Thanks to recent advances in ultrasound imaging and the recent introduction of endovenous laser ablation, safe and highly effective treatment of varicose veins can now be performed on an outpatient basis.  Complicated surgeries are no longer necessary and "vein stripping" is a thing of the past.

Only a few steps are necessary to diagnose and treat your varicose vein disease.

1. Consultation - During your first visit we do a thorough ultrasound evaluation of all the veins in your legs. We not only map out what they look like, but more importantly, we locate all the veins that have damaged valves, which are causing your symptoms. Typically these veins can be mapped out like a tree; with a main trunk, branches, and leaves. The branches and leaves are what you might see on the skin surface. The branches represent the rope like bulging varicose veins. The leaves represent the spider veins. It is essential to find all the trunks or leak points which are the main culprit in varicose vein disease.  After completion of the ultrasound and vein mapping,our providers will conduct a complete symptom assessment and medical history review.  Although treatment will not be done on your first visit, plan to spend time discussing your vein concerns as well as your therapy goals.  Approximate consultation time: 60 minutes.
   
   
   
2. Insurance pre-authorization - We participate with most insurance companies.  We submit our findings and obtain insurance pre-authorization prior to scheduling any treatment. Once we receive a pre-authorization, we will call you to schedule your outpatient procedure.
   
   
3. Treatment options:
   
   
   1. EVLA (endovenous laser ablation) - This treatment is what we use to close off the largest varicose veins (typically the "trunks" and some of the larger branches). The procedure requires placement of a catheter (very small tube) into the diseased vein. Then a laser fiber is inserted through the catheter, and local anesthesia is administered. The laser then emits energy which shrinks and seals the vein wall. Afterwards, the "healthy" veins will restore normal blood flow to the leg. EVLA has been proven effective in over 100,000 patient with varicose veins and has a reported success rate of 95-97% at 12 month follow-up.  Approximate treatment time: 60 - 90 minutes.
      
      
   2. Ultrasound guided foam sclerotherapy - This minimally invasive ultrasound guided technique invoves introducing a foam agent, called a sclerosant, into a vein to displace blood and promote vein wall collapse. The solution causes these veins to swell, stick together, and seal shut.  It is an excellent treatment option for large veins (branches) not amenable to laser closure.  Multiple treatements may be required . Approximate time: 30 minutes.
      
      
      
   3. Ambulatory Phlebectomy - This in-office procedure allows removal of large surface varicose veins through very small incisions that require no stitches.  It is done under local anesthesia and provides excellent cosmetic results for larger, more superficial, bulging veins.  Approximate time: 60 minutes.
   
   
4. Cosmetic treatment – We are able to offer a variety of treatment options for patients who do not have varicose veins, but have extensive spider veins. These options include liquid/foam sclerotherapy as well as a cutaneous laser therapy.  Effective treatment is based on the severity and extent of the disease and may require from 1 to 4 sessions to achieve optimal results.  Approximate time: 30-45 minutes