Varicose Veins Surgery

“A lot of people look at varicose veins, and they think that they’re a cosmetic problem, and sometimes they are.

But most of the time, varicose veins are a sign of something more serious that’s going on underneath the surface. And that something going on underneath the surface is what we call venous insufficiency.

Varicose veins can cause pain, swelling, itching, tenderness. Can lead to phlebitis or thrombophlebitis and blood clots. So my recommendation is that if you have varicose veins, it’s very important to have them checked by a vascular specialist.”

~ Dr. David Esposito
Board Certified Vascular Surgeon

“If you come to Milford Vascular Institute with varicose veins, the first thing we’ll do is perform a dedicated vascular ultrasound exam to determine if you have venous insufficiency.

If you do have venous insufficiency, we have various techniques where we can use lasers or microwave energy. We can do injections, we can remove veins, and it’s all done in the office.

It’s all done under local anesthesia with almost no recovery, minimal time down, very little risk, very little discomfort.”

~ Dr. David Esposito
Board Certified Vascular Surgeon

Here at Milford Vascular Institute, our top-rated vascular specialists serving New Haven, Bridgeport, Stamford and all of Southern Connecticut, use the most advanced minimally-invasive vein treatment techniques available anywhere in the world to treat your varicose veins and the underlying venous insufficiency.

Varicose veins surgery using radiofrequency (RF) ablation allows our vein specialists to use microwave energy to close the malfunctioning veins. RF ablation is the varicose veins surgery that is most commonly used here at Milford Vascular Institute. It is a low-risk outpatient procedure that takes less than an hour to complete.

Here is what you can expect during RF ablation:

1. In preparation for your procedure, your leg will be cleansed and prepped with Betadine solution.  Lidocaine will be used as a local anesthetic.  You will be fully awake and aware during your procedure.  You have the option to request the PRO-NOX™ self-administered nitrous oxide and oxygen analgesia system to reduce anxiety and discomfort.  Although most patients report little to no pain during this procedure.

2. Using ultrasound, your malfunctioning vein is identified and punctured with a small needle.

3. Through this puncture, the RF catheter is inserted into the vein and advanced under ultrasound guidance to the malfunctioning valve that is causing venous insufficiency and varicose veins.

4. The vein is anesthetized with a lidocaine and saline solution.

5. The catheter is then heated and cauterizes the vein from the valve to the mid-thigh or knee.

6. The catheter is then removed and a compression stocking is placed for 10-14 days to allow the vein to completely close.  You will require no stitching or staples at the puncture, and you can expect little to no scarring in the treatment area.

7. Immediately following the procedure, you will be able to get up and walk normally. You may experience tingling or pulling where the vein was closed down. It is normal to see some bruising in the treatment area. Elevate your leg when you are in a seated position, and make sure to walk around every few hours.

8. Three days after your procedure, you can resume low impact exercise at the gym. Two weeks after your procedure you may fly or take long trips as long as you make sure you wear your compression hose and hydrate sufficiently.

9. Within 5-10 days after your procedure you will come back to the office for a follow-up ultrasound to confirm successful closure of the vein. In time, the body will absorb the vein and it will appear on ultrasound as if the vein has been removed.​​ You do not need the removed vein, and in fact, your other veins will function more effectively without it.

Varithena® microfoam vein treatment is a minimally-invasive procedure where microfoam is injected directly into the diseased veins using a tiny needle. The foam fills the desired section of the vein, irritates the vein wall, causing the vein to collapse. Blood flow is redirected to healthier nearby veins.

The benefits of using Varithena® to treat varicose veins are as follows:

Varicose veins surgery using Varithena® is provided on an outpatient basis and allows quick recovery time so there is practically no downtime.

If you are afraid of needles, you have the option to request the PRO-NOX™ self-administered nitrous oxide and oxygen analgesia system to reduce anxiety and discomfort.  Although most patients report little to no pain during this procedure.

Factors that limit a person’s ability to be treated with Varithena® include the type of vein, the patient’s medical history, and the patient’s insurance plans. ​

Varithena® treats a wide variety of varicose veins. However, not all varicose veins can be treated with this product. The veins which make the best candidates for Varithena® treatment are:

Medicare and Medicare Replacement Plans cover Varithena®. Other insurance plans have varying protocols for coverage of this product. Our insurance coordinators will always check before your procedure to see the procedure will be authorized by your insurance.​

Please Note: You should not receive Varithena® if you have an allergy to polidocanol or if you have a history of blood clots.

The VenaSeal™ is the only venous closure procedure that does not require injections to numb the entire leg, does not use heat to close the vein, and does not use a sclerosing solution. During this procedure, a medical “super glue” is delivered inside the vein to close it.

Here is what you can expect during the VenaSeal™ vein closure procedure:

1. In preparation for your procedure, your leg will be cleansed and prepped with Betadine solution.  Lidocaine will be used as a local anesthetic.  You will be fully awake and aware during your procedure.  You have the option to request the PRO-NOX™ self-administered nitrous oxide and oxygen analgesia system to reduce anxiety and discomfort.  Although most patients report little to no pain during this procedure.

2. Using ultrasound, your malfunctioning vein is identified and punctured with a small needle.

3. Through this puncture, a catheter is inserted into the vein and advanced under ultrasound guidance to the malfunctioning valve that is causing venous insufficiency and varicose veins.

4. The glue is then applied in multiple steps from the valve down to the mid-thigh or knee. Gentle compression is done to allow the glue to adhere to the walls of the vein.

5. This completely seals the vein, closing off blood flow and instead diverting blood to a different series of healthy veins.

6. The incision will be dressed with sterile gauze. You will then walk out of the room, get dressed, and go home.

7. A massive advantage of this technique is that after the procedure, a compression stocking does NOT need to be worn.

8. Following the procedure, you can return to your normal routine right away with no downtime. Patients typically begin to see and feel results immediately, but some veins do take up to a year to disappear completely.

9. Within 5-10 days after your procedure you will come back to the office for a follow-up ultrasound to check the results.

The VenaSeal™ Closure System is covered by Medicaid, Cigna, Connecticare, Medicare, and Medicare Replacement plans. The only contraindication for VenaSeal™ is an adhesive allergy.

Laser vein removal, also known as EVLT (endovenous laser ablation) allows our vein specialists to use the heat from a laser to close the malfunctioning veins.

Here is what you can expect during laser vein ablation:

1. In preparation for your procedure, your leg will be cleansed and prepped with Betadine solution.  Lidocaine will be used as a local anesthetic.  You will be fully awake and aware during your procedure.  You have the option to request the PRO-NOX™ self-administered nitrous oxide and oxygen analgesia system to reduce anxiety and discomfort.  Although most patients report little to no pain during this procedure.

2. Using ultrasound, your malfunctioning vein is identified and punctured with a small needle.

3. Through this puncture, the laser is inserted into the vein. It is advanced under ultrasound guidance to the malfunctioning valve that is causing venous insufficiency and varicose veins.

4. The vein is anesthetized with a lidocaine and saline solution.

5. The laser is activated and cauterizes the vein from the valve to the mid-thigh or knee.

6. The catheter is then removed and a compression stocking is placed for 10-14 days to allow the vein to completely close.  You will require no stitching or staples at the puncture, and you can expect little to no scarring in the treatment area.

7. Immediately following the procedure, you will be able to get up and walk normally. You may experience tingling or pulling where the vein was closed down. It is normal to see some bruising in the treatment area. Elevate your leg when you are in a seated position, and make sure to walk around every few hours.

8. Three days after your procedure, you can resume low impact exercise at the gym. Two weeks after your procedure you may fly or take long trips as long as you make sure you wear your compression hose and hydrate sufficiently.

9. Within 5-10 days after your procedure you will come back to the office for a follow-up ultrasound to confirm successful closure of the vein. In time, the body will absorb the vein and it will appear on ultrasound as if the vein has been removed.​​ You do not need the removed vein, and in fact, your other veins will function more effectively without it.

Once the venous ablation procedure has been performed, the underlying problem has been treated. However, some large varicose veins may remain.

If these leftover veins are not addressed, you may continue to experience pain and discomfort. These unsightly veins may become inflamed and clotted. Therefore, it is best that these varicose veins are physically removed from your leg.

This procedure is called ambulatory phlebectomy, and here is what you can expect during the procedure:

1. In preparation for your procedure, our vascular specialist will use a marker to outline where the veins are that need to be removed. You will be fully awake and aware during your procedure.  You have the option to request the PRO-NOX™ self-administered nitrous oxide and oxygen analgesia system to reduce anxiety and discomfort.  Although most patients report little to no pain during this procedure.

2. You will then be asked to lie down. Your legs will be washed and painted with a solution to prevent infection.

3. You will feel a number of small pinches when the local anesthetic is injected around the vein.

4. Tiny incisions will be made where the veins were marked. The vascular specialist will grab the veins with a hook, and gently tease them out. You may feel a pulling sensation while this is happening. After each vein is removed, gentle pressure will be applied to stop any bleeding.

5. After all the veins are removed, the leg will be cleaned and sterile gauze will be placed over the incisions. The tiny incisions will heal without stitches.

6. Your leg will be wrapped with gauze and an Ace bandage. Leave the Ace bandage on overnight. Remove on the following day to shower. Then, place compression stocking and wear from morning to night for 14 days. When you remove the bandage you may see bleeding from the sites. This is common and not dangerous. Simply hold direct pressure for 5 minutes then place gauze underneath the stocking directly over the area.

7. As you heal, you may notice lumps and bumps under your skin. This is part of the healing process. With time,
they will be absorbed by your body and disappear. Mild pain and discomfort are normal after the procedure.

When you choose Milford Vascular Institute for vein treatment you can rest assured that you are getting the very best possible vascular care available in all of New Haven County. Our vein specialists are highly skilled in providing the most advanced, minimally-invasive vein treatments available anywhere.

At MVI, vein treatments are provided under the direction of board certified vascular surgeon Dr. David Esposito and Dr. Paul Davis, who is board certified in diagnostic radiology, and vascular and interventional radiology.

Dr. Esposito and Dr. Davis are top-rated experts in vein treatments. They are always at the forefront of technology in the vascular surgery field to ensure they are providing the best, cutting-edge vein treatments to their community.

Board certified Physician Assistant, Karin Augur, and Advanced Practice Registered Nurse, Erin Orozco specialize in diagnosing and treating vein disease, helping to restore healthy blood flow through your legs so they can look and feel their best.

With over 70 years of combined experience in diagnosing, preventing and treating vascular diseases, our outstanding group of highly trained and skilled providers have dedicated their lives to caring for you.

With over 20 years in practice, at Milford Vascular Institute, our staff is committed to excellent patient care, always treating our patients with respect and compassion because WE CARE.

If you’ve started to notice varicose veins developing on your legs, it is important to have an evaluation with a vascular specialist, because varicose veins are an indication of a deeper vascular problem called venous insufficiency.

Through a simple in-office ultrasound, we can determine if your varicose veins are due to venous insufficiency. If they are, we can treat you accordingly, using the most advanced vein treatment methods available anywhere.

Treatments are performed right in our offices using minimally-invasive techniques so you can enjoy no downtime and quick recovery.

To schedule a vein consultation with one of our top-rated vascular specialists here at Milford Vascular Institute, give us a call today at (203) 418-7386. It will be our pleasure to care for you.