Frequently Asked Questions

Are these procedures covered by insurance?

Vein treatment and the diagnostic tests are usually covered by insurance provided it is medically indicated. Many insurance plans require patients follow conservative management for several months consisting of compression hosiery, life style modification (weight loss, exercises) and increase in activity and leg elevations.

What can I do about spider veins?

Spider veins are a good indicator that problems lie ahead. In 85% of cases, spider veins are usually caused by an underlying hypertension in the veins that feed them. Once the underlying hypertension is treated, the little veins may disappear and those that don't can be treated with Sclerotherapy, an injection that delivers a sclerosant causes them to collapse and disappear.

Do these spider veins come back?

Spider veins are sometimes associated with hormonal levels, such as with pregnancy and when the patients are taking hormonal replacement treatment.

What causes varicose veins?

Varicose veins are the result of venous reflux disease. This results in increased pressure against the wall of the vein. The end result is elongation, and dilatation (increased diameter) of the superficial veins. They become tortuous, unsightly and sometimes they can rupture, bleed spontaneously or develop clots.

Most often, they are hereditary, and they are worsen by prolonged standing or sitting, tall stature, obesity, pregnancy and leg trauma. Blood clots can develop, a condition known as Superficial Thrombophlebitis.

What is Microphlebectomy?

Microphlebectomy is the minimally invasive, office based operation carried out under local tumescent anesthesia. Two mm skin incisions are made every few centimeters that permit the removal of up to 5 times larger varicose veins than the skin incision with special miniaturized instruments. These small incisions heal without visible scars in a few weeks.

What are the Greater Saphenous Veins (GSV)?

This is the longest superficial vein of the of the legs. It runs inside the legs from the sole of the feet up to the groin where they connect to the deep veins. The GSV is commonly the culprit in the condition known as Venous Reflux Disease and is the most commonly treated vein.

The deep veins constitute the main venous channels that drain blood from the legs back to the heart by the combined activity of walking (leg movements during sleep) and breathing.

What is DVT (Deep Vein Thrombosis)?

DVT (deep vein thrombosis) is a serious, potentially life threatening condition that can develop in the deep veins of the legs in healthy adults as a result of immobility such as a two hour flight. DVT can also occur as a complication to cancer, following general anesthesia, hip, knee or abdominal surgery. DVT can also occur in the third trimester of a normal pregnancy.

What complications and symptoms are commonly attributed to venous disorders?

  • Small red or blue veins along the thigh, knee leg or ankles
  • Burning, aching or swelling of the leg with Menses
  • Bulging-rope like blue or green veins
  • Ankle swelling that worsens as the day progresses
  • Brown skin discoloration in the ankle and or gaiter area of the legs
  • Inflammation, Redness, pain or swelling below the knees
  • History of ulceration or an active ulcer or sore above the ankles
  • History of superficial thrombophlebitis (clot in surface vein with inflammation of the overlying skin)
  • History of Deep Vein Thrombosis (DVT)
  • History of Pulmonary embolism
  • Bursting like pain in the legs with prolonged sitting or standing

Are these procedures painful and how much pain will I have afterwards?

Every patients pre-existing conditions and pain tolerance is different. The procedure is like when you go to the dentist-you walk in, you walk out. A series of local injections are administered to numb the area but you may experience some mild discomfort, most patients confess the pain was not as bad as they thought it would be. Afterwards, you may experience tenderness and discoloration along the injection site, it is not necessary for patients to take anything more than two Tylenol to alleviate any pain. If you have a microphlebectomy you may be given a prescription for a mild narcotic to control any discomfort.

Will I need to take time off work?

You will be able to resume normal activities immediately following your procedure. If your job does not require prolonged sitting or standing you may return to work the same day. For the first 48 hours the doctor will recommend that you avoid prolonged sitting or standing nor should you lift anything heavy, if your job requires these things you will be given a written excuse from your job. You should walk frequently and elevate your legs when possible especially if you had swelling before the procedure.

When will I be allowed to travel?

Air travel is restricted to for the subsequent 4 weeks. Car travel is allowed after the first week provided you can stop and walk for 5-10 minutes every hour.

How are these minimally invasive procedures done?

These minimally invasive procedures are done in the office using only a local anesthetic. Following a physical exam the doctor does a mapping of the patients veins using ultrasound to determine the exact cause of the patients problems and then determines the best course of treatment. One option involves making a micro incision and floating a catheter up the patient's vein. This procedure is done under local anesthetic and in a sterile setting. During this procedure the patient is draped with a sheet and ultrasound is used to guide a small catheter up the leg and radiofrequency is used to shut down the vein. After the vein is disabled, the surrounding smaller veins are forced to take over and normal blood flow is resumes through alternative channels. Another treatment involves the injection of foam which dissolves the smaller spider veins. This procedure is nothing more than getting a small injection. Another procedure involves making a series of micro incisions in a sterile environment in order to remove smaller surface veins. All procedures are followed by the application of a compression bandages and require follow up office visits. All patients are requested to wear compression stocking in order to maximize the results of the procedures.

How long do I wear the compression on my legs?

Following the laser or radiofrequency procedure your leg will be wrapped with compression bandages plus your compression hosiery over the dressing for 36 consecutive hours. If you have a Microphlebectomy you will be required to wear your compression bandage for four consecutive days, at that time you may remove your bandages and shower but are asked to wear your compression garment for several weeks thereafter to assure vein closure.