Varicose Veins: Not Just a Cosmetic Concern

Varicose veins are an unsightly nuisance that affects up to 40 million Americans. But they’re also a potential health hazard that could put you at risk for blood clots, ulcers and worse.

Swollen and twisted, and visible just under the skin, varicose veins develop when the one-way valves inside your veins become weak or damaged. When these valves don’t function properly, blood backs up and pools in your veins, causing them to swell. This occurs most often in the legs and ankles, but it can happen in other parts of the body as well. Hemorrhoids, for example, are a type of varicose veins.

This isn’t just a problem for women. Men can get varicose veins too. Anyone with an occupation that requires a lot of standing such as nursing, waitressing or bartending, is at risk.

If you don’t treat your varicose veins you will continue to experience pain, fatigue and swelling that keeps you from enjoying your life. In addition to the discomfort of varicose veins, there are a number of possible complications from untreated varicose veins:

  • Lipodermosclerosis: Blood that pools in the varicose veins is depleted of oxygen and nutrients. The veins don’t tolerate high pressure and red blood cells and fluid to leak into the tissues of the leg, which causes painful swelling. The red blood cells in the tissues cause chronic inflammation and the skin becomes dark and discolored. The medical term for the dark discoloration is hyperpigmentation. When the skin and the fat under the skin are inflamed for years, the tissues become woody and firm. The medical term for this woody, hard tissue is lipodermosclerosis.
  • Venous Leg Ulcer: A condition that may occur over time, with chronic venous insufficiency, is a venous leg ulcer. The ulcers due to varicose veins are painful and difficult to heal. In some cases, the ulcers cannot heal until the backward vein blood flow is corrected.
  • Spontaneous Bleeding: Another possible consequence of untreated varicose veins is spontaneous bleeding from the varicose veins. As the skin over the veins becomes thin, eventually the vein can be exposed and easily injured by clothing, bedding, etc. The blood loss can be significant but is painless.
  • Superficial thrombophlebitis (ST): ST is an inflammation of a vein just below the surface of the skin. The inflammation is not cause by and infection – rather, the inflammation is caused by decreased blood flow through the vein, damage to the vein and blood clotting. The symptoms of ST include skin redness and a firm, tender, warm vein. Localized leg pain and swelling often occur.
  • Deep vein thrombosis (DVT): DVT is often first noticed as a “pulling” sensation in the calf of the lower leg, and it can be quite painful. Symptoms also include associated warmth, redness and swelling. The swelling often extends to above the knee.

If a clot in a superficial (close to the skin) vein grows, it can move into a deep vein. These clots can break loose and move through the bloodstream to the lung, where it can cause a pulmonary embolism (a sudden, potentially life-threatening blockage). However, clots can be identified through ultrasound and then treated, typically with anticoagulants (blood thinners).

Varicose vein removal is covered by most insurance plans, a reflection of the procedure’s value beyond cosmetic concerns. If you’re not sure whether you need to treat your varicose veins, come in and see us.

Vein Center of Indiana is a leading provider in the treatment and removal of varicose veins and spider veins, including Phlebectomy, Sclerotherapy, Vein Imaging, and Compression Stockings. We serve the greater Indianapolis area, including Carmel, Westfield, Fishers, Noblesville, Geist, Broad Ripple, and Castleton.

What You Need to Know About Treating Varicose Veins and Spider Veins and Endovenous Laser Therapy (EVLT)

Vein Center of Indiana offers Endovenous Laser Therapy (EVLT) – a state-of-the-art, no hospital stay, non-surgical, minimal-to-no scarring vein procedure that takes less than an hour to complete.

What should I expect at my first visit at the Vein Center of Indiana?

Interventional Physicians of Indiana interventional radiologists always start with a detailed ultrasound examination. Both the deep and superficial veins are carefully evaluated. The greater and lesser saphenous veins are also carefully examined. If the saphenous veins have abnormal reflux then the patient is a candidate for endovenous laser therapy (EVLT). If the saphenous veins are normal, we will then offer ambulatory (micro) phlebectomy or sclerotherapy as the treatment. Ultrasound findings and treatment options are always discussed with the patient during a pre-procedure consultation.

How does the EVLT procedure work?

The laser shrinks the vein walls closing the faulty vein so that blood can no longer flow through it.  This eliminates the bulging vein at its source.  This laser therapy procedure is highly effective and FDA approved.

How long does the EVLT procedure take?

EVLT is an outpatient treatment that takes less than an hour.

Will I be awake during the EVLT laser procedure?

General anesthesia is not necessary. Patients are given the option of having oral or intravenous conscious sedation for relaxation.

Will eliminating my varicose vein or spider vein cause other circulation problems?

No.  Once treated, the blood will merely be re-routed into other functioning veins in the leg.

Is there any risk from the EVLT laser?

No.  As a precaution, everyone will be given laser goggles to wear to protect her/his eyes from harmful scattered, reflected, or direct laser radiation from the laser itself.

Does it hurt?

The EVLT procedure may cause minor bruising or soreness.  Any discomfort is easily treated with over-the-counter, non-aspirin pain relievers as recommended or necessary.

Will I need to take time off of work or activities?

After the EVLT procedure, there is usually no need to take time off of work.  Walking immediately after the procedure is encouraged.  Normal daily activities can be resumed right away, but consult your doctor about rigorous activity (such as gym workouts).

Will I have to have any lab tests done before an EVLT treatment?

There is no lab work or pre-op necessary for Endovenous Laser Therapy.

Is EVLT a successful procedure?

Some patients feel an immediate relief of symptoms.  Reports confirm our experience that demonstrate a greater than 98% success rate.

What is an Interventional Radiologist? 

An interventional radiologist specializes in treating disorders of the body using minimally invasive techniques and the blood vessels to gain access into the body. An interventional radiologist is a medical doctor with additional education and training (fellowship) above and beyond the required four years of a basic diagnostic radiology residency. All of our interventional radiologists are board certified by the American Board of Radiology. Learn more about us here.

Don’t suffer from Varicose Veins and Spider Veins any longer.

EVLT is covered by the vast majority of insurance companies. Our Indianapolis metro area interventional radiologists are considered national experts in the treatment of varicose veins and offer the full-range of vein treatment including ambulatory (micro) phlebectomy and spider vein sclerotherapy.

Using Ambulatory Phlebectomy For Varicose and Spider Vein Removal


What is 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 An Ambulatory Phlebectomy 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 about Endovenous Laser Therapy (EVLT) for Varicose and Spider Vein Treatment?


What is EVLT?

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.

Frequently Asked Questions About Sclerotherapy


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.

What are the Risks?

Sclerotherapy 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.

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.

Top 5 Things You Need to Do to Get Your Legs Ready for Spring


It takes real work getting ready for bare-leg weather. Though it seems like spring is a lifetime away, warmer weather really is just around the corner, and now is the best time to get those legs looking their best. So don’t waste time! There is so much you can do now!

Here are five things you can do during the cold winter months to get your legs ready by the time the sun shines in April.

1) Eat the Right Foods. 

You hear it all the time, but it is true. Eat well = look well. Our skin is the largest organ – it needs the right nutrients to look and function at its best. Vitamins A, B3, C, E and K are the ones needed to improve skin health. The Mediterranean Diet (which is high in fruits and vegetables, fish, nuts, bread and olive oil) provides these essential vitamins.

2) Get Plenty of Exercise.  

It’s no secret that exercise is healthy for the body’s internal organs. But not much emphasis is put on how exercise benefits the skin. Exercise increases blood flow, thereby nourishing skin cells and keeping them vital. In this process, blood carries oxygen and nutrients to working cells throughout the body – which includes the skin.

3) Re-Hydrate Every Night With a Good Moisturizer.

Our skin takes a lot of abuse. Think of all the pollution, rough weather and general stress our skin endures on a daily basis. As a result of all this, our skin tends to dry up, implying a deficiency in nutrients. To combat this, it’s best to hydrate your legs each and every night with a dermatologist-recommended lotion. The most effective lotions not only moisturize the skin, they also condition and repair it too.

4) Limit Exposure to Sunlight. 

Sun damages the skin. Yes, tanned skin looks fantastic and appealing, but not everyone can benefit from exposure to the sun. In fact, sunlight can be harmful to most people’s skin, often causing cancer. This is true even in the winter months, with cooler temperatures and sporadic sunlight. For those with fairer skin, it’s best to limit sunlight altogether – yes, even in winter. But, say, on a nice-weather day, a fair-skinned person wants to wear shorts or a skirt; he or she should still wear sunscreen to protect the skin from UVA and UVB rays.

5) If Needed, Get a Treatment for Those Unsightly Varicose Veins.

It is easy to hide varicose veins in the winter with long pants and staying indoors. However, when spring comes, people want to show off their legs a bit. This is why winter is the perfect time to get treatment to eradicate varicose veins: the winter months allow a person some time to heal from a treatment.

Breaking It Down!

There really is a simple and effective way to prepare your legs for spring. It requires changes in one’s daily habits and approaches to health, and it depends on being mindful of the effects daily life has on your overall health. Winter doesn’t have to be a dormant season; instead, it can be a season of preparation. It will take a little work, but it always pays off in the end. Bare-leg season is just a few weeks away! Take advantage of the time you have now to get your legs looking the best in time for spring.

Winter Is The Best Time To Get Rid Of Varicose Veins and Spider Veins


Warmer temps are right around the corner. So, now is the time to get ready to show off your legs. Don’t suffer through another season when you can take care of those painful and unsightly varicose veins and spider veins with non-surgical, minimally invasive, outpatient treatments that get you back to your healthy lifestyle – and those shorts.

Varicose vein and spider vein treatments can eliminate veins that create bulging and twisting lines in the lower body – and relieve common symptoms like: pain, aching, fatigue, swelling, leg heaviness, burning, and itching. Symptoms that can be so painful you can’t enjoy the active lifestyle you once did.

Both varicose veins and spider veins are cause by venous insufficiency. A real health concern, this backward flow of blood occurs when the tiny valves inside veins which keep the blood flowing in a certain direction, are damaged, and wear out, allowing blood to collect inside the affected area. This results in swelling of the vessels, which can often be seen on the outside of the legs. If unchecked this can result in tissue damage, as well as damage to the surrounding blood vessels. Skin changes, like discoloration and thickening will most often occur as well. Open sores may also develop around the ankle area, and can be prone to infection and challenging to treat..

Out-patient treatments such as Sclerotherapy, Endogenous Laser Therapy (EVLT), and Ambulatory Phelbectomy successfully treat both the symptoms and appearance of varicose and spider veins. These treatments are covered by an overwhelming majority of insurance companies for varicose veins and in some cases spider veins.

In addition, there are a number of reasons to treat your problem veins in the colder months:
– Wearing seasonally appropriate long pants and tights will hide the mild bruising/swelling that comes from vein treatment.
– It is more comfortable to wear compression stockings and conceal them in the cooler months.
– While wearing winter clothes, affected, treated areas are unlikely to be exposed to sunlight, which can cause discoloration during the time of treatment.
– More time to see the results is provided, since warmer weather is still a few months away.

While your instinct may be to put off treatment, your symptoms are reminding you that there is no better time to get rid if your varicose and spider veins and get back to your life.

Spider Veins and Varicose Veins 101

Millions of people suffer from spider veins and varicose veins, but most don’t know the difference between the two. Below is a simple explanation of the differences and signs you should see a doctor.

What are Spider Veins

Spider veins are broken capillaries, no more than 2 mm in diameter, just below the skin’s surface that can look like spider legs. They are red, purple, or blue, and though rarely a serious health problem, spider veins can cause annoying leg discomfort, including itching or burning.  They can appear throughout your body but often appear on the legs. Heredity plays a key role in developing spider veins. Extensive spider veins can be a sign of blood backup in your body you can’t see on the skin. If that’s the case, you may have symptoms similar to varicose veins.

What are Varicose Veins?

Varicose veins are veins that have become enlarged. They’re usually dark purple or blue and bulge out from the skin. Though they may not have serious implications, varicose veins can cause aching pain, throbbing, and discomfort. Varicose veins can occur throughout the body but are most commonly seen in the legs. In some cases, however, varicose veins can lead to more serious health problems, including:

  • Sores or Skin Ulcers: These are painful and hard to heal. Sores and skins ulcers are caused by chronic (long-term) back-up of blood in the veins. Some won’t heal until the backward blood flow in the vein is repaired.
  • Bleeding: Bleeding occurs when the skin over the veins becomes thin and easily injured. If untreated, the skin can break and significant blood loss becomes a concern.
  • Superficial Thrombophlebitis: Superficial thrombophlebitis is a blood clot that forms in a vein just below the skin. It can cause skin redness, a firm, tender, warm vein, along with pain and swelling.
  • Deep Vein Thrombosis: Deep vein thrombosis is when a blood clot occurs in a deeper vein. It can cause a pulling feeling in the calf, pain, warmth, redness, and swelling. While some deep vein thrombosis has no significant symptoms, if the blood clot travels to the lungs, it can be fatal.

Should You See A Doctor?

Contact a doctor immediately to discuss treatment options if you have any of the following:

  • Swollen, red, or tender veins that are especially painful or warm to the touch
  • You have sores or a rash on the leg or near the ankle
  • The skin on the ankle and calf becomes thick and changes color
  • A varicose vein begins to bleed
  • Leg symptoms interfere with daily activities
  • The appearance of the veins is causing you distress

Are Varicose Vein and Spider Vein Treatments Covered By Insurance?


Are you one of the many people who have avoided treatment of varicose veins or spider veins because you believe they are not covered by health insurance because they are a cosmetic condition? In many cases, this is a misconception. If you’ve put this procedure off because you’re concerned about cost, then read on…
Bad News and Good News.
The bad news is that people with varicose veins and/or spider veins can suffer from significant symptoms and the potential for serious complications.

The good news is that when performed for medical reasons, varicose vein and spider vein treatment is covered by health insurance. The following is a quick questionnaire to help you determine if you may qualify for insurance coverage.

Do you experience:
– Swelling in the lower legs, ankles and feet?
– Persistent pain or a heavy feeling in the lower legs?
– Development of open sores around the ankle?
– Skin changes such as thickening and discoloration?
– Leg cramping or restless leg syndrome?

Medical attention should be sought whenever these symptoms are present.
We are in-network with a number of health insurance providers and accept Medicare and Medicaid. You can find a general list of the insurance providers we work with here. (

Of course, before having any procedure, make sure you know what your financial responsibility will be. Check with your insurance provider to verify plan an benefit coverage. Depending on your plan, specific referrals or other preauthorization may be necessary.

Varicose Veins Gone For Good Without Major Surgery


Varicose veins are observed among as many as 60% of all American adults, and among 50% of women. According to The National Women’s Health Information Center, by the mid 50’s, 41% of women in the US suffer from either spider or varicose veins. Often the first signs of varicose veins appear during pregnancy. However, prolonged constipation, lack of exercise, and additional weight are also contributing factors.

In the past, people who suffered from varicose veins were offered only one treatment option – surgical removal of the diseased binding and veins. This painful procedure is still performed today. Surgery is performed under general anesthesia, followed by a cut in the groin and the knee. This traumatic surgery is often accompanied by the risk of scarring and nerve damage. Recovery from it is painful, time consuming and nearly always requires significant doses of pain medication.

Alternatives to Varicose Vein Surgery

Modern technologies offer alternatives to varicose vein treatment such as sclerotherapy. During this procedure a special drug (sclerosant) is injected into the vein. The drug forms a plug, which excludes the problem vein from the circulatory system.

The good news is that it is a painless procedure that takes about 10-15 minutes. Using this method allows us to selectively remove varicose veins, while maintaining the healthy areas of other blood vessels. It improves blood circulation, removes abnormal blood stasis in the varicose veins, and prevents disease from progressing. The signs of varicose veins disappear as do the clinical manifestations such as swelling, cramps, pain and fatigue.

In many cases, sclerotherapy can quickly solve the problem. However, in other cases, the problem requires a different approach: laser treatment.

Endovenous Laser Therapy (EVLT), is another fast and painless procedure. During EVLT the patient is conscious, but the leg under treatment is numbed under local anesthesia. A physician makes a small incision in the leg near the location of the damaged vein and a tiny fiber optic probe is inserted into the vein using ultrasound. A highly concentrated laser beam heats the walls of the veins and reduces them, which causes the unhealthy vein to close.

Laser accuracy allows the doctor to treat the vein, without affecting the surrounding tissue, and when the vein is closed, it is slowly absorbed into the surrounding soft tissue. Other healthy veins in the legs will then take the normal flow of blood to the heart.

We can see from all of this that varicose veins are not a life sentence. There are great alternatives to help you a recover an active and pain free life.