March 25, 2003

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Veins1: Welcome to today's Veins1 discussion with top vascular surgeon Dr. Marius Saines, of Los Angeles, California.

Veins1: Dr. Marius Saines attended Medical School at Brussels University, Belgium, and completed his training in General Surgery at Mount Sinai Hospital, New York Infirmary Hospital and New York University Hospital. He then completed a Vascular Fellowship at the University of Southern California. Dr. Saines has been in private practice for over 20 years and holds three US patents for medical devices he invented.

Veins1: He is a member of the International Society of Endovascular Specialists, and served a two-year term as Chairman of Surgery at Centinela Hospital, Inglewood, California.

Veins1: Users, we welcome your questions for Dr. Saines!

Eric: My wife is worried about Varicose Veins during pregnancy is this really merited?

Dr. Marius Saines: Yes. The majority of people develop varicosity during pregnancy, so they should wear elastic stockings and get treated after the pregnancy.

jkostal: Are there any new techniques for removing varicose veins from the legs? I've gone to a vein clinic in IL and had sclerotherapy along with ultrasound to really clear up my legs, but of course they are coming back little by little. Recently I have moved to Michigan and would like to keep them as clear and comfortable as I can, but I'm not sure if I should search out another vein clinic and have the same procedure done again or if there is some other way to remove these new veins. Do you know of anything else? Jane in Michigan

Dr. Marius Saines: Sclerotherapy has a high recurrence rate and is not definitive. The definitive cure is Trivex phlebectomy. The patient has to be evaluated by a vascular surgeon to eliminate the cause of the varicosity.

Marcy: I have had varicose veins injected in the past and it seems they came back several times worse and are more painful than before. What should I do next?

Dr. Marius Saines: Same thing as before... evidently the cause was not identified or eliminated. You need to be evaluated by a vascular surgeon to find the source of the varices.

Greta Cox: Is it possible to have the Trivex procedure done on both legs with minimal recovery time? I am asking for myself. I live on the East Coast and I'm a single parent with seven-year-old twins. I had surgery that didn't help and desperately want to get rid of the pain and would love to wear shorts again one day.

Dr. Marius Saines: Yes you can. Recovery is minimal. The patient can walk the same day and resume normal activities after three days.

Louise: I am 26 and have prominent veins all over my body, particularly in my legs, and they are very prominent on my ankles and feet. Could you advise me of any possible causes and cures? I have not had periods for a good while (I am having this checked out), and I was wondering if this could cause a blockage? Also, my job involves standing up all day, and poor circulation runs in my family. Could these be possible causes? Thanks.

Dr. Marius Saines: You need to be evaluated in the office of a vascular specialist. Your job and family history are contributing factors, but if the varicosities are treated you should be able to resume normal activities.

Eric: Some doctors still use the hook method is this really that much less advanced than current methods? Which method does Dr. Saines advise on using and why?

Dr. Marius Saines: The hook method creates multiple scars and is tedious. The TriVex system is minimally invasive and has shorter recovery times.

Michele CCA: In your opinion, what is the difference between Sclerotherapy and Laser treatment for treating spider and/or varicose veins? And what is your preference?

Dr. Marius Saines: Laser therapy or a combination of laser and sclerotherapy is the best treatment for spider veins. And for varicose veins, the best treatment is still phlebectomy.

M: I have deep vein reflux in both legs with incompetent perforators in one leg. I have bulging, twisted varicose veins in both legs. I had my saphenous vein tied in the leg with the incompetent perforators but left all my varicosities the same. I am very scared with the rate of progression as I seem to have either a new vein appearing, start bulging or an already existing one becoming much worse. I tried compression stockings but it seemed to make the veins in my lower ankle and foot worse. I have no ulcers or swelling. I do get red spots under the skin, which sometimes stay but fade, some completely eventually go away. Is it safe to have the SEPS procedure done when there is deep vein reflux? Is it ok to remove the varicose veins that are causing me pain when there is deep vein reflux or will it make my condition worse? What course of action should I be looking into to help me?

Dr. Marius Saines: Yes it is safe. The treatment should be first SEPS and then the phlebectomy of the varices.

M: Can increasing the muscle tone in your legs help to minimize the reflux of the deep veins?

Dr. Marius Saines: Yes, it can.

TKOin2: I noticed this on your website "Generally, defective valves in these veins send blood back into the vein instead of toward the heart, causing dilation and discomfort." What kind of discomfort do you mean? Can this a be symptom of another larger problem?

Dr. Marius Saines: Local burning or pain are the most common symptoms.

Pestilent1: I play many hours of video games; should I be worried that my veins are not getting enough "exercise"?

Dr. Marius Saines: You are absolutely right.

esteele: Can varicose veins on the testicles decrease chances of fertility?

Dr. Marius Saines: That question has to be addressed by a urologist.

Eric: Does Doctor Saines have a website where I can learn more about his procedures and techniques?

Dr. Marius Saines: Yes. Go to http://www.varicoseveindoctor.com

M: I have a 8 and a 4 year old child that have a very skinny, straight not visibly protruding but palpable vein on their leg. Is this something I should be worried about? Will exercise and their growth help return the vein to normal or should I have it treated?

Dr. Marius Saines: I would observe this, then go to a specialist when they become teenagers, if it persists.

Veins1: We're just about out of time. Dr. Saines, thank you for joining us today and lending your expertise.

Veins1: Users, thank you for joining us today. Stay tuned for upcoming Body1 discussions!