11, 3, 2022

Why Was I Offered a Phlebectomy?

2022-03-17T10:19:18-07:00

Micro-Phlebectomy for varicose veins 

 

A phlebectomy is a minimally invasive procedure, which is the surgical removal of bulging varicose veins through tiny skin incisions. This procedure is performed in the office with local anesthesia. Phlebectomy is also known as micro phlebectomy (because the incisions are tiny) or it can also be referred to as ambulatory phlebectomy. 

microphlebectomy

What are the options for treating bulging varicose veins at the skin surface? 

 

There are two main techniques to treat varicose veins: 

 

  1. Phlebectomy: surgical removal of the veins
  2. Foam sclerotherapy: injection of a medicated foam to close the veins

 

Sclerotherapy is the least invasive, but patients with large and or numerous bulging veins may require several sclerotherapy appointments over two or more months. This is because we can only administer a small amount of foam medication per day and larger veins may require two or more injections to close. Larger veins can also become firm and tender after sclerotherapy and/or deposit brownish blood pigments in the skin as the veins are healing. 

 

Why was I offered a phlebectomy?

Patients with bulging varicose veins may prefer to start with micro-phlebectomy removal of the largest veins, then sclerotherapy treatment for the remaining veins. This reduces the number of appointments and accelerates recovery. 

How does the procedure work?

The skin is numbed with lidocaine, then a tiny puncture is made in the skin (about ½ the size of a grain of rice). We then infuse additional numbing medication around the veins. A small hook is used to bring the vein to the skin surface, then the vein is removed. 

 

What should I expect on the day of treatment? 

The procedure is performed with local anesthesia, but many patients elect to use a mild oral sedative (Valium), which is taken after checking in and completing all paperwork. We will mark your bulging veins with a marker. A small hook will be used to bring the veins to the surface. More numbing medication will be infused around the veins. You will feel pressure as the veins are removed but not pain. Usually about 10-12 veins are removed.

Once the procedure is done, we will apply skin glue to the tiny puncture sites, then sterile bandages. We will help you into your compression stocking and place an ACE wrap around the treated area. You will walk for 30 minutes prior to getting in your car. The ACE wrap can be removed that night or the next day. You will wear the compression stocking for 72 hours continuously. 

 

Why Was I Offered a Phlebectomy?2022-03-17T10:19:18-07:00

What is Radiofrequency Treatment for Varicose Veins?

2022-03-17T10:17:50-07:00

At La Jolla Vein Care, we use a special procedure called radiofrequency treatment for varicose veins. This treatment uses a radiofrequency energy to heat up the wall of the vein. This treatment is used for varicose veins. Varicose veins develop when valves in the veins are damaged and this causes the veins to bulge or twist and stand out in the legs. Radiofrequency ablation treatment closes off the blood flow in the vein that causes the varicose veins. 

radiofrequency treatment for varicose veins

 

Radiofrequency Ablation for Saphenous Vein Reflux 

Why was I offered an endovenous radiofrequency ablation procedure?

Most patients who are offered a radiofrequency ablation procedure is for backwards flow (or reflux) in the saphenous vein(s). The great and small saphenous veins are the two main superficial veins of the leg. They run along the inner leg and the back of the leg, respectively. This minimally invasive procedure can be performed in the office in less than an hour and patients return to their usual level of activity the same day. 

 

How does the treatment work?

 

The skin is numbed with lidocaine, then a tiny wire and the Closurefast catheter are inserted into the vein. The catheter delivers radio-frequency energy to the vein wall, causing it to seal shut. The remaining healthy veins continue to bring blood back to the heart. 

 

What should I expect on the day of treatment?

 

The procedure is performed with local anesthesia, but many patients elect to use a mild oral sedative (Valium), which is taken after checking in and completing all paperwork. You will change into a gown and leave underwear on. Depending on the vein to be treated, you will lay on your back or on your belly. We do our best to make special accommodations (for example, if you cannot lie flat or cannot bend a knee very well) with body positioning and using pillows. We will do our best to make you comfortable. Then, we will give you the option of watching a movie on Netflix or listen to music. Once you are comfortable, your leg will be prepped with a cleansing solution for the sterile procedure. The doctor will perform an ultrasound to map the vein to be treated. Then, a numbing agent (lidocaine) will be injected into the skin.

In the numb area of the skin, a tiny puncture is made to pass the radiofrequency catheter. Your doctor will then use a  needle to administer a combination of cool saline and local anesthetic around the vein either in the thigh or calf (depending on which vein is treated). This solution numbs the vein and insulates it from the surrounding tissue. After the numbing solution is applied, the vein is painlessly treated with radiofrequency energy. Once your vein has been treated, we will clean your leg and apply a compression stocking which you will wear for 72 hours continuously. You will walk for 30 minutes prior to getting in your car. 

 

What should I do after treatment? 

 

You should walk 30 minutes twice daily after treatment and move your legs frequently throughout the day with short walks and/or calf exercises. This will alleviate discomfort and avoid pooling of blood in the legs. Most of the numbing solution around the vein will be absorbed by your body within a few hours, but you may have a small amount of blood-tinged saline leak from your puncture site onto the gauze. In that case, just remove the gauze and roll your stockings back up. 

 

What should I avoid after treatment?

 

For at least two weeks after treatment, you should avoid airline travel to minimize pooling of blood in the legs. You should avoid strenuous exercise (anything more than a brisk walk), heavy lifting, saunas or hot tubs, and leg massages. All of these dilate the superficial veins and interfere with their healing. 

 

What are the possible adverse effects? 

 

Expect some bruising over the injection sites, which fades over about two weeks. The skin overlying larger varicose veins may also develop some temporary inflammation and/or brownish hyperpigmentation as the blood products within those veins are absorbed by the body. An uncommon complication is a blood clot within a deep vein.

 

Before and After Varicose Vein Treatment 

4 BA VV NOR21553 BA VV varicose NOR2149

What is Radiofrequency Treatment for Varicose Veins?2022-03-17T10:17:50-07:00

22, 2, 2022

A Deeper Look Into Varicose Veins

2022-03-01T16:31:12-08:00

Varicose veins are swollen, blue, bulging, twisted, superficial (those closest to the skin) veins of the leg. High pressure inside the superficial veins of the leg causes varicose veins, but genetics are thought to play a large, contributing role. As many as 40 million Americans have them. Left untreated, varicose veins may become worse. Persons with varicose veins often experience leg aches and fatigue. They may also incur skin changes such as rashes, redness and ulcers.

What factors influence development of varicose veins?

  • Age: People between the ages of 30 and 70 often have varicose veins. 
  • During pregnancy, 50 to 55 percent of American women experience varicose veins. In most cases, the veins return to normal within a year after childbirth.
  • Women who have multiple pregnancies may develop permanent varicose veins.  

 

Risk factors include:

o being overweight, or a family history of varicose veins

o standing or sitting for long periods of time

 

A vascular surgeon will review your medical history, do a physical exam and look at your prominent veins. You may be sent for a duplex ultrasound test, also known as a venous reflux study, to identify the causes of your varicose veins. The painless test uses high-frequency waves to measure the venous blood flow. The test helps the physician visualize the vein structure and the blood flow in the veins.

Most doctors will suggest lifestyle changes for patients. This includes:

  • maintaining the proper weight
  • elevating legs when resting
  • not sitting or standing for long periods of time 
  • wearing compression (elastic support) stockings

 

In some cases, a vascular surgeon will recommend additional treatments:

  • Sclerotherapy is the sealing of the veins via an injection of a medication. This procedure is done mainly for smaller spider veins. It is performed in a doctor’s office. The physician injects a chemical into the varicose veins to prevent the veins from filling with blood.
  • Vein Stripping is performed. The physician may make two small incisions, one in the groin area and another below the knee, through which the diseased veins are removed. This is an outpatient procedure, usually done under general anesthesia. Patients can resume their normal activities after four weeks.
  • Ablation and laser treatment are performed on patients with severe varicose veins. They are done under local or general anesthetic. The ablation procedure inserts a thin, flexible catheter into the leg vein. The tip of the catheter has tiny electrodes that heat and seal off the walls of the vein. Laser treatments use a tiny fiber placed in the vein through a catheter. The fiber sends out laser energy that closes the diseased portion of the vein. These two modes of treatment frequently replace stripping of the saphenous vein. They can be performed alone or in conjunction with removal of individual clusters of the veins known as small incision avulsion or ambulatory phlebectomy.

 

A Deeper Look Into Varicose Veins2022-03-01T16:31:12-08:00

13, 8, 2010

Looking Good After Pregnancy

2010-08-13T22:14:41-07:00

It’s estimated that 70% to 80% of pregnant women develop varicose veins during the first trimester. Pregnancy causes an increase in blood volume; however, it’s the hormonal changes that cause the veins to enlarge. Elevated levels of progesterone, which the body produces to stabilize the uterus, allow the veins to dilate. Later, the uterus enlarges and causes increased pressure on the veins in the pelvic area. While varicose veins often disappear after delivery, the venous valves are damaged. When varicose veins are still visible after three months, it’s time  contact a vein specialist. It’s important you look good, feel good, and remain healthy—particularly after pregnancy.

Sincerely,

Executive Team

Looking Good After Pregnancy2010-08-13T22:14:41-07:00
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