By Dr. John Hogg, MD, DABR, DABVLM — Founder and Board-Certified Vascular Specialist, Medical Vein Clinic San Antonio | Published July 10, 2025
Varicose Vein Treatment at Medical Vein Clinic San Antonio: What to Expect
Medical Vein Clinic in San Antonio treats varicose veins using minimally invasive outpatient procedures — no surgery, no general anesthesia, and no hospital stay. Treatment follows a structured process: diagnostic ultrasound, a conservative trial of compression therapy and lifestyle changes, and then targeted procedures for patients who need further intervention. The two primary procedures offered are radiofrequency ablation (RFA), the gold-standard treatment for varicose veins, and Venaseal, a medical adhesive option for patients who cannot wear compression stockings. Varithena, an FDA-approved injectable foam, is also used for treating visible varicose veins and their tributaries. Most treatments are covered by insurance. Procedures are performed by Dr. John Hogg, MD, DABR, DABVLM — board-certified in radiology specializing in vascular and interventional radiology — and the Medical Vein Clinic team at both San Antonio locations.
Not long ago, treating varicose veins often meant undergoing highly invasive vein stripping surgery. Patients faced hours under general anesthesia and many months of recovery. Fortunately, treatments have greatly progressed. At Medical Vein Clinic, we provide our patients with minimally invasive, highly effective treatments that allow them to walk in and walk out the same day.
Why Varicose Vein Treatment Is a Process — Not a One-Time Procedure
Vein care is not a one-time fix. It’s a process built on careful evaluation and personalized treatment planning. Insurance companies rightly require a conservative trial period of three months before we can perform procedures, and in many cases, this conservative approach can provide significant symptom relief without the need for intervention.
The Conservative Treatment Phase
During your first visit, we perform a detailed medical history, physical examination, and visual leg assessment to identify potential vein disease. A second visit includes a comprehensive ultrasound exam to evaluate which veins are functioning properly and which are not.
If venous insufficiency is confirmed, we initiate a conservative treatment plan, which includes four key steps:
1. Compression Therapy: Patients wear medical-grade compression stockings daily (except when sleeping). Compression helps close weakened vein valves and encourages healthy blood flow upward toward the heart. How you respond to this step is often the best predictor of long-term treatment success.
2. Exercise & Movement: Your calf muscles act as a pump to propel blood upward. Regular leg movement throughout the day supports healthy circulation.
3. Elevation: Raising your legs above heart level allows gravity to help drain stagnant blood and refresh the veins with oxygenated blood.
4. Pain Management: When needed, over-the-counter analgesics can help manage inflammation and discomfort during this period.
Minimally Invasive Treatment Options
If conservative treatment does not fully resolve your symptoms, we offer several state-of-the-art procedures tailored to each patient’s unique vein structure and health needs:
1. Radiofrequency Ablation (RFA): The Gold Standard
RFA remains the most widely recommended treatment for varicose veins. Using local anesthesia, a thin catheter is inserted into the diseased vein using ultrasound guidance. Radiofrequency energy gently heats and seals the vein shut. Once closed, blood reroutes through healthy veins, restoring normal circulation. The entire procedure is virtually painless, takes about 15 minutes, and is covered by most insurance plans.
Post-RFA Instructions:
- Wear compression stockings for 21 days.
- Walk 10-15 minutes every hour while awake.
- Avoid heavy lifting, strenuous exercise, or high-impact activities for three weeks.
Most patients notice improvement in leg symptoms within one to two weeks. Treated veins are gradually absorbed by the body over two to four months — visible surface veins will fade during this time.
2. Venaseal: The No-Stocking Option
For patients unable to tolerate compression stockings, Venaseal offers an excellent alternative. Instead of using heat, we inject a medical adhesive (“superglue”) to close the damaged vein. Since some patients may have sensitivities to adhesives, we perform careful screening before treatment. Venaseal allows patients to resume normal activity immediately, without the need for compression stockings. It is covered by Medicare and select insurance plans, for others, we offer flexible payment plans.
3. Varithena: FDA-Approved Foam Treatment for Visible Varicose Veins
Varithena is an FDA-approved injectable foam used to treat visible varicose veins and their tributaries — the smaller branching veins connected to the main diseased vein. During the procedure, a physician injects the foam directly into the affected vein using ultrasound guidance. The foam fills the vein and causes it to collapse and close. Varithena is particularly effective for treating the visible, bulging veins that patients find most cosmetically concerning. It is often used in combination with RFA to treat the full extent of varicose vein disease in a single session. Most insurance plans cover Varithena when venous insufficiency is documented.
4. Sclerotherapy: Treatment for Spider Veins and Small Varicose Veins
Sclerotherapy is an injection treatment for spider veins and small varicose veins close to the skin surface. A physician injects a solution directly into the affected veins, causing them to contract and gradually disappear over several weeks. The procedure takes 15 to 30 minutes with no anesthesia. Insurance coverage for sclerotherapy depends on whether veins are treated for medical or cosmetic reasons. When treated for documented venous insufficiency symptoms, most plans provide coverage.
Schedule Your Varicose Vein Evaluation at Medical Vein Clinic San Antonio
If you’re living with leg pain, swelling, or bulging veins, don’t wait. Early evaluation can prevent complications and restore your mobility, health, and confidence. At Medical Vein Clinic, we are committed to delivering expert, compassionate care with the most advanced techniques available.
Call Medical Vein Clinic at 210-622-8000 or book your varicose vein evaluation online at medicalveinclinic.com/book-an-appointment. We have two San Antonio locations: Stone Oak at 18831 Meisner Drive and Northwest San Antonio at 5742 W. Loop 1604 N. Most insurance plans cover varicose vein treatment when venous insufficiency is documented.
Watch: Varicose Vein Treatment at Medical Vein Clinic San Antonio — Radiofrequency Ablation Explained
In this video, Medical Vein Clinic explains the radiofrequency ablation process for varicose veins — from ultrasound diagnosis through the outpatient procedure and recovery.
Frequently Asked Questions About Varicose Vein Treatment at Medical Vein Clinic
What is the difference between RFA and VenaSeal for varicose veins?
Both close off the problem vein without surgery, but they work differently. Radiofrequency ablation (RFA) uses heat delivered through a catheter to seal the vein from the inside, and it is the gold standard for varicose veins. VenaSeal uses a medical-grade glue to seal the vein shut and requires no compression stockings afterward, making it a good option if pulling on stockings is difficult for you. We screen for glue allergies before a VenaSeal procedure.
Does varicose vein treatment hurt?
Our treatments are minimally invasive and done under local anesthesia, so most patients feel little discomfort. We numb the area before the procedure, and there are no surgical incisions. Some patients notice mild soreness or bruising afterward, which settles within a few days.
How long does varicose vein treatment take?
Most procedures are done in a single appointment, and you walk out the same day. We treat the problem veins in one visit after numbing the area. Smaller spider veins treated with sclerotherapy take less than 15 minutes.
How soon after treatment can I return to normal activity?
Most patients return to work or normal activity right away. We ask you to walk 10 to 15 minutes every waking hour and avoid heavy lifting or running during the recovery period. You wear compression stockings for about three weeks after treatment to support healing.
Can varicose veins come back after RFA or VenaSeal?
Once a vein is closed, it stays closed, and blood reroutes to healthy veins. Our approach treats the source veins first, the larger leaking vessels that cause the smaller ones, which keeps varicose veins from coming back. New veins can develop over time, so follow-up care helps catch any changes early. RFA has a success rate above 95%.
Does insurance cover varicose vein treatment?
Yes. RFA and Varithena are covered by most insurance plans, and VenaSeal is covered by Medicare. Coverage applies when symptoms are medically documented, which is one reason we begin with conservative care. We verify your insurance before your appointment, so call 210-622-8000 to confirm your benefits.
Why do I need three months of compression therapy before a procedure?
Insurance generally requires a trial of conservative care, and it also confirms the diagnosis. You wear compression stockings daily for three months, and if your symptoms improve, we know your veins are the cause and you qualify for a procedure. This step makes sure treatment is targeting the real source of your symptoms.
What is Varithena and when is it used?
Varithena is a foam solution injected directly into the problem vein using ultrasound guidance. The foam cauterizes the vein and closes it, with the same three-week recovery as RFA. It is a good option for certain vein shapes and locations where a catheter-based approach is less suited, and it is covered by most insurance plans.
How many treatment sessions will I need?
This depends on how many veins need treatment and which procedure is used. We treat the problem veins in one appointment when possible, and your physician maps your veins with ultrasound on your first visit to plan exactly what is needed. Smaller spider veins treated with sclerotherapy may take more than one short session.
