veins worse? There are many risk factors associated with venous insufficiency, but no two people are alike in terms of how fast and how severe they develop varicose veins. The most common risk factors for the development of vein problems includes pregnancy, standing or sitting for long periods of time, family history, heavy lifting, strenuous activity, obesity, and trauma.  The patients who have varicose veins may also have associated hemorrhoids or hernias.  The development of varicose veins and venous insufficiency may take years or months to worsen.  If you are steadily developing varicose veins and size of venous insufficiency in your legs and thighs, early intervention is the key to proper treatment.
What does a vein mapping include? During your consultation for vein treatment, one of the most productive examination methods is to map out the veins in the legs and thighs.  By following the course of abnormal veins, a transilluminating light or ultrasound can be used to source out the root cause of abnormal and advancing veins.  By determining the root cause of the vein problems, treatment can be directed towards the most unhealthy portions of your varicose veins.  Treatment of varicose veins includes endovenous ablation, laser ablation, sclerotherapy, ultrasound guided sclerotherapy, microphlebectomy, and vein surgery.
Does your Los Angeles vein clinic perform the EVLT procedure? Endovenous laser ablation is commonly referred to as EVLT.  The treatment has become the goal standard for the treatment of venous insufficiency and venous reflux.  Our office offers the endovenous laser therapy and endovenous radiofreqency therapy for eradication of venous insufficiency and abnormalities of the proximal venous circuit.  Treatments with EVLT are performed on an outpatient basis with the patient awakes under local anesthesia. .
Will I be awake during the EVLT procedure? The EVLT procedure is commonly performed with the patients awake under local anesthesia.  Rarely, the patient need to be put to sleep or placed under general anesthesia during an EVLT endovenous vein treatment.  If you have anxiety about the EVLT procedure or any surgical procedure for your varicose veins, light sedation can be provided for patients on a case by case basis.
Is the EVLT procedure uncomfortable? The EVLT procedure is a radical departure from old fashioned vein stripping and vein surgery.  Unlike vein stripping of the past, ELVT does not require major surgery, incisions, or general anesthesia.  Most patients will tolerate the EVLT procedure well with minimal discomfort and minimal anxiety.  Return to normal activity is usually quick and the patients are advised to resume normal, non-strenuous activities after the procedure.
Is the EVLT procedure covered by insurance? The coverage for vein procedure depends on medical necessity.  Individual insurance companies have varying criteria for coverage of EVLT and the Venefit procedure.  Some insurance companies will require preauthorization prior to certifying treatment for EVLT or Venefit.  If you have question about your insurance coverage.
Is Dr. Karamanoukian board certified in vein surgery?  Dr. Raffy Karamanoukian is a fellow of The American College of Surgeons and an expert in the field of vein surgery.  He is double board certified and is a diplomate of the American Board of Phlebology (Vein Surgery), as well as the American Board of plastic reconstructive surgery.  Dr. Karamanoukian has traveled internationally to teach varicose vein procedures and vein treatments in other countries.  The advancement in endovenous laser ablation and endovenous RF ablation make the treatment of veins readily accessible throughout the nation.  Rest assured that you will receive the highest standards of care in our Los Angeles Vein Clinic.
My mother had Varicose Vein Stripping.  Do you perform the same procedures? No.  Vein Stripping is a decades old procedure that is effective, but relatively painful and usually requires a general anesthesia and a hospital stay.  The procedures that we perform in the Santa Monica Vein Center are just as effective but are performed in clinic under local anesthesia (much like a dental procedure), require no down-time, and are relatively painless when compared with vein stripping.  We have many men and women whose parents have undergone vein stripping decades ago and are elated by how painless this new technology is when compared with the older varicose vein techniques.
Is it true that teachers are at risk of getting spider and varicose veins? As if being a teacher wasn't hard enough, it is true that teachers are at higher risk of developing varicose veins over their careers.  Its probably due to the fact that teachers spend many hours standing in front of a classroom talking.  This may place undue stress on the vein valves and lead to a condition known as venous insufficiency.  The condition may also be caused by any employment that involves standing or sitting for long periods of time. Other professionals that we see with varicose veins include airline stewardesses, truck drivers, nurses, waitresses, secretaries, and pharmacists.
Will my varicose vein procedure be covered by insurance? Very often, insurance companies cover the cost of medically-necessary varicose vein procedures.  Our Santa Monica office accepts many types of insurance and can help you determine whether a particular vein procedure is covered by medicare or your insurance.

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