Type of Surgery
Last updated: 11/24/2009
The American College of Phlebology (ACP), a group of dermatologists, plastic surgeons, gynecologists, and general surgeons with special training in the treatment of venous disorders, comments that more than 80 million people in the United States suffer...
from spider veins or varicose veins. The American Society of Plastic Surgeons (ASPS) estimates that 50% of women over 21 in the United States have spider veins.
Women are more likely to develop spider veins than men, but the incidence among both sexes increases with age. The results of a recent survey of middle-aged and elderly people in San Diego, California, show that 80% of the women and 50% of the men had spider veins. Men are less likely to seek treatment for spider veins for cosmetic reasons, however, because the discoloration caused by spider veins is often covered by leg hair. On the other hand, men who are bothered by aching, burning sensations or leg cramps, can benefit from sclerotherapy.
According to the ASPS, there were 616,879 sclerotherapy procedures performed in the United States in 2001; 97% were performed on women and 3% were done on men. Most people who are treated with sclerotherapy are between the ages of 30 and 60.
Spider veins are most noticeable and common in Caucasians. Hispanics are less likely than Caucasians but more likely than either African or Asian Americans to develop spider veins.
Varicose veins are the tortuous veins that are visible just under the surface of the skin. While the condition is not generally medically important, varicose veins are not desirable cosmetically. The narrated animation describes how varicose veins are thought to form.
A commonly performed non-surgical treatment for varicose and "spider" leg veins is sclerotherapy. It has been used in the treatment of varicose veins for over 150 years. Sclerotherapy is often used for telangiectasias (spider veins) and varicose veins that persist or recur after vein stripping. Sclerotherapy can also be performed using microfoam sclerosants under ultrasound guidance to treat larger varicose veins, including the greater and short saphenous veins. A study by Kanter and Thibault in 1996 reported a 76% success rate at 24 months in treating saphenofemoral junction and great saphenous vein incompetence with STS 3% solution. A Cochrane Collaboration review concluded sclerotherapy was better than surgery in the short term (1 year) for its treatment success, complication rate and cost, but surgery was better after 5 years, although the research is weak. A Health Technology Assessment found that sclerotherapy provided less benefit than surgery, but is likely to provide a small benefit in varicose veins without reflux. Complications of sclerotherapy are rare but can include blood clots and ulceration. Anaphylactic reactions are "extraordinarily rare but can be life-threatening," and doctors should have resuscitation equipment ready. There has been one reported case of stroke after ultrasound guided sclerotherapy when an unusually large dose of sclerosant foam was injected.
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