Why We Treat Patients With Varicose Veins With An Initial Trial of Stockings

cr-017-200x300-calcagnoBy Dr. David Calcagno, co-founder, Calcagno & Rossi Vein Treatment Center

Each day we hear from patients that compression stockings are difficult to get on, partially roll down throughout the day, and are very hot especially in the summer.

So why would a vein treatment center like ours, specializing in the treatment of varicose veins, prescribe these stockings for patients for several months? The answer is simple.

Insurance Company mandates: We do not argue that when venous reflux is present (the backward flow of blood in many patients with varicose veins, resulting in the vein pressure in the leg being elevated), compression stockings can make your legs feel somewhat better by counteracting this higher pressure. However, we do argue that stockings do not actually treat or eliminate the disease, but only aid in symptom reduction until we can perform a minimally invasive procedure.

Let’s review the medical literature that supports this latter view:

  • The National Institute for Health and Care Excellence (NICE) studies in the United Kingdom in July 2013 recommended that patients should be referred to a vascular clinic first for varicose vein treatment rather than just prescribing compression support stockings.
  • In May 2011, The Journal of Vascular Surgery publishedthe consensus statement from the Society for Vascular Surgery and the American Venous Forum that a person who is a candidate for a venous procedure with varicose veins who are symptomatic should simply have them treated with modern venous procedures rather than being treated with compression stockings.
  • A study that was published based on patients treated here at the Calcagno and Rossi Vein Treatment Center was published in the journal Phlebology in September 2011 and showed that mandatory stocking trials did not change the ultimate definitive treatment patients needed for their varicose veins, but only delayed their care.

Why would insurance companies want to delay patient care by insisting on several months of stocking trial?

Although compression stockings can improve varicose vein symptoms while being worn, as soon as they are removed the patient’s symptoms return, and the problem remains unresolved. Progression of the disease continues, worsening over the time required to fulfill the mandated use of compression stockings.

We have seen many patients after several months of a stocking trial that require more extensive procedures to correct their venous disease than would have been needed initially. We have also seen patients who have developed bleeding and blood clots that could have been prevented had their problem been allowed to be treated when they first saw us.

The best time to do something about your varicose veins is now.

If you’ve been holding off treating on your varicose veins, the best time to act is now. Since your insurance company will likely require several months of stocking use prior to approving any procedures, winter would be a much better time to use the stockings than during the summer months.

By the time summer comes, your legs will be in good shape to enjoy outdoor activities including going to the beach or pool. Besides the obvious cosmetic benefits, your legs will be healthy and feeling good again.

So winter is the perfect season to give us a call at 717-921-1412 to have your varicose veins evaluated.