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Treatment of Varicose Veins and Spider Veins is Nothing to Fear at Greater Pittsburgh Vascular Associates
By Nancy Kennedy

Gennady GeskinVaricose veins and spider veins are common, bothersome conditions, but they are also highly treatable. At Greater Pittsburgh Vascular Associates, a division of Jefferson Cardiology, the diagnosis and treatment of varicose veins is a specialty. 

Expert, highly skilled cardiologists at the Center’s two locations offer the most cutting-edge care in a state-of-the-art catheterization lab equipped with the latest medical imaging and surgical technologies to diagnose and effectively eliminate problem veins and the discomforts associated with them.

Gennady Geskin, M.D., a board-certified cardiologist, says the prevention and treatment of varicose and spider veins and their complications is a primary focus of his practice.  “There is no reason for anyone to suffer with the aching, swelling, fatigue and heavy feeling in the lower legs that is common for those with varicose veins. Sometimes, people assume that they just have to live with it, or they are afraid to seek treatment because they mistakenly believe that the only treatment is surgery. Others think that varicose veins are merely a cosmetic problem. The truth is that varicose veins are a medical problem, not a cosmetic one, and they can have serious, long term consequences when untreated. They can result in skin breakdown, ulcers, infection, bleeding and phlebitis.”

Varicose veins are mostly a matter of genetics, according to Dr. Geskin. “If both of your parents had them, you have an 80% chance of developing them; if one parent had them, your chances are 50%. Pregnancy can cause varicose veins, and lifestyle is a contributing factor, too, especially if you are obese; occupations, such as hairdressing, that require long periods of standing can result in problem veins.”

Conservative treatment consists primarily of wearing compression stockings that provide support and reduce swelling and heaviness; elevation of the legs whenever possible; and making adaptations in the workplace to avoid prolonged standing.
But for severe varicose veins, the ideal treatment is to eliminate the veins altogether. That process begins with diagnosis, including a physical examination of the legs and a diagnostic venous ultrasound, done right on site in the lab, to precisely identify malfunctioning veins and the degree of reflux present. 

“The majority of patients will have reflux,” Dr. Geskin explains. The “venous system is a network of blood vessels that resemble a tree. The valves are located in the tree trunk, and the veins are the branches of the tree. We look for reflux in the superficial veins, which occurs when the valves aren’t working right. We treat the cause, using endovenous thermal laser ablation, a safe and minimally invasive procedure that uses a concentrated beam of light, or radiofrequency, which uses electricity. This is an outpatient, minimally invasive procedure; the patient is given a local anesthetic and the procedure is well tolerated; there is no incision. It takes only seven or eight minutes to complete and the patient is there for a total of just two hours. It’s safe and comfortable; the environment is not at all frightening, and patients walk out after the procedure.”

Post procedure, compression stockings must be worn for two weeks. Dr. Geskin says that outcomes are excellent: the recurrence rate is low, at just 4%. “In some situations, varicose veins may be getting fed by multiple sources; these will shrink by 80% and that is probably enough. If the varicose veins are a longstanding problem, we may have to do a phlebectomy to pull them. This is also an outpatient procedure.”

Varicose veins cannot be entirely prevented, but they can be minimized; this is a matter of knowing your risk factors and delaying the onset as long as possible. Well-fitted compression stockings are very helpful, and Jefferson Cardiology provides expert custom fitting.
The most important point for those with varicose veins, says Dr. Geskin, is that this is not a cosmetic problem but a medical condition and it requires treatment by specialists. The treatment is not something to be feared: it’s actually pretty easy and is nearly always covered by health insurance.

Greater Pittsburgh Vascular specializes in the treatment of varicose veins, spider veins, peripheral arterial disease, chronic venous insufficiency and deep vein thrombosis. The web site  www.greaterpittsburghvascular.com offers excellent videos, diagrams and other educational resources.

For more information or to to schedule an evaluation, call Dr. Gennady Geskin, Greater Pittsburgh Vascular Associates
(A Division of Jefferson Cardiology Association),  at (412) 469-1500 or visit www.greaterpittsburghvascular.com.



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