What is the Best Vein Treatment For Your Specific Needs?

Our Vein Doctors in Maryland Rank the Best Spider and Varicose Vein Treatments
If you have spider veins, varicose veins, or other vein problems, you have a lot of possible vein treatments to choose from. You might be confused about the ideal vein treatment for your specific needs. Our vein doctors in Maryland explain the unique pros and cons and costs of the best minimally invasive spider vein and varicose vein treatments. We will help you select the best vein doctor in Bethesda and the ideal vein treatment for yourself.

Are you wondering whether vein treatment
is right for you? Are you confused by the multiple treatment options?

The state of medical technologies has improved by leaps and bounds over the past 30 years. However, advancements in vein care have outpaced most other medical fields. In the not-so-distant past, chronic venous insufficiency could only be treated via complex surgeries that involved hospitalization, harsh side effects, a high risk of complications, and extended downtime. But advanced minimally invasive vein treatments promise even better results and a negligible risk of complications, and they conclude within an hour with no downtime. However, the number of minimally invasive vein treatment options can be overwhelming for everyone – you may struggle to find the ideal treatment for yourself. We take an in-depth look at all the latest minimally invasive spider vein and varicose vein treatment options to help you make an informed decision about your vein treatment in Maryland.

Before describing the minimally invasive vein treatments, we must briefly discuss the core concerns of vein care and vein conditions. Spider veins and varicose veins are the most visible vein conditions, and they’re the reasons most patients consult vein doctors. However, spider veins and varicose veins are merely physical manifestations of an underlying circulatory disorder known as chronic venous insufficiency. This is a medical condition wherein the collapse of vein valves leads to the accumulation of blood in leg veins, which, over time, leads to vascular dilation and the formation of spider veins and varicose veins. Treating spider veins without addressing the root cause is pointless – the spider veins will keep returning until the vein disease hasn’t been treated. Our vein doctors in Maryland always diagnose and treat the root cause of your vein problems, and their vein treatment plan is personalized according to your diagnosis.

Vein Treatment Options In Maryland

Endovenous Ablation

Also Known As: Endovenous Laser Ablation (EVLA), Radiofrequency Ablation (RFA)

Best For: Treating chronic venous insufficiency, large varicose veins, and other symptoms of vein disease, such as leg heaviness, frequent leg cramps, and restless leg syndrome.

What Is Endovenous Ablation?

The veins responsible for the formation of spider veins and varicose veins, known as saphenous veins, are usually located deeper under the skin. When vein valves collapse, blood accumulates in the leg veins and leads to increased pressure in the saphenous veins, which can lead to unhealthy spider veins and varicose veins on the skin’s surface. Endovenous ablation is a procedure wherein thermal energy (radiofrequency ablation) or laser energy (laser ablation) is used to destroy the diseased vein.

How Does Endovenous Ablation Work?

Ablation technology is one of the most important developments in the field of vein care. Endovenous ablation can be performed using two techniques – radiofrequency ablation and laser ablation. During the procedure, the vein doctor makes a small incision on the skin’s surface after administering local anesthesia for comfort. The incision is the entry point for a hollow tube-like device known as a catheter, which is driven into the diseased saphenous vein under ultrasound guidance. Once the catheter is lodged in place, the vein doctor delivers tumescent anesthesia to insulate the surrounding tissues from the radiofrequency or laser energy. Finally, the catheter is activated to channel either thermal energy or laser energy, which destroys the diseased vein. The accumulated blood reroutes into healthier leg veins, restoring optimal blood circulation to the heart. The vein doctors at our vein clinic in Maryland have performed hundreds of endovenous radiofrequency and laser ablation. While both treatments are equally effective, some patients say radiofrequency ablation is more comfortable. Your vein doctor will have their reasons to select one or the other technique.

Pros

Endovenous ablation is one of the safest and most effective vein treatments, certainly safer and more effective than vein surgery. The ablation techniques address the root cause of your vein problems, not just the visible spider veins and varicose veins, so they ensure long-lasting results with a negligible risk of recurrence. You can also resume your daily activities and work immediately, even though you have to wear compression stockings for a few weeks. The ablation procedures are usually covered by most insurance plans.

Pros Summary:

  • Safer and more effective than surgery
  • No downtime or extended recovery period
  • Completely safe treatment
  • Usually covered by most insurance plans

Cons

The ablation techniques are perfectly safe and effective when performed by highly-skilled vein doctors with specialized training in minimally invasive spider vein and varicose vein treatments. However, the treatment has to be executed using the latest and safest techniques and technologies, particularly when it comes to delivering tumescent anesthesia. An inexperienced vein doctor may use outdated techniques or a solution that causes unnecessary pain and side effects. As such, we highly recommend consulting our vein doctors in Maryland.

Cons Summary:

  • Must be performed by an experienced vein doctor
  • Might be difficult to execute

Am I a Candidate for Endovenous Ablation?

Endovenous ablation might be the ideal procedure for you if you are diagnosed with underlying chronic venous insufficiency. This treatment is covered by most insurance plans, and we will verify your insurance details to determine if you’re eligible. Maryland Vein Clinic usually favors radiofrequency ablation over laser ablation because it causes less post-treatment discomfort, but your vein doctor may also choose laser ablation for a unique set of reasons.

VenaSeal

Also Known As: Vein Glue Treatment, VenaSeal Closure System

Best For: Treating chronic venous insufficiency and its associated symptoms, such as varicose veins, spider veins, leg heaviness, leg cramps, restless leg syndrome, etc.

What Is VenaSeal?

The VenaSeal Closure System is one of the latest minimally invasive vein treatments, having received FDA approval in 2015. Developed by one of the world’s leading medical technology developers, Medtronic, this treatment uses cyanoacrylate glue (rather than thermal or laser energy) to destroy the diseased saphenous vein responsible for your vein problems. Cyanoacrylate glue is a completely safe medical-grade adhesive that’s been used for medical procedures for decades, so this treatment is completely safe.

How Does VenaSeal Work?

VenaSeal is one of the most effective minimally invasive treatments for chronic venous insufficiency. During this procedure, the vein doctor administers local anesthesia to numb the skin’s surface and make a small incision. The incision serves as an entry point through which a catheter is driven into the diseased vein under ultrasound guidance. Once the catheter is lodged inside the diseased vein, as confirmed via vascular imaging, the vein doctor delivers the medical-grade adhesive to seal its walls shut. The accumulated blood flows into healthier leg veins, restoring optimal blood circulation to the heart.

Pros

VenaSeal doesn’t involve tumescent anesthesia or radiofrequency/ laser ablation. As such, there’s no post-treatment swelling, and the risk of nerve injuries is negligible. This treatment is particularly suitable for varicose veins and diseased veins with multiple branches because the vein glue can easily flow into all the branches, allowing the vein doctor to close multiple pathways with one treatment.

Pros Summary:

  • Performed using advanced technology
  • Ideal for the retreatment of vein disease
  • Doesn’t involve ablation, so there’s no risk of nerve injury
  • Doesn’t involve tumescent anesthesia, so no post-treatment swelling

Cons

VenaSeal is a relatively new procedure, having only recently received FDA approval. As such, long-term studies on the impact of VenaSeal treatment are scant. This treatment also leaves the medical-grade adhesive within the body as an implant, which might be an undesirable thought for some patients, even though the medical implant doesn’t cause any problems. An extremely small number of patients experience allergic reactions to the implant, and numerous insurance companies don’t yet cover this treatment because it’s fairly new.

Cons Summary:

  • Has to be performed by highly-skilled vein doctors
  • Vein glue remains within the body as a medical implant
  • Minor risk of allergic reactions to the vein glue
  • Not covered by all insurance policies (yet)

Am I a Candidate for VenaSeal?

VenaSeal is the ideal minimally invasive treatment for patients who have undergone vein treatments in the past using other techniques, i.e., patients experiencing vein disease recurrence. Our vein doctors also administer a thorough allergy test to ensure you’re not allergic to the medical adhesive before the treatment. We will also review your insurance coverage details to determine if you can receive coverage for VenaSeal treatment. Basically, our vein doctors will consider numerous factors to determine if you’re the ideal candidate for VenaSeal.

Sclerotherapy

Also Known As: Vein injections, cosmetic sclerotherapy, STS, salt solution injections, saline injections

Best For: Treating superficial varicose veins and spider veins

What Is Sclerotherapy?

Sclerotherapy is widely considered the best minimally invasive spider vein treatment. During this treatment, the vein doctor injects a sclerosant medicine into unhealthy spider veins to irritate the vein walls, shut them down, and facilitate their absorption into the body. The spider veins gradually fade away from the skin’s surface.

How Does Sclerotherapy Work?

Sclerotherapy is a simple, in-office treatment that concludes within 30 minutes. The vein doctor examines your leg veins and identifies the diseased veins using ultrasound energy. Sclerosant is a special chemical that fuses the spider veins’ walls, making them turn into hardened scar tissues eventually absorbed by the body. The vein doctor either injects sclerosant medicine directly into the visible spider veins or injects the medication under ultrasound guidance if the veins are deeper within the skin. Severe medicines can be used as a sclerosant. In the past, sclerotherapy was performed using a concentrated saltwater solution known as hypertonic saline, but modern sclerosant medications cause less discomfort.

Pros

Sclerotherapy is one of the most effective spider vein treatments because the sclerosant medication easily spreads into all the branches of the vein, coating and covering the entire damaged vein. It can easily cover parts of the vein that ablation techniques might not cover. This treatment also works immediately, turning the unwanted spider veins into hardened scar tissues.

Pros Summary:

  • Best minimally invasive treatment for spider veins
  • No harsh side effects or complications
  • Can remove all unhealthy spider veins
  • No downtime necessary

Cons

The efficacy and experience of your sclerotherapy depends on your vein doctor’s skill levels, the chosen sclerosant medication, and the administration method. Different vein clinics use different sclerosant medications, all of which are available at different price points. Some medications are almost painless while others (hypertonic saline) cause extreme discomfort. Furthermore, some medications must be diluted with sterilized water to ensure optimal dosage. An inexperienced vein doctor may not use the correct medicine or dosage, causing more pain and discomfort than necessary. Furthermore, if the vein doctor accidentally injects sclerosant into arteries, you may experience necrosis. That’s why you must only seek sclerotherapy treatment from highly skilled and reputable vein doctors.

Cons Summary:

  • Must be performed by an experienced vein doctor
  • Older sclerosant medications cause considerable pain and discomfort

Am I a Candidate for Sclerotherapy?

Sclerotherapy is the perfect treatment for patients with spider veins. If you’re determined to be ineligible for radiofrequency ablation or VenaSeal, you might be a suitable candidate for sclerotherapy. Furthermore, this treatment alleviates the superficial varicose veins and spider veins, making it ideal for patients seeking cosmetic relief. Your vein doctor will discuss your goals and diagnose the root cause of your spider veins to determine if you’re a candidate for sclerotherapy.

Foam Sclerotherapy

Also Known As: Vein injections, foamed sclerosant ablation

Best For: Treating large and small varicose veins that bulge out of the skin’s surface

What Is Foam Sclerotherapy?

Similar to liquid sclerotherapy, foam sclerotherapy also involves using a sclerosant medicine to fuse and close off unwanted veins. In this case, however, the sclerosant medicine is agitated with air to create a foamy mix that can cover larger areas using the same concentration of medicine, making it suitable for large varicose veins. The vein doctor injects the foam sclerosant medicine into large varicose veins to make them seal shut and collapse, rerouting the accumulated blood into healthier leg veins. This treatment minimizes the amount of medicine necessary for large varicose veins, making it extremely safe and comfortable.

The Procedure:

The vein doctor administers local anesthesia to numb the skin’s surface. Using duplex ultrasound, the vein doctor examines the diseased varicose veins. After preparing your leg, the vein doctor agitates the sclerosant medicine with air to produce foam sclerosant, which is carefully injected into the unhealthy varicose veins. The vein doctor uses vascular imaging to ensure the optimal delivery of foam sclerosant into the diseased vein’s walls, making it collapse. The diseased vein hardens into scar tissues eventually absorbed by the body.

Pros

Foam sclerotherapy is the ideal minimally invasive vein treatment for large, tortuous, and twisted varicose veins because they’re harder to cover with other techniques. The foam sclerosant medicine easily enters all the branches of the diseased vein, sealing it completely. This treatment is also suitable for recurrent vein disease treatment.

Pros Summary:

  • Suitable for large, tortuous varicose veins
  • Suitable for the treatment of vein disease recurrence

Cons

Foam sclerotherapy should only be performed by a vein doctor with specialized training in vascular imaging and the mapping of tortuous varicose veins. Since superficial varicose veins connect to deeper veins via perforating veins, the vein doctor must prevent the foam sclerosant medicine from traveling into the deeper veins. Doing that involves optimal precision, and even small miscalculations can cause problems.

Cons Summary:

Must be performed by a highly skilled vein physician

Am I a Candidate for Foam Sclerotherapy?

Foam sclerotherapy is suitable for patients with large varicose veins and reticular veins, i.e., larger than spider veins but smaller than varicose veins. This treatment is mostly suitable for the cosmetic treatment for unhealthy veins because it can’t address the root cause of varicose veins. If you’ve been unsuccessful with other treatments, this treatment might work for you. Our vein doctors in Maryland will determine if you’re the ideal candidate for foam sclerotherapy.

Pre-Mixed Foam Sclerotherapy

Also Known As: Foam sclerotherapy

Best For: Treating chronic venous insufficiency, large varicose veins, and the symptoms of vein disease, such as leg heaviness, restless leg syndrome, and frequent leg cramps

What is Pre-Mixed Foam Sclerotherapy?

Pre-mixed foam sclerotherapy is a highly effective, advanced, and safe modification of the foam sclerotherapy procedure. This is a pre-mixed formulation that comes in a special canister, so the vein doctor doesn’t have to produce the foam formulation on their own. The traditional foam sclerotherapy treatment has led to a few instances of embolism because of air bubbles entering the sclerosant solution. Embolism is a dangerous condition wherein air bubbles move through the bloodstream to the lungs, preventing the effective oxygenation of blood. The pre-mixed foam formulation contains a high concentration of nitrogen and carbon dioxide with the chosen sclerosant medicine, allowing it to deactivate more quickly than foam sclerotherapy mixed with room air. This leads to safer and more consistent results, negating the risk of air embolism.

How Is Pre-Mixed Foam Sclerotherapy Performed?

Pre-mixed foam sclerotherapy works in much the same way as all other sclerotherapy techniques. The vein doctor identifies the deep veins and varicose veins that need to be treated using ultrasound energy. The vein doctor injects the pre-mixed foam sclerosant medicine into the superficial varicose veins and uses ultrasound guidance to reach deeper veins. The vein physician doesn’t have to agitate the sclerosant medicine with air because it comes as a pre-mixed foam solution, thus negating the possibility of human error.

Pros

Pre-mixed foam sclerotherapy is the ideal alternative to vascular surgery because it’s safe, consistent, and convenient. The vein doctor doesn’t have to administer general anesthesia or create incisions. The treatment is performed via injections, and it’s also effective for vein disease recurrence. This treatment is better and safer than foam sclerotherapy because it negates the possibility of human error.

Pros Summary:

  • Ideal minimally invasive treatment for large varicose veins
  • Extremely effective varicose vein treatment
  • Suitable for large, twisted varicose veins
  • Safer than foam sclerotherapy because it negates the possibility of embolism
  • Suitable for the treatment of vein disease recurrence

Cons

Pre-mixed foam sclerotherapy can be fairly expensive, especially since it’s not covered by all insurance providers. Furthermore, the treatment must be performed by a highly skilled vein doctor who can adjust the medicine’s potency and concentration.

Cons Summary:

  • Must be performed by a highly skilled and trained vein doctor
  • Not covered by all insurance plans

Am I a Candidate for Pre-Mixed Foam Sclerotherapy?

Pre-mixed foam sclerotherapy is a suitable alternative to varicose vein surgery and traditional sclerotherapy. This treatment is generally recommended for patients with recurrent vein disease. Please talk to your doctor to determine if you’re a suitable candidate for pre-mixed foam sclerotherapy.

ClariVein

Also Known As: Mechanochemical ablation

Best For: Treating chronic venous insufficiency, large varicose veins, and symptoms of vein disease, such as leg heaviness, restless leg syndrome, and frequent leg cramps

What Is ClariVein?

ClariVein is a highly innovative minimally invasive vein treatment that involves combining mechanical energy and medication to treat chronic venous insufficiency. The vein doctor inserts a specialized catheter with a rotating tip to damage and destroy the diseased saphenous vein responsible for your vein problems. This treatment also secretes a sclerosant medicine to seal the diseased vein’s walls, making it highly effective for large, tortuous varicose veins with multiple branches.

How Is ClariVein Performed?

The vein doctor administers local anesthesia to numb the skin’s surface and makes a small incision. The incision serves as an entry point for a specialized catheter with a rotating wire tip that’s driven into the diseased vein under ultrasound guidance. Once the catheter is inside the diseased vein, the vein doctor activates it to damage the vein and deliver a sclerosant medicine to fuse its walls shut, rerouting the accumulated blood into healthier leg veins. The diseased vein eventually hardens and gets absorbed by the body.

Pros

ClariVein is suitable for patients with large tortuous varicose veins because the specialized catheter is small enough to navigate them. Furthermore, it doesn’t leave a permanent implant in the diseased vein, and there’s no need for tumescent anesthesia, so the risk of swelling is minimal.

Pros Summary:

  • No need for tumescent anesthesia
  • Doesn’t leave a permanent, medical implant behind
  • Suitable for large, tortuous, twisted varicose veins

Cons

ClariVein isn’t covered by all insurance plans. Some vein doctors have also highlighted complications associated with navigating the catheter past the vein valves, which can be uncomfortable for the patient.

Cons Summary:

  • Not covered by all insurance plans
  • Can be uncomfortable for some patients

Am I a Candidate for ClariVein?

ClariVein is ideal for patients with large, tortuous varicose veins. This is also a great alternative for patients who are allergic to lidocaine, and hence can’t undergo other treatments that involve tumescent anesthesia. Furthermore, if you don’t like the idea of an implant being left in your body, you can opt for this procedure instead of VenaSeal. Most insurance plans don’t cover ClariVein, so you may have to pay for the entire treatment out of pocket.

Surgery

Also Known As: Vein stripping, vein removal, phlebectomy

Best For: Treating extremely large varicose veins

What Is Vein Stripping?

Vein surgery is a procedure wherein an open incision is used to reach and remove the diseased saphenous vein. After gaining access to the diseased vein, the vascular surgeon may use numerous techniques and devices to extract it from the body.

How Is Vein Stripping Performed?

During vein surgery, the vein doctor uses ultrasound guidance to identify the diseased vein, following which the patient is given local anesthesia to ensure comfort. The vein doctor may use numerous surgical tools, such as a hook, to pull and extract the diseased saphenous vein from the body. This treats the root cause of varicose veins and spider veins.

Pros

Vein surgery might be necessary in some (rare) cases with large, tortuous varicose veins. If minimally invasive treatments aren’t deemed suitable, in extremely rare cases, you may need surgery – but that should always be the last resort.

Pros Summary:

Suitable for extremely large varicose veins that can’t be treated by other procedures

Cons

Good, skilled, and reliable vein doctors no longer recommend vein surgery as a treatment option. Over the past decades, minimally invasive spider vein and varicose vein treatment options have arisen, and they offer better results with minimal risks and no downtime, making them safer, more effective, and more convenient. You must avoid vein doctors that recommend vein surgery as the primary treatment option.

Cons Summary:

Minimally invasive techniques are safer and more effective

Am I a Candidate for Vein Surgery?

You should only consider vein surgery if you have extremely large and tortuous varicose veins that can’t be treated with minimally invasive procedures. In most cases, you should only consider vein surgery if other vein treatments have failed, i.e., it should be a last resort option. This treatment may also be advisable for patients with blood clots in leg veins.

We encourage you to talk to a reliable, reputable vein doctor at our vein clinic in Maryland. Our vein doctors are board-certified, Ivy League-trained experts with specialized training in minimally invasive spider vein and varicose vein treatments. We always curate personalized treatment plans using the latest and safest minimally invasive techniques.

Which is the Best Vein Treatment for Me?

You must speak with a highly skilled and experienced vein doctor at a state-of-the-art vein clinic in Maryland to explore your vein treatment options. Each individual is unique, and your medical history, anatomy, and lifestyle are unique to you. That’s why all vein treatments must be uniquely calibrated to address your concerns and goals. The ideal vein doctor will curate a personalized vein treatment plan after carefully considering all factors.

The following are the primary factors to consider when looking for the best vein clinic in Maryland for your spider vein and varicose vein treatments:

1

The vein doctor must be extremely patient.

1

The vein doctor must be extremely patient.

Lots of vein doctors rush their patients and barely listen to their symptoms before curating a treatment plan. That means they only treat superficial symptoms or provide cookie-cutter treatments without a deeper consideration. At our vein clinic in Maryland, all vein doctors take the time to listen to your concerns and goals, review your medical history, and ensure you feel heard.
2

Some patients assume that spider veins and varicose veins are purely cosmetic concerns

2

Some patients assume that spider veins and varicose veins are purely cosmetic concerns

But the truth is that they’re often indicative of underlying vein disease. Inexperienced vein doctors often treat spider veins without a deeper investigation, increasing the risk of recurrence. At Maryland Vein Clinic, we conduct ultrasound diagnostic tests to visualize the root cause of your vein problems and curate comprehensive vein treatments.
3

You should choose vein doctors with specialized training in vascular imaging

3

You should choose vein doctors with specialized training in vascular imaging

Some vein doctors have ultrasound technicians perform ultrasound scans instead of specializing in it themselves. However, the latest minimally invasive vein treatments are often performed under ultrasound guidance, so a thorough understanding of vascular imaging is crucial. Our vein doctors in Maryland are registered physicians in vascular imaging, so they can diagnose and treat vein disease themselves.
4

You must find an accredited vein clinic in Maryland

4

You must find an accredited vein clinic in Maryland

The Intersocietal Accreditation Commission is an organization that certifies vein clinics that meet all of their strict requirements. Ours is one of the few vein clinics in the country with double accreditation for vascular imaging and vein treatments, which means our vein clinic prioritizes safety above all else.
5

Everyone is unique and has unique expectations

5

Everyone is unique and has unique expectations

You must avoid vein clinics that follow cookie-cutter treatment plans and favor those that provide personalized treatments. If your vein doctor doesn’t personalize the treatment plan, you have a higher risk of side effects and complications. At Maryland Vein Clinic, our vein doctors recommend the ideal vein treatments based on your symptoms, diagnostic results, lifestyle, medical history, insurance coverage options, allergy tests, and much more.
If you’re experiencing leg heaviness, restless leg syndrome, frequent leg cramps, throbbing leg veins, spider veins, or varicose veins, you may have underlying chronic venous insufficiency. The Maryland Vein Clinic has the ideal solutions for you. Our board-certified and nationally recognized vein doctors can be found at our state-of-the-art vein clinic in Bethesda, Maryland, and we will help you select the ideal vein treatment.
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Vein Treatment
Overview

Our vein doctors are some of the best in the field, having written multiple books and articles. They are continuously on the watch for new and innovative treatment alternatives. If we consider a new therapy is safe to utilize in our clinic, we will add it to our list of options to guarantee that our patients obtain the minimally invasive, most painless, and most successful vein treatments available. Sclerotherapy, radiofrequency ablation, venaseal, and laser vein ablation are the best solutions for most venous problems.

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