Varicose Veins

Varicose veins are blood vessels, usually in the legs, that have become swollen or twisted near the skin’s surface. They often appear blue or purple. Spider veins are similar but usually smaller. Varicose veins and spider veins are caused by blood flowing backward through faulty valves inside the veins or by hormonal changes.

Varicose Vein Severity
Appearance is the biggest concern for most people with varicose veins or spider veins. However, more significant blood pooling can cause your legs to feel painful, heavy, or achy.

Some people with varicose veins experience phlebitis (superficial blood clots and inflammation) or other complications, including swelling and skin changes like discoloration, hardening, and thickening. In the most severe cases, skin ulcers can form and cause infections.

Comprehensive Care for Varicose Veins
Whether your concern is cosmetic or more complex, Duke vascular specialists have the experience, resources, and technologies to address varicose veins and help you avoid serious complications.

Vascular surgeons are uniquely equipped to evaluate the severity of your varicose veins and whether you may benefit from a surgical procedure.

Duplex Ultrasound 
A unique type of ultrasound imaging called duplex ultrasound is specifically designed to show your veins in detail and assess blood flow and valve function.

MRI
MRI imaging can help rule out more serious issues, like vein obstructions in the pelvis.

Venogram
This catheterization procedure uses contrast dye and X-ray imaging to assess blood flow through the veins in real time.

Our vein experts develop a treatment plan based on your goals and overall circulatory health.

Nonsurgical Options

• Compression Therapy: Compression stockings help improve blood flow, prevent swelling, reduce inflammation, and (in some cases) relieve leg pain.
   
• Physical Activity: Walking is one of the best things you can do to improve blood flow in your legs and mitigate the effects of varicose veins. Elevating your legs during rest, weight management, and physical therapy can also reduce symptoms.
   
• Skin Care: Keeping your skin healthy is important for avoiding skin problems associated with severe varicose veins.

Sclerotherapy
This in-office surgical procedure treats both varicose veins and spider veins. A tiny needle is used to inject medication into the target vein. This causes the vein to fade or appear lighter in color. It also causes the vein walls to stick together, preventing blood from filling it again, while blood is redirected to healthier veins. This procedure takes about 30 minutes and requires only local numbing.

Endovenous Laser Ablation (EVLA) and Radiofrequency Ablation (RFA)
Designed to close large, long varicose veins, these procedures use heat energy to seal the diseased vein shut. After numbing a small incision site, your doctor inserts a thin, flexible tube called a catheter into an artery and guides it to the problem vein. As the catheter is slowly removed, a device heats up the vein and causes it to shut down, rerouting blood through healthy veins to drain blood and fluid from the leg. Endovenous laser ablation and radiofrequency ablation are minimally invasive and highly effective. They are performed in a comfortable outpatient setting, usually take less than an hour, and leave no scars.

Ambulatory Phlebectomy
This procedure is performed in an operating room to surgically remove large varicose veins through tiny incisions along the leg.

From Diagnosis to Long-Term Follow-Up
We review your symptoms comprehensively to understand the source of your concern, since issues like varicose veins can be caused by underlying factors. Throughout treatment and beyond, we regularly see you in clinic to follow your progress and prevent complications.

All Available Treatment Options
We offer the full range of therapies for varicose veins, including minimally invasive surgical options. We use a team approach to vein health, so we can connect you with other experts and resources to ensure all aspects of your care are considered.

Leaders in Vascular Research
In addition to participating in ongoing training and research, our vascular experts have helped write treatment guidelines for the American Venous Forum and Society for Vascular Surgeons, the organizations that set professional care standards for venous disease.