16, 3, 2022

What are the adverse effects of Vein treatment?

2022-03-17T10:21:05-07:00

What are the adverse effects of Vein treatment?

Patients generally do very well with vein treatments, all of which have a low risk of complications. Some post treatment effects can include:

 

Aching over the treated veins is normal after vein treatment. This responds well to walking, ice packs, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) or naproxen (Aleve). 

vein treatment pain

Bruising over injection sites is also normal after vein treatment and resolves in about two weeks. 

vein treatment bruise

Hyperpigmentation over a vein can occur from blood pigments that are released as the vein is healing. It is more common in patients with large bulging veins and certain complexions. Hyperpigmentation tends to fade over many weeks after vein treatment if you stay out of direct sunlight. 

deep vein clots

Intravascular hematoma refers to a large varicose vein that becomes firm and tender days to weeks after treatment. This also responds well to ice packs and anti-inflammatory medications. We may also recommend a confirmatory ultrasound and/or offer needle drainage of the trapped blood to alleviate discomfort and minimize skin pigmentation. 

 

Deep vein clots are very uncommon, and usually are limited to patients with poor mobility, advanced age, hormone treatment, and/or genetic tendency for clotting. We monitor all patients with ultrasound throughout treatment so we can detect clots at a very early stage before they cause a symptom. We may recommend surveillance ultrasounds, extra walking, and/or a short course of blood thinners. 

deep vein thrombosis

Numb spot over a treated vein is another uncommon event after radiofrequency or laser vein ablation. This occurs when a branch of a skin nerve gets stunned during the heat treatment. It tends to improve over several weeks. The nerves that control the movement of the leg and foot are located far from the superficial veins. 

 

What are the adverse effects of Vein treatment?2022-03-17T10:21:05-07:00

Why have I been offered an endovenous laser ablation (EVLA) procedure? 

2022-03-17T10:20:32-07:00

Endovenous Laser Ablation for Saphenous Vein Reflux 

Endovenous laser vein ablation, also known as endovenous laser therapy (EVLA), is a type of treatment for saphenous vein reflux, the underlying cause of most varicose veins. At La Jolla Vein Care, we offer ALL treatment modalities for varicose veins, not just one. Treatment is customized based on a person’s individual pattern of venous reflux (determined by ultrasound examination), personal preference, and personal health history.

The  endovenous laser vein ablation procedure may be offered for backward flow (or “reflux”) in your saphenous vein(s).  The great and small saphenous veins are the two main superficial veins that run along the inner thigh/ calf and the back of the legs, respectively. Some people have anatomic variations where the small saphenous vein in the back of the calf extends to the thigh. Many people also have reflux in their anterior or posterior saphenous veins.

evla

This minimally invasive procedure can be performed in the office in less than 30 minutes and patients return to their usual level of activity the same day.

evla treatment

How does the treatment work?

The skin is numbed with lidocaine, then a tiny wire and the laser catheter are inserted into the vein. The catheter delivers laser 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 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 laser catheter under ultrasound guidance. Your doctor will then use a needle to administer a combination of cool saline and local anesthetic around the vein. This solution numbs the vein and insulates it from the surrounding tissue. Laser energy will then be used to painlessly treat the vein. Once your vein has been treated, we will help you into your compression stocking, which you will wear for 72 hours continuously. You will walk for 30 minutes prior to getting in your car. 

 

Why have I been offered an endovenous laser ablation (EVLA) procedure? 2022-03-17T10:20:32-07:00

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

The Best Way to Treat Reticular Veins

2022-03-17T10:17:12-07:00

The best treatment for Reticular Veins is through a painless alternative to traditional sclerotherapy: Cryo-Sclerotherapy.

Why have I been offered cryo-sclerotherapy?

 

We recommend patients undergo cry-sclerotherapy to mainly treat spider veins and small varicose veins at the skin surface (also known as reticular veins). Traditional sclerotherapy involves injection of a medication into the vein using a tiny needle. This causes the vein to collapse and eventually fade away. The medication will be administered in a liquid and /or foam formulation, depending on the size of the veins. Cryo-sclerotherapy is the combination of traditional sclerotherapy in combination with the use of a cryo device. The cryo device delivers puffs of cold air simultaneously during sclerotherapy. The result  is the cold air anesthetizes the skin so the treatment is relatively painless. This is especially helpful for treatment of sensitive areas like the inner ankles and thighs. Instead of feeling the needle prick, you will feel puffs of cold air instead. The cold air may also reduce bruising and pain. 

 

What should I expect on my treatment days? 

 

You will sign your consent form then change into shorts provided by the office. We will clean your skin with alcohol. The sclerosant medication will then be injected into your veins with a fine needle. Just before the needle is used, you will feel puffs of cold air. The cold air will anesthetize the skin, so that the prick from the needle is not felt or lessened. Every time the needle is used, you will feel puffs of cold air instead. After your treatment, we will help you into your compression stockings, then you will walk for 30 minutes prior to getting in your car. It is normal for your legs to be achy and tender to the touch after treatment. 

 

What should I do after treatment?

 

You will be instructed on how long to wear compression stockings after treatment, depending on the size of the veins that are treated. Most patients wear thigh-high compression stockings continuously for 1-3 days, then another 7 days. 

 

You may shower with the stockings on or take a quick cool shower with them off. 

 

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 avoids pooling of blood in the legs. Avoid prolonged sitting during the day. 

 

It is normal to have aching in the treated veins. This responds well to walking, ice packs, and anti-inflammatory medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve). 

 

What should I avoid after treatment? 

 

For at least two weeks after treatment, 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. You should also avoid airline travel for two weeks after treatment. 

 

What are the possible side effects? 

 

You will likely have some bruising over the injection sites, then the treated veins may become firm and blue. 

 

The skin overlying treated veins may also develop brownish hyperpigmentation as the blood products within those veins are absorbed by the body; in some patients it can take up to a year to fade. Some patients temporarily develop some very fine, pink spider veins in areas where veins have been treated (telangiectatic matting). These usually resolve spontaneously over several weeks but occasionally require additional treatment to clear. 

 

Many patients will feel their veins look a bit worse in the first month after sclerotherapy, but through the best treatment for reticular veins, cryo-sclerotherapy, patients have reported it to be a more painless approach for treatment.  

 

The Best Way to Treat Reticular Veins2022-03-17T10:17:12-07:00

28, 2, 2022

What is Venous Reflux Disease?

2022-03-17T10:21:46-07:00

What is Venous Reflux Disease?

 

Venous reflux disease is also known as venous stasis, venous insufficiency or venous incompetence and refers to ‘leaky valves’ in the veins of the legs. 

leaky valve

Reflux may occur in the deep and/or superficial leg veins. The deep veins are those within the muscle; they bring at least 80-90% of the blood from the legs back to the heart. The superficial veins are outside the muscle and under the skin. The main superficial veins are the Great Saphenous Vein that courses up the middle of the thigh and calf and small saphenous vein. Normally, there are one-way valves within the leg veins, which help blood flow in one direction: toward the heart. This means blood is traveling against gravity. The calf muscle also helps move blood toward the heart. When vein valves are leaky, blood flows backward (reflux) towards the feet. Blood pools in the lower legs, causing bulging veins at the surface. 

leakyveinvalves

Symptoms of Venous Reflux Disease:

 

Symptoms of venous reflux disease include; leg heaviness, leg fatigue, leg pain, ankle swelling, phlebitis (inflamed and painful veins), restless legs at night, and night cramps. Venous reflux disease is progressive and worsens over time. Skin changes may also develop, including darkening of the skin around the ankles. The darkening of the skin is sometimes referred to as venous stasis skin changes. The skin can become dry and itchy (venous eczema). Eventually, the skin can break down causing a wound, called a venous leg ulcer. All of which are possible symptoms of venous reflux disease to look out for. 

 

What influences the development of Venous Reflux Disease?

 

A patient is more likely to develop venous reflux disease if they are:

 

  • Overweight
  • Pregnant
  • Have a family history of vein disease
  • Have damage to the leg due to injury, surgery, or previous blood clots
  • High blood pressure
  • Lack of exercise
  • Smoking
  • A blood clot in a deep vein (calf or thigh) “deep vein thrombosis” 
  • Swelling and inflammation of a vein close to the skin, known as “phlebitis”

 

How is Venous Reflux Disease Diagnosed? 

 

In addition to physical exam findings and medical history, an ultrasound examination is an important tool in the assessment of venous disease. Not all venous disease is visible to the naked eye, and it usually arises from veins that are beneath the surface of the skin, only visible by ultrasound technology. 

 

The ultrasound allows us to see if the valves are leaky; it can detect the direction of blood flow and also detects blockages in the veins, for example from blood clots or scars within the veins from previous clots. The ultrasound will determine exactly which veins are “bad” or incompetent. Reflux may be detected in the deep veins (within the muscle), the great and small saphenous veins, and /or branches of the saphenous veins. This will help determine the treatment plan. 

 

What is Venous Reflux Disease?2022-03-17T10:21:46-07:00

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