Spider and Varicose Veins

Spider veins and other visible or bulging veins are not dangerous. They are more common in women and become more visible after pregnancies and with age. 

Varicose veins are enlarged veins that can affect circulation and can be very painful.

Varicose veins can cause or be associated with:

• Pain, aching, itching, burning, swelling, or skin changes in the legs.
• Skin discoloration near the ankles.
• Aching or restlessness in the evenings.
• Reflux and dilation — when blood travels toward the feet rather than the heart.
• Superficial phlebitis — a blood clot in a superficial vein.
• Blood clots, including deep vein thrombosis.

Pelvic congestion syndrome is similar to varicose veins in the legs, but involves the development of internal varicose veins in a woman's lower abdomen.

Pelvic congestion is identifiable by pain or heaviness in the pelvis or genital area. Symptoms are usually chronic and can be worse during or just before the menstrual cycle.

Treatments for Spider and Varicose Veins

The Vein Center at the UPMC Heart and Vascular Institute offers the following treatments for spider and varicose veins:

• Compression: compression stockings generally help symptoms from varicose veins and are frequently required as a first step in the treatment of venous disorders. A short period of compression is usually required after any venous treatment.
• Anticoagulation: used to treat clots and deep vein thrombosis. The duration of treatment depends on the case.
• Polidocanol: this is an FDA-approved medication administered as sclerotherapy — a series of injections. This closes and eliminates spider and varicose veins. Performed as an outpatient procedure, doctors use a very small needle to deliver this therapy.
• Ultrasound-guided foam sclerotherapy: in this procedure, injections of polidocanol foam are used to close veins that are too large or too deep for regular injections.
• Venous ablation: an outpatient laser or radiofrequency therapy for symptomatic reflux and dilation of superficial veins, involving the placement of an ablation fiber.
• Venous recannalization: treatments to open narrow or blocked veins with a balloon and a stent.
• Venous embolization: this procedure for treating pelvic congestion stops blood flow to problematic veins in the pelvis or abdomen. A surgeon inserts a catheter into either a groin or neck vein, injects dye to identify the problematic vein, and then places a wire into the vein under x-ray guidance.

Side effects associated with these treatments

• Sclerotherapy (injections) — tenderness, redness, or hard lumps at the injection sites.
• A pulling sensation along the vein.
• Bruising, scabbing, leg swelling, or, rarely, small ulcers.
• Hemosiderin staining — a light brown discoloration of the skin over the treated vein, resulting from iron in the red blood cells moving into the skin as your body resorbs the treated vein. This typically fades and resolves over time, but may take several months.
• Matting — a small cluster of thin, red spider veins in very close proximity to each other may develop at the injection site. This can be treated with further sclerotherapy, but may not completely resolve.
• Ablation — a pulling sensation along the vein.
  
• There is a very small risk of deep vein thrombosis with any vein treatment.

To make an appointment with a vascular expert at the UPMC Heart and Vascular Institute, complete an appointment request form or call 1-855-UPMC-HVI (876-2484).

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