Advanced Varicose Vein Therapy



Ask the Doctor:  Noted Physician Dr. Geller answers some common questions about vein therapy.

Q: Dr. Geller, what will happen on my first visit?

A: The doctor will review your medical history and examine your legs to determine the types of veins you have. Dr. Geller will then determine whether you are a candidate for EVLT or for sclerotherapy injections. Your first injections, if you wish to have a treatment, will then be given by the physician. 

Q: Which veins can be injected?

A: The small "spider veins" and most non-bulging and bulging "blue" veins can be treated with injections. 

Q: What is the solution injected?

A: The solution is called Sotradecol. Sotradecol was developed in Europe and has been used for many years. However, the solution has been diluted so as not to produce any unwanted side effects on the surrounding skin. In our extensive experience, we have seen no systemic effects. We do not use saline solution because it is painful and less effective. 

Q: How does the solution work?

A: The solution is injected directly into the veins with one of the smallest needles available. As the solution enters the veins, it temporarily displaces the blood and causes a gentle irritation to the inner lining of the vein. The blood returns into the injected area and becomes trapped in the injected veins. The body then gradually absorbs the trapped blood and the veins disappear.

Q: Is the solution safe if you are pregnant?

A: For patients who are pregnant, we can use a different solution that is safe for both the mother and baby. 

Q: Will the veins disappear immediately?

A: No. This is the most important fact in understanding the course of your treatment. The healing process begins as soon as the solution is injected. However, in the beginning, the healing process is microscopic and is not visible to the naked eye. 

Q: When will I be able to see any changes?

A: The length of time varies greatly between patients and size of veins. Most patients will see results within 2-3 weeks after the injections. 

Q: Will the veins return?

A: No. The veins that have been injected will not return. However, since the tendency to have varicose veins is inherited, it is very likely that you will develop other veins in the future. One or two visits every year will keep the veins under control. 

Q: Is the injected procedure painful?

A: Since the solution is diluted and prepared with local anesthesia, there may only be a slight stinging or burning sensation as it is injected. You may also feel the small pinch of the needle. It is so minimal that often nothing is felt by the patient. 

Q: Do I have to stay in bed after the injection?

A: Absolutely not! We want you to continue with your normal activities. 

Q: Do Ihave bandages or elastic wrap after injection?

A: Usually, there are no bandages necessary. However, on some larger veins, a temporary "pressure" bandage will be applied at the Doctor's discretion. 

Q: How will my legs look after injection?

A: You may notice some slight redness and a few little welts similar to mosquito bites. This is normal and will disappear in 48 hours. 

Q: Are there any complications to this procedure?

A: On very rare occasions, one may develop a small blister at the injection site. This will usually heal without scarring. This is most likely to occur in older patients with very fragile skin. 

Q: Will I have any pain after the injections?

A: No. However, you may notice some "itching" or "tingling" for a few hours after injection. This is not an allergic reaction. Allergic reactions are extremely rare. 

Q: What about very large, painful varicose veins? 

A: Large, painful varicose veins are treated with Endovenous Laser Ablation (EVLT). Surgical procedures are no longer necessary for bulging, painful veins. Endovenous Laser Ablation is a quick, minimally invasive laser procedure that is performed in Dr. Geller's office and takes less than half an hour. Dr. Geller has performed over 4,000 EVLT's.

Here's what to expect from the procedure: 

  • Dr. Geller uses ultrasound to map the vein
  • Local anesthetic is applied
  • A thin laser fiber is inserted through a tiny entry point, usually near the knee
  • Walking immediately after the procedure is encouraged and normal daily activity can be resumed 
  • Relief of painful symptoms and disappearance of treated large varicose veins 
  • No hospitalization
  • No scars
  • No sutures