Interventional Radiology

Unsightly varicose veins can cause considerable discomfort and may progress over time to more serious conditions that can be treated with minimally invasive therapies in our office to minimize the disruption to our patients’ busy lives.

Varicose veins are caused by incompetent one way valves in the leg veins. When working correctly, they are supposed to prevent blood from pooling in our legs with gravity failing. When the veins allow blood to flow back down the leg instead of up to the heart, the veins dilate to accommodate the extra blood. Because veins are thin walled pliable structures they often get tortuous and enlarged bulging from under the skin. This can also lead to smaller superficial “spider veins” which are smaller veins that get dilated closer to the skin surface.

In addition to the cosmetic changes patients may experience symptoms of:

  • Bulging veins typically apparent behind the knee, calf and ankle
  • Aching pain
  • Burning
  • Itching
  • Swelling or fatigue in the legs
  • Skin changes, including ulcers

Over time, or if left untreated, these symptoms may progress to more serious complications of venous reflux including:

  • Inflammation (phlebitis)
  • Blood clots (e.g., DVT)
  • Ankle sores or skin ulcers
  • Bleeding

To determine if you are affected by this condition and have incompetent one way valves, a focused history and physical as well as ultrasound can be performed. This documents the presence of reflux and helps assess if you are a candidate for minimally invasive therapies.

Here’s what to expect from the VenaCure EVLT(TM) procedure:

  • Our Interventional and Vascular Radiologist uses ultrasound to map out your vein.
  • Local anesthetic(Lidacaine) is applied.
  • A thin laser fiber is inserted through a tiny entry point, usually near the knee.
  • Laser energy is delivered to seal the faulty vein.
  • Immediately after the procedure your leg will be wrapped tightly and compression hose will be worn
  • Walking for 20 minutes immediately after the procedure is encouraged. Normal daily activity can be resumed; just avoid rigorous activities such as gym workouts.
  • There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter, non-aspirin pain relievers as necessary. Approximately on the 5-7 day, you will experience a “pulling sensation”.


  • 45-60 minute outpatient office procedure
  • Uses only local anesthetic
  • Excellent Success rate(90%)
  • No/minimal scarring
  • No Hospitalization
  • Lower complication risk than operative hospital based procedures
  • Fast return to normal activities
  • Reimbursable by most health insurance plans

If you choose not to get treatment for your varicose veins, they will probably slowly worsen over the years. If you are currently not symptomatic, more often than not they will become symptomatic over time and interfere with patient comfort. Late stage changes including ulcers and skin changes can also arise over time.

Varicose veins affect 40% of women and 25% of men. The cause is multifactorial with the most common causes being:

  • Heredity: If your parents or grandparents had the problem, you are at increased risk.
  • Gender: Women have a higher incidence than men in part as a result of female hormones and their effect on the vein walls.
  • Pregnancy: The increased effect of increased blood volume and hormonal changes during pregnancy contribute to the vein wall changes and vein size increase.
  • Age: The tissues of the vein wall lose elasticity over time causing the one way valve system to fail because of incomplete closure.
  • Prolonged Standing: If you have to stand for prolonged periods of time it can cause increased volume and pressure in the lower limbs due to gravity effect.
  • Obesity: Increases in weight often is accompanied by increased abdominal pressure which can worsen vein problems.

As a result of the nature of the underlying conditions discussed above it is impossible to “cure” varicose veins but there are some measures that can be taken to alleviate symptoms and discomfort from existing varicose veins and prevent progression:

  1. Regular exercise to improve leg circulation and strength
  2. Avoid prolonged standing and sitting by alternating periods of activity with rest.
  3. Control weight
  4. Avoid wearing clothing which restricts blood flow to the groin or calf

Consultation appointments can be made by calling 919-781-1437 or you can submit your information online on our home page. Select “Request a Vein Consult”.