Varicose Vein Surgery
6 Questions to Ask Before Varicose Vein Surgery

When you see a doctor about varicose vein surgery, the treatment you’re offered often comes down to your doctor’s skill and preference for different techniques, and may not always align to your exact wants and needs as a patient. In this review, we share six questions to ask before varicose vein surgery to ensure you are fully educated.
Because we reference them throughout this review, we’ll start by summarizing the most common varicose vein treatment methods.
Foam Sclerotherapy: foam sclerotherapy is a minimally invasive treatment that involves the injection of a chemical solution called a sclerosant. The solution has a foamy consistency that fills the vein, displacing blood while the sclerosant irritates the vein walls, effectively closing off the vein.
Thermal Vein Ablation: thermal ablation is a minimally invasive treatment uses laser or radiofrequency energy to apply heat to the inside of the vein. This is done with catheter-based medical devices that are designed specifically for the veins. Intense heat causes the vein to collapse and seal shut.
VenaSeal Vein Glue: a specialized bio-safe, permanent glue is applied to the inside of the vein using minimally invasive devices and techniques. The vein is then compressed by pressing on the leg until the glue hardens and seals the vein shut.
Vein Stripping Surgery: vein stripping surgery is done by making incisions at the two ends of the vein and then threading a wire device (the “vein stripper”) through the vein from one incision to the other. The surgeon then pulls the wire out, bringing the vein out with it.

Vein Specialist
Dr. Michael Lalezarian
Dr. Michael Lalezarian is a double-board certified Vascular Interventional Radiologist specializing in minimally invasive vein treatments. He is a committed partner in the battle against the devastating consequences of venous insufficiency.

“I was referred to Dr. Lalezarian from my orthopedic surgeon for varicose vein treatment options. From the second I walked into the office, I was at ease and felt very welcomed from Kimberly and the staff. Upon meeting the doctor, he was so kind and fully explained my options after the initial ultrasound on both legs. I decided to go with the sclerotherapy and am so happy that I did. The procedures were quick and virtually painless but the results are life changing for me. The pain suffered for so many years and countless sleepless nights are a thing of the past.”
Vickie W, March 2022
(1) Will this varicose vein surgery address all of my vein problems?
Varicose veins are often sustained by accessory vessels, which are short segments of veins that connect the major veins together into a network. Foam sclerotherapy is also effective in treating these short accessory vessel segments that cannot be treated with thermal ablation or VenaSeal.

(2) Is this treatment going to be painful?
There are several ways to treat a varicose vein. Some are more painful than others. Thermal ablation, for example, works by applying intense heat to the inside of the vein. Although steps are taken to numb the area and limit pain with local tumescent anesthesia, recipients of this therapy sometimes comment on the pain or discomfort that they experience during treatment. Veins tripping surgery also requires anesthesia, but with vein stripping, patients are given general anesthesia or spinal anesthesia to put the patient to sleep or to completely numb the leg prior to operating. While this eliminates pain during the procedure, recovery from the surgery can be quite painful. VenaSeal and foam sclerotherapy, on the other hand, are non-thermal treatments with a much lower risk of pain or discomfort during the procedure.
(3) How long does this treatment take?
(4) How long does varicose vein surgery recovery take?

(5) Are there side effects?
(6) How long does it last?
If you have more questions about varicose vein treatments or if you would like a second opinion on your current treatment plan, give us a call at ProVascularMD. We’ll help you work through your options and ensure that you find the most effective vein treatment for you.
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Vascular Specialist in Los Angeles
Learn more about Los Angeles Vascular Specialist Dr. Michael Lalezarian.
[1] Biemans AA, Kockaert M, Akkersdijk GP, van den Bos RR, de Maeseneer MG, Cuypers P, Stijnen T, Neumann MH, Nijsten T. Comparing endovenous laser ablation, foam sclerotherapy, and conventional surgery for great saphenous varicose veins. J Vasc Surg. 2013 Sep;58(3):727-734.e1. Epub 2013 Jun 13.
[2] Coleridge Smith, P. (2009). Sclerotherapy and foam sclerotherapy for varicose veins. Phlebology, 24(6), 260–269.
[3] Chen CH, Chiu CS, Yang CH. Ultrasound-guided foam sclerotherapy for treating incompetent great saphenous veins–results of 5 years of analysis and morphologic evolvement study. Dermatologic Surg., June;38(6):851. Epub 2012 Apr 27.
[4] Wrona, M., Jöckel, K. H., Pannier, F., Bock, E., Hoffmann, B., & Rabe, E. (2015). Association of Venous Disorders with Leg Symptoms: Results from the Bonn Vein Study 1. European Journal of Vascular and Endovascular Surgery, 50(3), 360–367.
[5] Brittenden, J., Cooper, D., Dimitrova, M., Scotland, G., Cotton, S. C., Elders, A., … Campbell, M. K. (2019). Five-Year Outcomes of a Randomized Trial of Treatments for Varicose Veins. New England Journal of Medicine, 381(10), 912–922. http://doi.org/10.1056/NEJMoa1805186
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