Treatments Available

VNUS Closure (Radio Frequency Vein Ablation)

The VNUS® Closure procedure, an alternative treatment option to traditional vein stripping surgery, brings state-of-the-art technology to an age-old disease.

The Closure procedure is performed on an outpatient basis. Using ultrasound, your physician will position the Closure catheter into the diseased vein, through a small opening in the skin. 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 As the RF energy is delivered and the catheter is withdrawn, the vein wall is heated, causing the collagen in the wall to shrink and the vein to close.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 other healthy veins.

Following the procedure, a simple bandage is placed over the insertion site, and additional compression may be provided to aid healing. Your doctor may encourage you to walk, and to refrain from extended standing and strenuous activities for a period of time.

Patients who undergo the Closure procedure typically resume normal activities within a day.

Before Closure                                                            After Closure

EVLT (Endovenous Laser Treatment)

Endovenous laser therapy is one of the newest techniques for the treatment of varicose veins as the result of superficial venous insufficiency. A tiny laser fiber is inserted into the vein, with ultrasound guidance, to the exact source of the venous problem. Laser pulses are then used to close the vein. It requires a small non-scarring incision in the skin, local anesthesia, no hospitalization and short recovery. In some cases, other treatments including sclerotherapy, ultrasound guided sclerotherapy, foam sclerotherapy, and or ambulatory phlebectomy, are used in combination with endovenous laser therapy.

Benefits:

• The procedure is minimally invasive and less traumatic than traditional surgery
• It involves only a tiny non-scarring incision
• Recovery time is short allowing return to normal activities usually within a day
• The treatment is in-office.
• The procedure is performed under local anesthesia

Ambulatory Phlebectomy

Ambulatory phlebectomy or “hook” phlebectomy is a micro-extraction procedure which allows for the removal of large and small surface varicose veins through very small incisions that need no stitches.

Skin incisions or needle punctures as small as 1 mm are used to extract veins with a phlebectomy hook. A hook is inserted into a micro-incision in the leg. A section of the vein is hooked and then removed through the incision. With this procedure, a compression bandage is worn for two weeks. This minimizes swelling and discomfort and allows for proper healing.

Before Ambulatory Phlebectomy                              After Ambulatory Phlebectomy

Compression stockings

What is Compression and why is my doctor recommending it? Compression is the most commonly prescribed treatment for venous disease issues and with good reason – it works! Unfortunately, it works only temporarily. Compression is applied to the venous system from the ankle and then moving upward, compressing the veins at that point, and transferring the compression up the leg, thereby hoping to keep the valves in your leg in close proximity to each other. This in turn allows the valves to push blood upward to the heart, which is just what you want.

Though not a long term solution, and one that is downright uncomfortable in the warmer weather, compression stockings definitely have a place in helping you achieve a level of comfort and in reducing pain and slowing the disease progression. We insist on compression after most of our procedures for 5 days, and long term for chronic sufferers of venous disease. Here at The Advanced Vein & Vascular Center, we carry a variety of styles, types, and sizes of stockings and socks for one-stop shopping convenience. We recommend always wearing compression when flying, as the pressures exerted on the venous system from changes in elevation are considerable, and can be helped by wearing compression stockings. Flight attendants, airline employees such as those for Fedex and UPS, and pilots should consider compression stockings as part of their essential uniform.

What are compression stockings? These are medical grade, knee-hi, thigh-high, and pantyhose socks and stockings that apply a high degree of “tightness” or pressure to your leg. Highly elastic, these are much tighter than everyday pantyhose or socks. They come in a variety of gradients, with most people who need them wearing “20-30- mmHg” or 30-40 mmHg”. (Remember your high school chemistry? That’s “millimeters of mercury” which is how compression is measured). The higher levels become very difficult to apply, and most people who have to wear compression hose regularly will also purchase an inexpensive and durable applicator to help with the donning of such apparel. You may remember the “thick beige stockings” your grandmother wore. Certainly not a fashion statement. In recent years however, many manufacturers have added a wide variety of compression stocking to include many shades, colors, and open toe/open foot varieties that make the warm weather months more manageable. However, as said before, compression provides temporary and usually only partial relief to your symptoms – they are NOT a cure for the cause of your problems. Unless you are one of the few with contra-indications (reasons why NOT to treat) you will achieve a far more lasting and convenient solution to venous problems by having them treated in any of the ablation and surgical manners described on our “treatments” page.

Compression stockings

Sclerotherapy

What is exactly is “sclerotherapy” or “injections”? Sclerotherapy, also referred to as injections, are injections of a solution, called a “sclerosing agent” with a super fine needle. Most patients feel little and tell us it does not hurt at all, although this will depend on what solution is used. The solution injected damages the inner wall of your spider veins, causing the shrinkage and destruction of the collagen, thereby causing them to shrivel up and eventually be absorbed by the body. This process takes several weeks to months, and requires pressure applied immediately after, and the wearing of compression socks or stockings for several days following treatment, and in order to achieve the best result. As the veins close off, the blood flow is interrupted and halted, thereby removing the unsightly spidery lines on your legs or other areas of the body. Before treating a patient for the first time with sclerotherapy, we will conduct a thorough exam to make sure there are no reasons you should not have this treatment. Depending on the outcome of that exam, we may be able to treat you the same day, or we may require you to have an ultrasound to determine the likelihood of success for you with this technique. If you are found to have larger underlying veins with faulty valves, or deep venous concerns, we will need to address those before wasting your time and money on injections – if you are found to have underlying problems which are not resolved, you will likely be unhappy with your result, as the spider veins will soon re-appear.

Before Sclerotherapy                                                After Sclerotherapy

Laser

Superficial laser treatments can be very effective, and are often used for veins too small to inject. New technology in laser treatments can effectively treat spider veins in the legs. Laser surgery sends bursts of light energy into the vein. Different wavelengths of laser energy are attracted to different mediums, and we prefer a laser frequency that has good affinity for blood. As the light energy traverses the vein, it causes the same kind of damage to the vein walls as injections, and causes the vein to slowly shrivel and disappear over time. Lasers are very direct and accurate when used by a skilled operator. Most skin types and colors can be safely treated with lasers.

Laser surgery is more appealing to some patients because it does not use needles or incisions. Still, when the laser hits the skin, the patient feels a heat sensation that can be quite painful. Cooling helps reduce the pain. Laser treatments last for 15 to 20 minutes. Depending on the severity of the veins, two to five treatments are generally needed to remove spider veins in the legs. Patients can return to normal activity after treatment, just as with sclerotherapy. Some form of compression (compression stockings) is required for the first week following spider vein treatment. Stockings are also available at The Advanced Vein & Vascular Center, Inc. For spider veins larger than 3 mm, laser therapy is not very practical.