Varicose vein treatments: minimally invasive options

Varicose veins are dilated superficial veins, most often in the legs. They appear when the vein valves no longer work properly and blood pools in the veins, which makes them widen.

Although at first they may be only a cosmetic problem, varicose veins can progress and cause pain, a feeling of heaviness, swelling, cramps at night or even complications such as thrombophlebitis and venous ulcers.

Medical advances in recent years have brought modern, minimally invasive treatments to the fore, with good results, quick recovery and less discomfort for the patient. At NOVOMED CLINIC, a vascular surgery consultation with Doppler ultrasound helps decide whether you need treatment and which option suits you. Of the procedures described below, only sclerotherapy is done at the clinic; for the others, we refer you to a center that performs them.

Many patients put off seeing a doctor because they think varicose veins are only a cosmetic problem. Left untreated, however, they can lead to:

• constant pain and discomfort,
• edema (swelling of the legs),
• skin changes (hyperpigmentation, dermatitis),
• venous ulcers,
• superficial vein thrombosis (a clot in a vein under the skin, which becomes hard and painful) and, more rarely, a blood clot deeper inside the leg (deep vein thrombosis), which can be dangerous.

This is why early treatment not only improves how your legs look, but also helps prevent serious complications.

Today, most varicose veins can be treated with quick, effective procedures, without the need for classic surgery. The most commonly used methods are:

1. Sclerotherapy with foam or liquid

A sclerosing substance is injected directly into the vein. The substance causes a controlled reaction that makes the affected vein close and be absorbed by the body.

Advantages:

• a quick procedure (15-30 minutes)
• no anesthesia needed
• immediate recovery

It is well suited to small and medium veins, telangiectasia (“spider veins”) and reticular veins.

2. Endovenous laser treatment (EVLT)

The laser delivers heat through a fiber inserted into the vein, which makes the vein close. Blood is redirected through healthy veins.

Advantages:

• a precise and safe method
• a good cosmetic result
• quick recovery (you go home the same day)

3. Radiofrequency ablation (RFA)

It is similar to laser treatment, but it uses radiofrequency energy to heat the vein walls and close the vein. Patients usually tolerate it well.

Advantages:

• little pain
• a high success rate
• a short recovery time

4. Microphlebectomy

It is done through very small incisions (2-3 mm), through which segments of the affected vein are removed. The scars are usually small and fade over time.

Advantages:

• it removes the visible veins
• long-lasting results
• no hospital stay needed

There is no single solution for every case. The choice of method depends on:

• the size and location of the varicose veins
• how severe the venous insufficiency is
• your general health
• your preferences and your doctor’s recommendation

The specialist usually performs a venous Doppler ultrasound to assess blood flow and decide on the most effective treatment plan.

One of the main advantages of these methods is that you can quickly return to your usual activities.

General recommendations after the procedure include:

• wearing compression stockings for a few days or weeks,
• avoiding intense physical effort in the first days,
• daily walks to stimulate circulation,
• attending your follow-up visits.

The results become visible gradually, as the treated veins are absorbed and circulation improves.

1. Are varicose vein treatments painful?
Usually only mildly. Most minimally invasive procedures are well tolerated and need only local anesthesia, or none at all. You may have some pain or bruising afterward.

2. Can varicose veins come back after treatment?
After laser or radiofrequency treatment, the treated vein usually stays closed; after foam sclerotherapy of the large superficial (saphenous) veins, it reopens more often. New varicose veins can also appear in other areas, which is why regular check-ups are recommended.

3. How long until I can return to my normal activities?
In most cases, patients return to their activities within 24-48 hours.

4. Are the treatments only cosmetic, or medical too?
They can improve both how your legs look and the symptoms caused by venous insufficiency.

Modern treatments have changed the way patients see varicose veins. While classic surgery used to be the main option, today there are minimally invasive, quick and effective options.

At NOVOMED CLINIC, we focus on a correct assessment, choosing the right method and carefully following each patient’s progress. Our aim is to restore the health of your legs and your everyday comfort, with a good cosmetic result.

If you have varicose veins, do not put off seeing a doctor. The sooner the problem is treated, the better the results and the easier it is to prevent complications.

If you are in Constanța, see what NOVOMED CLINIC offers: varicose vein treatment, options and prices and sclerotherapy.

Medical sources

• NICE: Varicose veins, diagnosis and management (clinical guideline CG168)
• Gloviczki P et al. The 2022 SVS, AVF and AVLS clinical practice guidelines for the management of varicose veins of the lower extremities, Part I. Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2023;11(2):231-261
• NHS: Varicose veins