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 Therapy for Varicose Veins: In the late 1990's, vein care experienced a quantum leap forward. Previously, the only widely accepted therapy for varicose veins originating from the greater or lesser saphenous veins was surgery. First, we experienced the use of ultrasound to treat veins. This introduced a greater degree of safety, and also allowed the treatment of veins that could not be seen or felt. The door was opened to new modalities of therapy, beginning with radiofrequency ablation and followed by laser closure. Both allowed the closure of veins which could be done with local anesthesia. Each procedure could be performed in an office setting without sedation. After following patients for more than five years, the results have been as good as a surgical stripping, patients had less discomfort, and resumed normal activities sooner. At the same time in Spain, a phlebologist, Dr. Cabrera, showed that sclerosing solutions could be made into a foam which was injected into veins. The process was safe and the foam stayed in contact with the target veins' walls longer giving a more intense reaction. The results were far more dependable, especially for large veins than just solution. After more than five years of use, the results are comparable to surgery, laser, and radiofrequency ablation treatments.
 We are the only vein center in Central Florida who employs all modalities. State-of-the-art technology is available today, and can be performed in an office setting, with less pain, risk, and a faster recovery time.
Rarely, but occasionally, it is better to perform a surgical excision of varicosities. This can be done using very small openings in the skin and removing small segments of vein with a tiny hook. This effectively eliminates the target, and the cosmetic result is excellent. The procedure is referred to as Ambulatory Phlebectomy.
At the Vascular Vein Centers, we offer a variety of treatments, including, but not limited to:
Endovenous Laser Therapy (EVLT)
In this procedure, laser energy is transferred to either the greater saphenous vein or the short saphenous vein in order to cause a thermal injury to the vein itself which cases the vein to collapse and no longer be a source of flow to varicose veins. The patient is placed on an operating table and the leg is prepared with antiseptic solution. An ultrasound (Doppler) evaluation is performed and a suitable site for accessing the vein is found. After infiltrating adequate local anesthetic, a needle is placed into the vein and this is followed with a guide-wire. Over the guide-wire a catheter (sheath) is placed and through this sheath a laser probe is placed and positioned just below the point that the vein flows into the deep veins. Local anesthetic is injected around the vein so that the patient does not feel pain when the laser is activated and also to protect surrounding structures. Once this infiltration procedure is completed, the laser is activated and slowly withdrawn while watching with the ultrasound. The vein is thermally ablated. Once the procedure is completed, a compression dressing is placed around both the thigh and the lower leg so as to avoid swelling in the leg. This compression dressing is kept on for approximately two days and then an elastic compression stocking should be worn. An appointment is made to have a follow-up ultrasound evaluation in three to five days to ascertain that the treated vein has been closed and that the deep venous system is functioning normally.
Radiofrequency Closure (VNUS® Closure®)
This procedure is directed toward closure of the greater saphenous vein or the short saphenous vein. In both cases these are the feeding sources for the varicosities that one sees in the leg, and in order to successfully treat the varicosities one must close or ablate the feeding source. The procedure consists of placing the patient on an operating table and prepping the leg with an antiseptic solution. Using the ultrasound (Doppler) the saphenous vein is imaged. Once the vein is imaged and seen to be straight without any significant bends, then a needle is introduced into the vein. This is followed with a guide-wire which is positioned where the vein enters the deeper venous system. A catheter (sheath) is placed over the guide-wire and then the radiofrequency probe is placed though that catheter. Once in position, anesthesia is injected around the vein so that the patient experiences no pain when the probe is activated and heat is transmitted to the vein wall. Once this injection procedure is completed, the tip of the probe is activated and slowly withdrawn. The heat from the end of the probe creates a thermal transfer of energy to the vein and causes it to collapse on itself and the vein is effectively taken out of the circulatory system. Because the deep system is still intact and functioning, this makes no difference as far as the return of blood from the leg. This also decreases the pressure in the varicose veins further down the leg and makes it easier to treat them in future weeks. After the procedure a compression dressing is placed on the leg, both over the thigh and in the lower leg in order to diminish swelling. The patient is asked to return to the office in the next three to five days in order to perform an ultrasound to ascertain that the vein has been closed and that the deep system is functioning normally. The patient will then wear elastic compression hose.
Ambulatory Phlebectomy
Portions of varicose veins are removed through a small incision. Ambulatory phlebectomy is an office procedure done with local anesthetic. Special small hooks are used to remove a varicose vein. After the procedure compression is used for two days.
Sclerotherapy
Sclerotherapy is a treatment method in which a fluid (a sclerosant) is injected into a vein in order to cause a chemical reaction in the walls of the vein which in turn causes the vein to become non-functional and to gradually fade away. Sclerotherapy is actually a rather simple procedure in which a trained practitioner, using veinlite or ultrasound guidance, injects a small amount of solution (called a sclerosing agent) into a diseased or varicose vein. The sclerosing agent irritates the lining of the vein and causes the vein to become inflamed. Eventually the inflamed vein dries up, is replaced with fibrous tissue, and it disappears.
Transcatheter Chemical Ablation Using Foam Sclerotherapy
In this procedure a foam solution of an irritating chemical is used to close the greater or the short saphenous vein. The patient is placed on an operating table and using ultrasound (Doppler) an adequate segment of vein is found. Then local anesthetic is injected into the skin and a needle is introduced into the saphenous vein. This is followed with a guide-wire and subsequently a catheter is introduced over the guide-wire. When in position, the foamed solution is injected while observing the vein with ultrasound. The catheter is slowing withdrawn and the vein is closed using a chemical reaction with the vein wall. After withdrawing the catheter, the leg wrapped with a compression dressing or an elastic stocking is placed. If a compression dressing is used, it is left in place for approximately 24 hours and then a compression stocking is worn.
Laser closure, radiofrequency ablation, and foam sclerotherapy are office procedures and have essentially no down time. They are relatively painless compared to surgery.
All treatment methods have been shown to effectively eliminate veins.
We are dedicated to providing you with the best patient care, the latest techniques, and the most qualified medical team anywhere! We hope you will consider scheduling a Free, No Obligation Consultation Today!
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