Lifewatch: Varicose Veins

MARYLAND -- Nearly 25 million Americans have varicose veins.  They're raised, blue bulging veins in the legs that cause pain and discomfort.

Getting rid of varicose veins hasn't been easy, and they often come right back.  But now, doctors can remove them.

Margaret Jaqueumin loves chasing her daughter, Riley, around.  She has had varicose veins since her 20's.

"You don't want to be young and you know, wearing fun outfits and then you see these ugly blue-ish green veins sticking out," said Margaret.

She hated how they looked and felt.

"They were hurtful. They were very painful. They would burn your skin, get swollen," said Margaret.

Dr. Peter Lawrence said 40% of adults have varicose veins, and many get them removed.

"The more completely we can remove it, the better their symptoms relief will be and the better they'll look cosmetically," said Dr. Lawrence.

Laser or vein stripping treatments can leave bruises that last for days.  Now, Dr. Lawrence has a better way to remove them with crochet hooks.

"Maybe once or twice a year, I'll go into a knitting store and buy my crochet hooks," said Dr. Lawrence.

He spends an hour filing them down to get the hooks ready for surgery.  He also uses trans-illumination during surgery to light up veins under the skin.

"It allows me to see virtually all of the vein. I can make a tiny little incision next to the vein, catch it with a crochet hook and then remove it," said Dr. Lawrence.

A study of more than 260 patients shows the technique resulted in quick vein removal, little bruising, and excellent cosmetic outcomes.

"They seem to prefer this to virtually anything else that had been tried on them," said Dr. Lawrence.

Margaret had the procedure last summer and it worked.

"It's nice and smooth and soft and youthful. It looks like a leg that belongs on a 30-something year old woman, versus a 70 year old woman," said Margaret.

The incisions are so small, doctors don't need stitches to close them.  Patients are usually back on their feet in just a couple of days.


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BACKGROUND: Statistics show varicose veins affect up to 40 percent of the population -- 25 percent of whom are women. Varicose veins are enlarged, twisted veins that most commonly pop up in the legs and feet. For some people, varicose veins are simply a source of "ugliness" posing only a cosmetic concern. But for others, varicose veins can cause pain and lead to much more serious conditions like blood clots. Simple steps like exercising, weight loss, and elevating the legs can relieve the ache varicose veins may cause and may keep them from getting worse. However, sometimes procedures such as sclerotherapy, laser removal and phlebectomy may be needed to treat the veins. More invasive treatments like these are effective, but it doesn't mean varicose veins are gone forever. Recurrence can and does happen.

NEW TECHNIQUE: Results of a new technique, developed at UCLA by Peter Lawrence,M.D., were published in the October 2007 issue of the journal The American Surgeon. The technique was developed to remove branch varicose veins from the thighs, calves and ankles by combining two varicose vein-removal procedures. For the new technique, Dr. Lawrence combines powered phlebectomy and stab phlebectomy, which remove veins through a small incision in the skin. He also uses transillumination to light up the veins under the skin -- making them easier to see and easier to remove. Finally, the technique also involves the use of crochet hooks -- size 7 crochet hooks to be exact. There is minimal, if any, scarring. Dr. Lawrence says, "We can essentially leave the leg looking like it's been untreated or at least not treated surgically and yet, we've removed all the veins."

Dr. Lawrence does the procedure with the lights in the operating room turned off -- to maximize the benefit of transillumination. He makes a tiny incision next to a varicose vein and uses a crochet hook to pull the vein through the opening. The vein is then dislodged from the skin. A separate incision is made to remove each vein. Dr. Lawrence says, "The recovery phase is very, vey rapid and the discomfort is minimal because they are just tiny little incisions." When compared to other procedures, Dr. Lawrence says, "Virtually all patients said it was an easier procedure to go through with better cosmetic results. They seem to prefer this to virtually anything else that had been tried on them."

Dr. Lawrence's study shows the technique resulted in quick vein removal, minor bruising and excellent cosmetic outcomes in the more than 260 patients who received it.  Patients were followed for about a year after their procedures. During that time, researchers found few early postoperative complications such as infection or pain that required additional pain prescriptions. A larger study is the next step for the research.

Reported by Kristy Ondo