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Get A Leg Up for Summer: Help Is Available for Troublesome Veins

April 5, 2019

Starling is proud to introduce Dr. Shishir Mathur, a Board Certified Interventional Cardiologist who offers minimally invasive treatments for varicose veins. He shares some of the most common vein conditions and current options.

What are the most common vein issues?

Varicose Veins

The two most common types include:

What causes vein conditions?

Spider veins are caused by unhealthy valves inside feeder veins, allowing blood to flow backwards instead of upwards toward the heart. Some of this backed-up blood can lead to non-functional, “dead end” veins that appear under the surface of the skin as spider veins.

Varicose veins are caused by unhealthy valves inside the veins that impede the normal flow of blood back to the heart. Blood pools in the veins, enlarging and distorting them.

Are vein conditions painful?

Spider veins may lead to discomfort. Varicose veins can be more problematic, resulting in pain, fatigue, itching, burning, swelling, cramping, restlessness, and throbbing.

What are risk factors for vein conditions?

Some of the most common risk factors include:

What is the newest option for treating vein conditions?

The first step in treating varicose veins is usually conservative measures like stockings, but for patients with resistant or severe symptoms, radiofrequency ablation treatment (RFA) is indicated.   

The procedure is performed in the office. Using ultrasound guidance, a thin catheter is inserted into the diseased vein without incisions. The tiny catheter delivers radiofrequency (RF) energy to the vein wall.

As the RF energy is delivered and the catheter is withdrawn, the vein wall is heated, causing the collagen in the wall to shrink and the vein to close.

Once the diseased vein is closed, blood is re-routed to healthy veins. The circulation actually improves after the vein closure! The procedure takes about 30 minutes and is performed using local anesthesia. There is virtually no post-operative discomfort.

Most people notice an improvement in their symptoms within a few days. The procedure is approved by the FDA and is covered by medical insurance plans and Medicare.

What are the benefits of radiofrequency ablation for varicose veins?

What can I expect during my consultation with Dr. Mathur?

Dr. Mathur will review your medical history and conduct a physical exam and venous ultrasound. If your clinical profile and venous ultrasound findings confirm venous reflux problem, Dr. Mathur will discuss different treatment options like conservative measures or RFA procedure for further treatment.

What should be expected after the RFA procedure?

Following the procedure, the leg is wrapped in an Ace bandage for 24 hours. Patients are encouraged to walk but refrain from strenuous activities for several days. Patients who undergo the RFA procedure can resume normal activity the same day. A compression stocking is worn for 3 days. Full activity, including strenuous exercise, can resume after 7 days.

Normal daily activity can be resumed immediately. There may be minor soreness and bruising. Any discomfort can be treated with over-the-counter, non-aspirin pain relievers as necessary.

Are there any risks?

As with any treatment, there are associated risks, though they are minimized in the hands of trained physicians. These include:

What other treatment options are available?

Occasionally, patients require more than one kind of treatment. Dr. Mathur takes a personalized approach in finding the right therapy or combination of therapies to bring about a positive result.

Additional therapies may include:


Sclerotherapy is a safe, proven medical procedure that treats both the symptoms and the causes of varicose veins and spider veins. Sclerotherapy treatment sessions usually take less than half an hour, with no hospitalization required. Most patients do not find sclerotherapy treatments to be particularly painful, and recovery time is generally very short – most people are back to their regular routines the same day.

For sclerotherapy treatments, a series of microinjections of a solution (“sclerosant”) are administered directly into varicose veins or spider veins.


Some patients may have residual veins after RFA procedure. These veins are then removed with phlebectomy. Phlebectomy is an office based procedure where residual veins are removed with very small incisions. This procedure is done under local anaesthesia and lasts about 30 minutes. Patients can go home and resume routine activities the same day.

Non-surgical Options

May include use of compression stockings.

Why should I see a board certified Interventional Cardiologist?

Vein symptoms can represent serious underlying medical conditions. Therefore a comprehensive approach to this problem is needed. To successfully evaluate and treat vein conditions, it is safest to see a board-certified cardiovascular specialist who has in depth training and expertise in both cardiac and vascular diseases. While a number of walk-in day spas and clinics offer these treatments, there are risks of missing serious underlying medical conditions or complications with RFA procedure when it is not clinically warranted. Some treatments delivered by inexperienced staff may result in short-term cosmetic improvements while failing to treat the underlying cause.

How do I get started?

The first step is to meet with Dr. Mathur who can assess the type of vein issues you face. He will recommend the appropriate treatment and discuss what you can expect.

Vein treatments for medical purposes are usually covered by all insurances. However, not all treatments are covered, especially if the treatment is for cosmetic purposes. It is important to check with your carrier.

Dr. Mathur is now scheduling patients in New Britain, Wethersfield and Glastonbury. Call (860) 258-3477.