Radiofrequency vein ablation (RFA) uses heat from radiofrequency energy to close a leaking vein from the inside. Blood then reroutes through healthier veins, and your physician guides a thin tube into the vein using ultrasound.

VenaSeal closes a diseased vein with a medical adhesive instead of heat. Your physician places the adhesive in the vein under ultrasound guidance. The vein seals shut, and blood flows through healthier veins. It is one of the non-heat options the 2022 guidelines endorse for leaking leg veins.

Varithena is a foam, approved by the Food and Drug Administration (FDA), that your physician injects into a varicose vein under ultrasound guidance. The foam makes the vein collapse. Blood then flows through healthier veins nearby. Varithena can treat the main leg vein, its branches and visible bulging veins, above and below the knee.

A diagnostic venous ultrasound uses sound waves to create images of the veins deep in your leg and close to the skin, and it shows where blood is flowing backward. The 2022 guidelines name ultrasound the test of choice for evaluating vein reflux, and most patients have one during their first consultation.

Phlebectomy removes bulging varicose veins near the surface of the skin through tiny openings, using a minimally invasive approach. It is often used for visible veins that are painful or bother you for cosmetic reasons. Your physician may combine it with another treatment that closes the leaking vein underneath.

Ultrasound-guided sclerotherapy closes larger twisted veins by injecting a solution or foam directly into them. Ultrasound shows exactly where the medicine goes. The treated vein closes and fades over time, and regular follow-up visits let your physician monitor your progress.

Cosmetic sclerotherapy uses tiny injections to reduce the look of spider veins and small surface veins. Dr. Georgevich performs this treatment, which is aimed at appearance rather than symptoms. An exam first checks for deeper vein problems that may need treatment as well.

Lymphedema is swelling that develops when lymph fluid can’t drain well, and it can affect an arm or a leg. Your physician evaluates your swelling to find out what is causing it. When it fits your needs, your physician refers you to St. Clair’s outpatient rehabilitation team(opens in a new tab) for physical therapy.

Compression therapy uses graduated stockings that squeeze the legs gently, with the most pressure at the ankle, to help blood flow upward. It can ease aching and swelling. For people who are candidates for a procedure, the 2022 guidelines recommend treating symptomatic varicose veins with a procedure. They advise against relying on compression stockings alone long term.

Embolization blocks the blood supply feeding a problem area. It uses a thin catheter guided by imaging instead of open surgery. At St. Clair Vein & Embolization Center, Dr. Repko performs hemorrhoid embolization(opens in a new tab), uterine fibroid embolization(opens in a new tab) and prostate artery embolization(opens in a new tab). Visit St. Clair’s Vein & Embolization Center page(opens in a new tab) to learn more about each one.