Diagnosis & Treatment
Diagnosis: Simple and Fast
Varicose veins are easily seen on physical exam in most people. In order to better look at the underlying venous function, a painless ultrasound exam is performed in the office. The ultrasound can detect direction of flow in the veins, evaluate valve function, examine the size of feeding veins under the skin too deep to see on inspection, and detect any signs of blood clots.
The ultrasound exam is necessary to determine which feeding larger veins are abnormal and is essential to making a treatment plan. Our accredited vascular lab and experienced technicians are available to perform painless, accurate ultrasound examinations.
Spider veins and small varicose veins may be treated by injection, performed in the office. A very small needle is used to inject a chemical directly into the vein causing it to close.
Endovenous Vein Ablation
Reflux (backwards flow) in the great saphenous vein is the most common cause of varicose veins. Endovenous saphenous ablation, using radiofrequency heat (VNUS Closure) or laser energy (EVLT), is a minimally invasive procedure that replaces stripping surgery to treat painful varicose veins. Under ultrasound guidance, the vein is entered at the inside of the leg and a small catheter is threaded towards the groin. The catheter delivers heat energy to the vein wall causing it to seal down on itself. The procedure is often performed under local anesthesia and does not require hospitalization. Most patients resume normal activities in a few days.
Ultrasound-Guided Sclerotherapy and Microphlebectomy
Bulging varicose veins left over after endovenous ablation may be injected in the office to achieve optimal cosmetic and functional outcome. Very large veins may be removed in a simple outpatient procedure.
Percutaneous Ablation of Perforating Veins
Severe venous insufficiency may lead to pigmentation (dark blotches in the skin), dermatitis (an itchy scaly rash), or ulceration (sores that fail to heal). Failure of the one-way valves in the connecting veins (perforating veins) of the lower leg contributes to the chronic inflammation over the inside of the leg and ankle. New, minimally invasive techniques using radiofrequency heat to close these perforating veins have helped the skin to heal and prevent future complications of venous disease.
Chronic blockages in the deeper veins, usually due to old blood clots, can be opened using angioplasty balloons and stenting in a simple outpatient procedure.