Varicose veins are unsightly, swollen – bulging veins that are usually uncomfortable and often painful. When the valves in the vein stop closing properly, the blood flows backward away from the heart and lungs. When this happens, blood collects, overfilling the vein, thus causing varicose veins. Left untreated, varicose veins cause pain, swelling, skin ulcers that won’t heal, phlebitis, tired legs, itching, night cramps and potentially life threatening blood clots. While the possibility of these more serious problems is very small, it is nonetheless, very real. Varicose vein disease typically gets progressively worse, and each stage has more serious consequences. If you have any of these conditions listed above, you should seek treatment.
For 80% of the people with varicose veins, a hereditary weakness in the vein is the primary cause. Additional causes are pregnancy, hormonal influences, obesity and people that are on their feet for extended periods of time. The accumulation of birthdays adds to the likelihood of this problem. However, this disease does not discriminate against anyone. Young men, women and even athletes in peak condition may develop venous disease.
Duplex Ultrasound Mapping is a test performed in the office that establishes the definite diagnosis required before treating varicose vein disease. The procedure is non-invasive and painless. Most medical insurance and/or Medicare will cover a portion or all of the charges. This examination helps identify the origin of the varicose vein problem. The test results help in designing a treatment plan specifically for each individual patient.
EVLT is the newest most advanced FDA approved treatment method for treating and correcting the disease that results in varicose veins. A small laser is placed inside the vein at the knee. Laser energy is used to close the diseased vein. This procedure eliminates any necessity for vein stripping, which in the past was the only procedure to eliminate varicose veins. Vein stripping requires general anesthesia, is painful, leaves scars and requires a 3 – 4 week recovery period. For patients that have experience with vein stripping, EVLT is a miraculous advancement.
By using local anesthesia and mild sedation, patients experience a near painless procedure. Our patients walk in, have their procedures then walk out in less than two hours. Most return to normal activity within a day or two. Post-operative instructions typically include a 30-minute walk the same evening as the procedure. Most patients require only Tylenol or Advil for any mild postoperative discomfort.
EVLT is performed by very few specialists within the medical discipline called “Phlebology” (the treatment of varicose and spider veins). The technical and clinical skills required for EVLT can only be acquired through extensive training. This advanced level of dedication is often not possible unless the Surgeon has devoted his full time energies to this pursuit of excellence. In this regard, Dr. Ashton MD, FACPH has successfully performed over 4,000 EVLT and phlebectomy procedures.
Ultrasound Guided Sclerotherapy (UGS) is the placement of a medication via injection into the diseased vein using ultrasound imaging as a guide. The medication (sclerosant) causes the treated vein to collapse and eventually become absorbed by the body.
Once EVLT has been performed to eliminate the cause of the varicose veins, Microsurgical Ambulatory Phlebectomy’s are sometimes performed to remove the unsightly lumpy varicose veins. Micro incisions are made and the veins are removed. This procedure simply requires local anesthesia, therefore, it is painless and no stitches are needed. There are no scars resulting from this procedure, and as long as this procedure has been performed in conjunction with EVLT, these procedures provide most patients with instant gratification. It is important to note, that Microsurgical Ambulatory Phlebectomies are typically pointless if the cause of the problem isn’t first treated. Further, Medicare and private insurance will not reimburse for Microsurgical Ambulatory Phlebectomy’s if it is not in conjunction with a definitive procedure like EVLT. (The only other recognized definitive procedure other than EVLT, is vein stripping).
Transcatheter Ablation is the placement of medication via a tiny catheter inserted into the diseased vein using ultrasound imaging as a guide. TCA allows for the treatment of longer segments of a vein compared to UGS.
Sclerotherapy involves the placement of a sclerosant (medication) into the feeder veins and spider veins of the legs. Many patients report improvement of symptoms including lower leg pain and discomfort post-treatment. Although spider veins are typically smaller in size, it is highly recommended that they be treated as many patients experience relief after their procedure to eradicate these smaller vessels.
Ulcers of the lower leg region can result from longstanding vein disease. The elevated pressures and low blood flow lead to severe damage to the skin structures. Ulcers can become chronic and result in long term disability. Treatment can reverse this process and allow closure of the ulcer.
Many insurance companies require a trial of stocking use. However, gradient compression stockings do not permanently reverse the disease process. Nevertheless, research has shown that wearing gradient compression stockings post treatment will help with patients’ over-all results, speed the healing process and reducing symptoms associated with these procedures.
We have extensive experience working with Medicare and insurance companies. We make every effort to minimize your out of pocket expenses. A financial consultation is conducted to explain what Medicare and insurance will and will not cover. This eliminates any surprises down the line. Dr. Ashton’s Clinic is one of very few that will go the extra mile for its patients by billing directly to Medicare and private health insurance.