FAQS

Veins and arteries, while both part of the circulatory system, function quite differently from each other. "Poor circulation" is a nonspecific term that often refers to arterial blockages. Arteries bring oxygen-rich blood from the heart to the extremities and can be thought of like a tube or hose. Veins, unlike arteries, have one-way valves and channel oxygen-depleted blood back toward the heart. If the valves of the veins don't function well, blood doesn't flow efficiently. The veins become enlarged because they are congested with blood. These enlarged veins are commonly called spider veins or varicose veins. Spider veins are small red, blue, or purple veins on the surface of the skin. Varicose veins are larger, distended veins that are located somewhat deeper than spider veins.

Pain in the legs is frequently related to abnormal leg veins. Symptoms, often made worse by prolonged standing, include feelings of fatigue, heaviness, aching, burning, throbbing, itching, cramping, and restlessness of the legs. Leg swelling can occur. Severe varicose veins can compromise the nutrition of the skin and lead to eczema, inflammation or even ulceration of the lower leg.

Vein disorders are not always visible; diagnostic techniques are important tools in determining the cause and severity of the problem. In addition to a physical examination, non-invasive ultrasound is often used.

Heredity is the number one contributing factor causing varicose and spider veins. Women are more likely to suffer from abnormal leg veins. Up to 50% of American women may be affected. Hormonal factors including puberty, pregnancy, menopause, the use of birth control pills, estrogen, and progesterone affect the disease. Other predisposing factors include aging, standing occupations, obesity and leg injury.

Deep Venous reflux is a condition that occurs when the valves within the deep venous system become damaged or diseased, causing blood to pool in your legs. The deep veins evaluated for venous reflux include the common femoral, proximal superficial femoral, deep femoral (profunda), popliteal,
and posterior tibial veins. These veins are necessary for circulation.

What are the treatment options for Deep Venous Reflux?
The treatment options for deep venous reflux include conservative therapy:

• Compression therapy
• Elevation
• Walking program

Superficial venous reflux is a condition that develops when the valves that usually keep blood flowing out of your legs become damaged or diseased. This causes blood to pool in your legs. Common symptoms of superficial venous reflux include pain, swelling, leg heaviness and fatigue, as well as varicose veins in your legs.

There are several treatment options for superficial venous reflux, including:

• Venefit Closure Procedure uses radio frequency energy delivered by a tiny catheter to seal the vein closed.
• VenaCure (EVLT) Closure Procedure uses targeted laser energy (at a higher temperature than radio frequency) to seal the vein shut.
• Ambulatory Phlebectomy is a method of surgical removal of the veins. This is not "stripping" of the veins. Tiny incisions are made and pieces of the bulging veins are removed. This is completed in our office using local anesthesia. Incisions are tiny (stitches are generally not necessary) and typically do not leave scars. Post-operative discomfort is minimal. After the vein has been removed by phlebectomy, a compression stocking is worn for a short period.
• Sclerotherapy, or vein injections, is a method using high concentration saline that is injected into each blood vessel. The solution irritates the lining of the vessel, causing it to swell, stick together, and the blood to clot. Over time, the body will absorb the treated vein. Mild discomfort may occur, and a cramping sensation may be felt for 1 to 2 minutes when larger veins are injected. The number of veins injected in one session is variable, depending on the size and location of the veins, and the patient's overall medical condition. Anywhere from one to several sclerotherapy sessions may be needed for any vein region. Medically prescribed support hose and/or bandages may need to be worn for several days to several weeks to assist in resolution of the veins. In general, spider veins respond to treatment in 3 to 6 weeks, and larger veins respond in 3 to 4 months.
• Foam Sclerotherapy is a variation of established sclerotherapy utilizing a sclerosant solution that has been transformed into foam by being forcibly mixed with air. The foam causes inflammation of the vein wall, obliteration of the vein's lumen and vein occlusion.
• Ligation or Stripping is a surgery that is generally not performed anymore. It is done under general anesthesia and involves making one or more incisions over the varicose veins and is tied off (ligated).

As with any medical intervention, potential risks and complications exist with the vein closure procedure. All patients should consult their doctors to determine if their conditions present any special risks. Potential complications can include: vessel perforation, thrombosis, pulmonary embolism, phlebitis, hematoma, infection, paresthesia (numbness or tingling), and/or skin burn.

The vein simply becomes fibrous tissue after treatment. Over time, the vein will gradually incorporate into surrounding tissue. Once the diseased vein is closed, blood will reroute itself to other health veins.

Due to the amount of local anesthetic that the doctor must deliver, both legs may not be done on the same day.

Many patients can resume normal activities immediately. For 1 week following the treatment, your doctor will recommend a regular walking regimen and suggest you refrain from very strenuous activities (heavy lifting, for example) or prolonged periods of standing.

Most patients report a noticeable improvement in their symptoms within 1 to 2 weeks following the procedure.

Many insurance companies are paying for vein closure procedures in part or in full. Most insurance companies determine coverage for all treatments based on medical necessity. Our staff can discuss your insurance coverage further at the time of consultation.