Diagnosis & Treatment

Diagnosis & Treatment

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Lower limb vascular examination

Lower limb vascular examination

Diagnosis of Venous Disorders

Varicose veins and telangectasias (spider veins) are easily seen on physical examination. The symptoms of longstanding venous insufficiency such as leg swelling, skin changes or ulceration are also evident. Ultrasound, a noninvasive diagnostic imaging tool, is the most efficient and accurate method for evaluating patients with venous disease. An ultrasound screening is performed in the office, and helps identify the presence or absence of venous insufficiency.

Our on-site Vascular Lab department performs a variety of non-invasive vascular studies. These studies are performed by our skilled and experienced vascular technician, Ariana Prince, RDMS, RVT, and are interpreted by our surgeons.

Varicose veins

Varicose veins

Treatment of Large Vein Incompetence

The traditional treatment for varicose veins was, until a few years ago, known as ligation and stripping. This procedure required general anesthesia and hospitalization, was fairly painful, and did not yield good, long-term results. In 2002 the FDA approved the use of Endovenous laser ablation (EVLA) for the treatment of superficial vein reflux. The laser uses light energy to close the incompetent vein from the inside. The procedure is minimally invasive and results in less pain, faster recovery, and better cosmetic results than ligation and stripping. In addition, there is a high success rate (>95%) for long term closure.

If a vein is not amenable to laser closure for any reason, the vein may be accessed, using the ultrasound for guidance, and injected with a medication, which irritates the inner lining of the vein and causes it to clot off and close. This method, known as ultrasound guided Sclerotherapy (UGS), is also minimally invasive and involves minimal discomfort, but may require multiple sessions for complete closure.

Spider Veins

Treatment of Smaller Veins

If there is no large vein incompetence, or after large incompetent veins have been closed by EVLA or UGS, then smaller veins, visible under the skin (reticular veins) or at the skin surface (spider telangectasias) are amenable to treatment. These veins are injected with medications (Sclerotherapy) that irritate the vein lining and cause the veins to clot off and close. Our surgeons use Veinlite technology and polarized lenses to assist them in visualizing tiny veins, and accessing them with very fine needles. Once veins are closed they will be reabsorbed by the body over time. The larger the vein the longer the reabsorption will take. Achieving a good cosmetic result may require multiple sessions spaced over months. Results develop slowly over the days and weeks following treatment so we recommend at least one month between treatments.

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