Member of:
The Vein Institute of Toronto Technique
Description of Spider and Reticular Veins:
Telangiectasias are dilated superficial veins. They are
often found on the face and legs. The thin veins on the legs termed spider
veins usually appear on the thighs and ankles. The veins on the face generally
appear on the nose, chin or cheek area and often occur in rosacea. These
veins are purple, blue or red and usually appear in three basic shapes:
linear, branch-like or spider-shaped, with a dark center point.
Branch-Like |
Linear |
Spider-Shaped |
Symptoms:
Burning or itching are the most common symptoms of spider
veins.
Incidence and Causes:
Nearly 70% of all women and 30% of men will develop some type of venous disorder. Spider veins result from reticular veins or truncal insufficiency. If the patient has pain or swelling a duplex ultrasound is performed to make a complete diagnosis. If truncal (great or small saphenous vein) insufficiency is diagnosed, this condition should be treated prior to treatment of the spider veins.
Contributing factors include:
- Heredity
- Pregnancy
- Hormonal changes
- Being overweight
- Standing or sitting for prolonged of time
- Advancing age
- Trauma
- Sun-exposure for veins on the face
Anatomy
 
Normal Venous Flow |
Abnormal Venous Flow |
Procedures:
Pre-Procedure Protocol:
At The Vein Institute of Toronto all patients will first undergo a complimentary physician consultation involving a focussed venous history, detailed venous physical examination and a duplex ultrasound to rule out truncal (Great saphenous or Small saphenous) venous insufficiency. We have developed a unique vein mapping technique to completely map out your spider and reticular veins and ensure a complete treatment plan. The initial consultation will allow us to develop a personalized treatment plan tailored to your schedule and goals.
Skin pigmentation can impact the effectiveness of any surface laser treatment, therefore the patient should have no sun exposure for four weeks prior to treatment to guard against blistering and scarring.
Procedure Protocol:
We utilize the Revolutionary Syris 300 T patented subsurface technology which allows us to see approximately 1mm below the skin's surface. This allows to have a more complete patient assessment and treatment, with reduced procedure times and improved outcomes.
We utilize the "Double Injury" method when treating
spider veins on the leg. This technique treats the spider veins with our D940 SkinPulse S laser T, followed by an injection of sclerosing solution into the associated reticular or "feeder" vein. Laser energy is applied first through a hand piece that is extremely small and lightweight. The 5 Hertz system allows patients to be treated quickly and efficiently. The laser can be set to pulse or continuous mode. Spot sizes are easily interchangeable and come in 0.5, 1.0 and 1.5 millimeter sizes. Our D940 laser has the smallest focal spot available. This allows precise treatment of fine spider vein networks. At The Vein Institute of Toronto the sole function of the D940 Skin Pulse Laser is the treatment of spider veins. We do not believe in multi-functional lasers which are not tailored to one specific application. By injuring the veins with the laser first, the vein vasoconstricts and less sclerosant is required. The benefit of the "Double Injury" method over sclerotherapy alone is a quicker resolution and a significant decrease in the risk of staining or bruising. Staining appears as brownish discoloration on the skin.
Although discomfort with the surface laser treatments is minimal, we utilize a Zimmer Cryo Cool 6 T air cooling device to increase the patient's comfort. The Zimmer Cryo Cool 6 T air cooler is designed both for comfort and safety. Cooling the skin during a laser treatment protects the outer layer of the skin (epidermis) from potential damage while making the treatments more comfortable for the patient. Because cooling the skin protects it from damage, the laser power can be increased to more effective levels, making each treatment maximally beneficial and minimizing the number of treatments. We are the first clinic in Canada to utilize a Zimmer Cryo Cool 6 T for surface laser spider vein treatments.
The duration and number of sessions will vary depending on the severity of the condition and the location. Many facial veins can be treated in one session; however, most conditions on the leg require three to five treatments to ensure all spider veins are treated. These treatments are spaced four to six weeks apart.
We perform sclerotherapy after surface laser therapy utilizing the Veinlite T technology. The Veinlite T patented Side-Transillumination provides uniform illumination and visualization of unprecedented clarity. Light generated by a halogen bulb travels though a high-quality fiber into the Veinlite ring, where it is directed into the skin at an angle so that it is concentrated in a bright spot under the skin. The bright spot behaves like a virtual light source below the skin that transilluminates the open area within the ring. Superficial blood vessels are seen with high clarity and networks of varicose veins can be examined in detail. This technology allows us to completely map out the feeding veins and perform a complete treatment with decreased chance of recurrence.
Post Procedure Protocol:
Once the procedure is completed, we recommend that compression stockings be worn for five days.
As with any procedure, some mild side-effects might occur. These side effects include slight redness to the skin tone or mild swelling in the treated area.
Common recommendations for the patient:
- Stay out of the sun and tanning beds for at least two weeks
- Wear compression
stockings for a minimum of five days
- Abstain from high impact
activities such as running or step aerobics for two weeks
- Walk at
a moderate pace, as it will aid in the healing process
Exemple
Before Laser Vein Therapy |
After Laser Vein Therapy |
References
Thierry Passeron, et.al., The New 940-Nanometer Diode Laser:
An Effective Treatment for Leg Venulectasia., 2003
P. Kaudewitz, Effective
Treatment of Leg Vein Telangiectasia with the New 940nm Diode Laser., 2001
P.
Kaudewitz, Treatment of Leg Vein Telangiectases: 1-Year Results with the
New 940nm Diode Laser., 2001
E. Victor Ross, et.al., Laser Leg Vein Treatment:
A Brief Overview., 2003
Leslie Baumann, MD, Using the 940-nm Laser for
Facial Indications., 2005.
Patient Procedure Instructions:
THE VEIN INSTITUTE OF TORONTO
www.theveininstitute.com
416-929-0834
Sclerotherapy and Laser Therapy Protocol
WHAT SHOULD I DO BEFORE MY SCLEROTHERAPY/LASER TREATMENT?
1. Do not
shave your legs or apply cream for one day prior to your appointment.
2.
Do not take aspirin or blood thinners 3-5 days prior to procedure.
3.
Eat a snack one hour prior to your treatment.
4. Bring shorts to wear
during the procedure and slacks to wear out of the office.
WHAT SHOULD
I DO AFTER MY SCLEROTHERAPY/LASER TREATMENT?
1. Keep stockings on
until bedtime.
2. You can resume normal activities today.
3. You
can resume exercising in 14 days.
4. You can shower in the morning
but no hot baths, hot tub or sauna for 1 week.
5. Wear your support
hose for 5 days, from the first thing in the morning (ideally, take
a quick 5 min shower and then put them on before doing the rest of
your morning ritual), until last thing at night.
6. Bruising, local
swelling and some tenderness are normal after treatment, but please
feel free to call the office if you have any questions.
7. Use sunscreen
(SPF 30) for at least 2 weeks following procedure.
8. Apply Aloa
Vera Gel or Vaseline to treatment area at night to prevent dehydration.
9.
If there is swelling, wrap ice in a cloth and apply to the affected
area.
10. You will not notice an immediate improvement. Clearance
usually occurs over a 2-week period and in some cases may take up
to 6 weeks. There may only be a partial response after the first one
or two treatments.
11. The spider veins may initially turn darker red
after treatment, before healing response occurs.
Call 416-929-0834
for a Complimentary Physician Consultation
