Treatments for Chronic Venous Insufficiency (CVI)
Treatment aims to improve the patient’s quality of life. CVI presents a wide spectrum of severity and symptoms. Whether the patient’s desire is to cosmetically improve the appearance of one’s leg or to heal an advanced stasis ulcer, we are here to help.
There are non-surgical treatment options for CVI. These include consistent compression stocking treatment, refraining from long standing and sitting times, and leg elevation. These tend to improve symptoms but typically do not treat the source of the disease. Surgical treatment involves rerouting veins to improve blood return.
Our top-of-the-line technology targets five different techniques to yield the best results:
Radiofrequency ablation (RFA) is an office-based minimally invasive procedure in which a diseased vein is accessed and treated using a small catheter. The procedure is sometimes called the ClosureFast™ procedure. Ultrasound is used throughout the process to ensure precision.
What to expect DURING your RFA Procedure
The treatment will take about forty-five minutes to an hour per session with one major vein treated each time. Once the leg is cleaned with a sterilizing solution, ultrasound is used to determine several landmarks along your leg and its veins. The entry site and the length of the vein are numbed using a local anesthetic. A tiny incision is made and a catheter is inserted into the diseased vein. Heat is then delivered to close the target vein. As a result, the body will now reroute through healthy veins to deliver blood back towards the heart.
What to expect AFTER your RFA Procedure
Once the procedure is completed, we will place your leg in a compression stocking. We recommend wearing this for the next several days. You will be scheduled for a follow-up ultrasound within one week of placement.
Endovenous laser treatment (EVLT) is another treatment option that is minimally invasive and delivers heat to collapse the diseased veins.
What to Expect DURING a EVLT Procedure
The EVLT procedure is extremely similar to the RFA procedure. One major vein will be treated per each session of about forty-five minutes to an hour. Once the leg is cleaned with a sterilizing solution, ultrasound is used to determine several landmarks along your leg and its veins. Using a local anesthetic, the entry site will eventually be numbed. A tiny incision is made, and a catheter is inserted into the diseased vein. Heat is then delivered to the target vein. As a result, the body will reroute using healthy veins to deliver blood back towards the heart.
What to Expect AFTER an EVLT Procedure
Once the procedure is completed, we will place your leg in a compression stocking. Plan on wearing the stocking for the next several days. You will be scheduled for a follow-up ultrasound after seven days.
The VenaSeal™ procedure is the newest office-based minimally invasive procedure in which a medical proprietary adhesive is used to close the diseased veins. It is currently the only procedure that is performed without either tumescent anesthesia or heat.
What to Expect DURING a VenaSeal™ Procedure
We will start with a brief ultrasound of your leg. Your leg will then be cleansed with a sterile solution, and a numbing agent will be injected into your skin. A catheter will be placed into the diseased vein. Using the guidance of ultrasound technology, VenaSeal™ is introduced through the catheter to treat the appropriate vein. Once the catheter is removed, a bandage is placed on the puncture site.
What to Expect AFTER a VenaSeal™ Procedure
Unlike most other vein treatments, VenaSeal™ does not require wearing a compression stocking after procedures. You can expect to resume most daily activities following treatment.
Sometimes, even after other vein treatments, there are residual veins that may require surgical removal. Ambulatory microphlebectomy is an office-based procedure that involves removal of such veins through tiny incisions. Small vein hooks are used as part of this process.
What to Expect DURING a Ambulatory Microphlebectomy Procedure
First, we will mark your leg while you are standing up. Then you will be asked to lay on the procedure table. After a series of numbing medication injections, tiny incisions are made and micro-hooks are used to retrieve and remove the diseased veins.
What to Expect AFTER an Ambulatory Microphlebectomy Procedure
Small bandages will be placed on the small incisions followed by a compression stocking covering the leg. We ask that you wear the compression stocking for two weeks. Tylenol or other over-the-counter analgesics will often address potential soreness experienced post-procedure. We recommend that you refrain from strenuous exercise for the following two weeks.
Visual Sclerotherapy is a minimally invasive treatment in which visual superficial veins, spider veins, or even some of the larger surface varicose veins are treated with a medical sclerosant. Sclerosant is a medicine that will safely close these veins.
What to Expect DURING a Visual Sclerotherapy Procedure
The procedure will take approximately thirty minutes per session with the number of sessions depending on the case at hand. Lidocaine may be used to numb larger areas of treatment. Tiny needles inject medicine into your superficial veins to close them. This may cause mild discomfort but rarely significant pain.
What to expect after your Visual Sclerotherapy procedure
Upon completion of the procedure, we recommend wearing a compression stocking for the first two days and ideally during the day for the next two weeks. We also strongly recommend walking regularly following the procedure to prevent any blood clots.