Vein Treatments and Procedures

York Vein Clinic is operated by Dr. Philip Kritzinger. He is American Board Certified in Venous Medicine and a Fellow of the Canadian Society of Phlebology (phlebology is the study and treatment of veins). The clinic is equipped to treat virtually all types of vein problems including varicose veins, spider veins, and facial veins. We use EVLA (Endovenous Laser Ablation), Clarivein, sclerotherapy (including micro-foam and ultrasound-based sclerotherapy), microphlebectomy, and transcutaneous lasers to treat veins from the smallest facial veins to the largest leg veins. We have thousands of satisfied patients who are living proof that veins can be treated without surgery, with minimal pain, no scars, and minimal downtime.

For several decades, varicose veins were treated either surgically or by sclerotherapy (injections). Both types of treatment have been fraught with complications, recurrences, and failures. However, since about 2002, technological advances have made the treatment of veins far more successful and much less invasive.

SURGERY:

Stripping of varicose veins has been done for several decades, but it is rarely offered now. It has almost completely been replaced by modern, less invasive techniques. This procedure is only used to treat the largest veins (the greater saphenous and short saphenous veins). Under general anesthetic, an incision is made in the groin and just below the knee, and the vein is located. A wire is passed through the length of the vein, and it is used to pull the vein out. This surgical procedure results in painful wounds, one to three weeks of downtime, a lot of bruising, and scars. The recurrence rate (development of new varicose veins) is about 25% within 3 years. OHIP stopped paying for stripping in 2012 unless you have complications of vein disease like leg ulcers.

Phlebectomy is a minor surgical technique that can be used to treat veins just below the surface. Under local anesthetic, several tiny incisions are made along the course of the vein, and it is extracted bit by bit through these tiny wounds using a small hook. No sutures are required. When it is done well, it is effective, mildly painful, leaves scars that are virtually invisible, and involves minimal downtime. Unfortunately, very few people know how to do this well. Most commonly, the incisions are too large, require sutures, and leave noticeable scars.

SCLEROTHERAPY:

This technique has stood the test of time, coming into common use in the 1920s. It involves the injection of various chemicals into veins to kill them. These veins subsequently turn into scar tissue and disappear. Veins of all sizes can be treated in this way. The largest veins are treated using ultrasound-guided injections  (echosclerotherapy) and foam, a revolutionary innovation in sclerotherapy that came on the scene in about 2002. Ultrasound is used to guide a needle into leg veins that are too deep to see or feel. In the past, these veins could only be treated surgically (vein stripping). The procedure is very safe, virtually painless, inexpensive, and involves minimal downtime. Please refer to our section on spider vein treatment and varicose vein treatment for in-depth information.

THERMAL ENDOVENOUS TECHNIQUES:

This procedure is only used to treat the largest veins (the greater saphenous and in some cases the short saphenous veins). Under local anesthetic, a thin optical fiber or RF catheter is inserted into the vein. A laser beam (endovenous laser) or radio frequency signal (RF occlusion) is passed through, heating and closing the vein. The procedure is very safe, mildly painful, and involves minimal or no downtime. 

NON-THERMAL ENDOVENOUS TECHNIQUES:

There are currently two techniques in this category: VenaSeal and Clarivein. 

VenaSeal: a cathter is inserted into the vein, and glue (cyanoacrylate which is basically Crazy Glue) is administered to close the vein. We don't offer VenaSeal.

Clarivein: This is a modified version of sclerotherapy. A catheter is inserted into the vein. It contains a wire which is spun to scratch the inside of the vein. At the same time liquid medication is injected to cause further injury. 

This table summarizes the methods that are available to treat the largest superficial vein, the greater saphenous vein. This vein runs from the top of the foot all the way up to the groin.

* Success rate is the percentage of veins that close immediately after treatment

** Recurrence rate is the percentage of veins that come back within a few years

***van den Bos et al, JVS 2009;49:230-39

****Varies depending on the modality of treatment. Varies from clinic to clinic.