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Is it necessary to diagnose and treat venous insufficiency before treating telangiectasias (spider veins)? - Buffalo Niagara Vein Treatment Center and
Thursday, September 5, 2013



It has been shown that the efficacy of treatment of telangiectasias is not only based on the visual disappearance of telangiectasias but also on the effective treatment of venous insufficiency (if present).


Failure of treatment for telangiectasias with sclerotherapy or topical lasers is the result of persistence of venous insufficiency or venous reflux disease.  The persistence of venous insufficiency after treatment can be responsible for early recurrence of telangiectasias or undesirable side effects such as hyperpigmentation or neovascularization, also called telangiectatic matting or post- treatment matting.


It is imperative that a board certified phlebologist (vein specialist) look for and exclude the presence of axial venous insufficiency in patients who present with telangiectasias.  The presence of telangiectasias alone is classified as CEAP C1 disease in the venous classification system.  Duplex venous ultrasonography can determine sources of axial venous insufficiency such as in the superficial vein system with saphenofemoral venous reflux disease or saphenopopliteal venous reflux disease or combined saphenofemoral and saphenopopliteal venous reflux disease.


In summary, the presence of axial reflux is a relative contraindication to treatment of telangiectasias unless the underlying venous insufficiency is corrected.  This can be done using either VNUS closure, EVLT or the ClariVein procedure.


The VNUS closure procedure, EVLT and ClariVein procedures are available at the Vein Treatment Center with offices in Williamsville, New York and Clarence, New York.  Hratch Karamanoukian, MD FACS is a board certified phlebologist (diseases of the venous system and lymphatic system) with added board certification in surgery and thoracic surgery (cardiovascular surgery). Call 716-839-3638 to schedule an appointment for consultation and evaluation.  and are partners with .



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