The physicians at Carolina Vein Care & Aesthetics are highly experienced in the treatment of venous disease. During the evaluation appointment, a vein specialist will complete a full exam, which may include the use of Ultrasound, and develop a personalized treatment plan to address your condition. All the vein treatments performed at our office are considered minimally invasive and are associated with minimal pain and faster recovery time.
Our physicians may recommend one or more of the following treatments:
A complete ultrasound exam is an important first step in successfully treating venous disease. The venous duplex examination permits your physician to see the anatomy and check the flow characteristics of the veins beneath your skin. A thorough ultrasound exam will be completed during the initial exam to identify underlying chronic venous insufficiency, which may be causing other symptoms. Ultrasound is often used during the treatment and post-procedure to confirm results and to rule out any complications. Routine ultrasound exams are part of follow-up visits to track progress and ensure a successful treatment.
Endovenous Radiofrequency Ablation
Endovenous Radio frequency Ablation (RFA), also called the Closure procedure, is a minimally invasive varicose vein treatment procedure that uses radio frequency energy (electricity) to heat, collapse and seal off the targeted blood vessels.
After using ultrasound to map the course of the vein to be treated, the physician guides a catheter (thin tube) through a small incision into the diseased vein, threading it through the blood vessel. Electricity is delivered to a heating element in 20-second pulses, heating and contracting the collagen within the walls of the vein until they shrink and shut down. This process is called ablation.
The vein is treated in segments as the catheter is gradually inched back down towards the incision. When the entire vein has been ablated, the blood flow is automatically rerouted through healthier adjacent veins, restoring healthy circulation and reducing swelling. The ablated vein becomes scar tissue and is absorbed by the body. Possible complications of endovenous radio frequency ablation are thermal skin burns and transient numbness.
RFA is usually covered by most private insurers and Medicare when proof of medical necessity and previous conservative therapy is provided. Approved for use in the United States by the Food and Drug Administration in 1999, the RFA treatment procedure is performed in a physician’s office. Patients are encouraged to walk immediately following the procedure and are usually able to resume their normal activities within a day.
Endovenous Laser Ablation
Endovenous Laser Ablation (EVLA) uses laser energy, which is simply a highly concentrated beam of light. Medical lasers work by delivering this light energy to the targeted tissue with extreme precision, so as not to affect the surrounding tissue. Lasers have proven their safety and effectiveness through years of use in all types of medical procedures, from eye surgery to dermatology. In the hands of a skilled physician, lasers offer far less risk for complications than conventional surgery.
In EVLA, a thin jacketed fiber is inserted into the damaged vein through a very small entry point in the skin. Using ultrasound technology, a thin laser fiber is guided into the vein through a very small opening to deliver pulsed laser heat to the diseased vein wall. This causes the vein to close and seal shut, eliminating venous reflux at its source. The veins that are closed are superficial veins that handle less than five percent of the body’s blood flow. The blood is automatically routed to other healthy veins.
Some patients may experience temporary soreness or some slight swelling, which can be treated effectively with over-the-counter, non-aspirin pain relievers, and typically subsides within 1 to 2 days. Possible complications of endovenous laser treatment are thermal skin burns and transient numbness.
Both RFA and EVLA procedures are an alternative to more invasive leg stripping surgery that requires hospitalization and general anesthesia. RFA and EVLA are used primarily to treat the great saphenous veins (GSV), small saphenous vein (SSV), and other superficial veins in the legs. Varicose veins that branch off from these blood vessels are treated with Sclerotherapy or Ambulatory Phlebectomy.
Perforator Vein Treatment
Perforator veins connect the superficial venous system to the deep venous system. If the valves in the perforator veins become damaged it can cause the superficial venous system to work poorly and cause varicose veins and other associated symptoms. As part of our commitment to total vein care, it is important to diagnose and treat the full disease to achieve complete symptom relief and long-term results.
Ultrasound Guided Sclerotherapy
Ultrasound Guided Sclerotherapy is another in-office treatment alternative to surgical stripping. With this technique and based on the clinical judgment of the doctor, sclerotherapy is done with either a liquid or “foamed” sclerosant, while the doctor visually monitors the vein on an ultrasound screen. This enables treatment of veins that can’t be seen because they are below the surface of the skin and would otherwise require surgical removal. Ultrasound imaging is used to guide a needle into the abnormal vein and deliver medication to destroy the lining of the blood vessel and seal it shut. Ultrasoundguided sclerotherapy is primarily used to treat large veins beneath the surface of the skin.
Ambulatory phlebectomy is a method of surgical removal of surface varicose veins. Ambulatory phlebectomy is usually performed in a doctor’s office using local anesthesia. The area surrounding the varicose vein clusters is flooded with anesthetic fluid. A needle is then used to make a puncture next to the varicose vein and a small hook is inserted into the needle hole and the varicose vein is grasped and removed. The punctures typically leave nearly imperceptible scars. After the vein has been removed by phlebectomy, a bandage and/or compression stocking is worn for a short period. Ambulatory phlebectomy is sometimes performed in conjunction with minimally invasive endovenous catheter procedures.
Sclerotherapy is often the treatment for spider veins and small varicose veins closer to the skin surface. With sclerotherapy, a solution is injected into the varicose or spider veins, which causes them to seal off and close over time eventually being absorbed into the body. Blood is rerouted to healthy veins in the leg. A vein light or ultrasound guidance may be used to assist in the delivery of the solution. Sclerotherapy is usually considered a cosmetic procedure and used in conjunction with other therapies to treat the underlying venous disease.
The VenaSeal closure system is a non-tumescent, non-thermal, non-sclerosant procedure that uses a proprietary medical adhesive delivered endovenously to close the vein. The procedure is administered without the use of tumescent anesthesia, avoiding patient discomfort associated with multiple needle sticks.
Deep Vein Thrombosis (DVT) Screening
Deep vein thrombosis, or DVT, is a blood clot that mainly affects the larger veins deep in the lower leg and thigh. DVT, though rare, can be life-threatening if the blood clot breaks off and travels to the lungs. During the initial exam, an ultrasound is used to rule out DVT. Also, following any vein procedure, a follow-up appointment including a DVT screening using ultrasound will be required. A physician may recommend an annual DVT screening as part of your wellness plan.
Many insurance companies require the use of compression hose as the first step in treating vein disease to see if symptoms improve before approving any other treatments. Compression stockings are also required before and after treatment of varicose veins to help reduce the risk of blood clots post-procedure. Our staff is trained to properly fit compression stockings.