FAQ

General Phlebology Questions

What is a duplex ultrasound examination?


The venous duplex examination permits your phlebologist to see the anatomy and check the flow characteristics of the veins beneath your skin. Useful information is gathered that your physician can use to adequately diagnose your specific vein problem and to plan and guide treatment.




What is sclerotherapy?


Sclerotherapy is the treatment of varicose veins by injection of the veins with chemicals that cause destruction of the veins. Many patients who select this treatment option for cosmetic reasons notice improvement in the way that their legs feel after treatment.




What new treatment options exist for patients who have abnormal blood flow in the major vein trunks other than vein stripping?


In order to control the backward flow of blood in these large veins, the vein that is the source of the visible varicosities must be sealed shut or removed. The vein may be sealed shut using energy sources such as a laser, or radiofrequency energy electrical energy, or by ultrasound guided sclerotherapy injections.




What is ultrasound guided sclerotherapy?


Visual sclerotherapy refers to injection of surface veins that are visible to the naked eye. Some veins that need to be treated are below the surface of the skin and cannot be injected safely without the aid of ultrasound imaging assistance.




Is sclerotherapy safe?


Most patients do not experience any complications from sclerotherapy. However, some patients develop changes in skin pigment in locations where the veins are injected. Some patients may experience chemical burns of the skin while a rare patient may develop an allergy to the medication. Serious complications such as deep vein blood clots and unintentional arterial injection occur rarely.




What are laser and radiofrequency sealing of veins?


Light energy (laser) or electrical energy (radiofrequency) may be used to seal shut abnormal main superficial trunk veins. Both treatments involve the application of heat energy to inside of the long or short saphenous veins. Usually treatment of the GSV starts at a location in the vein at or below the knee. The GSV is then treated from its junction to the deep system at the level of the groin down to the entry site near the knee. Ultrasound guided injections may also be used to seal the GSV or LSV.




What are my treatment options?


Vein treatment programs are designed to treat visible varicose veins and to treat abnormal veins that may not be visible but that may be the source of the visible varicosities. If varicose veins are the only abnormality detected by the treating physician, the treatment involves surgical removal of the visible varicose veins (micro-incision phlebectomy) or the injection of chemicals (sclerosants) into the vein (sclerotherapy).




Why can’t I just have the branches injected or removed if the main superficial trunk is abnormal?


For the treatment of the visible veins to last a long time, the source that may not be visible to the naked eye must be controlled as well. From a practical standpoint some insurance carriers will not pay for treatment of branch varicosities if an abnormal main trunk is not treated at the same time or before the branches are treated.




Why do doctors recommend gradient compression stockings?


The properly fitted gradient compression stocking can temporarily reverse the effects of vein disease and lessen the discomfort as well as skin damage. Many insurance companies require a trial of stocking use before approving definitive therapy.





Treatment Method Questions

What is a duplex ultrasound examination?


The venous duplex examination permits your phlebologist to see the anatomy and check the flow characteristics of the veins beneath your skin. Useful information is gathered that your physician can use to adequately diagnose your specific vein problem and to plan and guide treatment.




What is sclerotherapy?


Sclerotherapy is the treatment of varicose veins by injection of the veins with chemicals that cause destruction of the veins. Many patients who select this treatment option for cosmetic reasons notice improvement in the way that their legs feel after treatment.




What new treatment options exist for patients who have abnormal blood flow in the major vein trunks other than vein stripping?


In order to control the backward flow of blood in these large veins, the vein that is the source of the visible varicosities must be sealed shut or removed. The vein may be sealed shut using energy sources such as a laser, or radiofrequency energy electrical energy, or by ultrasound guided sclerotherapy injections.




What is ultrasound guided sclerotherapy?


Visual sclerotherapy refers to injection of surface veins that are visible to the naked eye. Some veins that need to be treated are below the surface of the skin and cannot be injected safely without the aid of ultrasound imaging assistance.




Is sclerotherapy safe?


Most patients do not experience any complications from sclerotherapy. However, some patients develop changes in skin pigment in locations where the veins are injected. Some patients may experience chemical burns of the skin while a rare patient may develop an allergy to the medication. Serious complications such as deep vein blood clots and unintentional arterial injection occur rarely.




What are laser and radiofrequency sealing of veins?


Light energy (laser) or electrical energy (radiofrequency) may be used to seal shut abnormal main superficial trunk veins. Both treatments involve the application of heat energy to inside of the long or short saphenous veins. Usually treatment of the GSV starts at a location in the vein at or below the knee. The GSV is then treated from its junction to the deep system at the level of the groin down to the entry site near the knee. Ultrasound guided injections may also be used to seal the GSV or LSV.




What are my treatment options?


Vein treatment programs are designed to treat visible varicose veins and to treat abnormal veins that may not be visible but that may be the source of the visible varicosities. If varicose veins are the only abnormality detected by the treating physician, the treatment involves surgical removal of the visible varicose veins (micro-incision phlebectomy) or the injection of chemicals (sclerosants) into the vein (sclerotherapy).




Why can’t I just have the branches injected or removed if the main superficial trunk is abnormal?


For the treatment of the visible veins to last a long time, the source that may not be visible to the naked eye must be controlled as well. From a practical standpoint some insurance carriers will not pay for treatment of branch varicosities if an abnormal main trunk is not treated at the same time or before the branches are treated.




Why do doctors recommend gradient compression stockings?


The properly fitted gradient compression stocking can temporarily reverse the effects of vein disease and lessen the discomfort as well as skin damage. Many insurance companies require a trial of stocking use before approving definitive therapy.





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