Varicose Veins — Consultation, Diagnosis & Treatment
The Consultation/ Diagnosis
Much of vein disease is hidden. Varicose Veins visible on the surface of the skin are usually the tip of the iceberg. Other diseased veins that feed into the visible varicose veins lie hidden deeper in the skin. Ultrasound imaging allows us to see beneath the skin to the entire network of vein disease. Finding the root source of vein disease allows us to make an accurate diagnosis in order to treat effectively.
All screenings and treatments are performed by Dr. Andrew Douglass. At the time of your consultation he will spend 30-45 minutes with you. An ultrasound screening of your legs will help him assess the extent of your vein disease and allow him to prepare a treatment plan. Dr. Douglass will advise you which treatments would best suit your particular case. A report describing your diagnosis will be provided as a courtesy to your primary care physician.
The Treatment - Dr. Douglass will decide with you which treatment(s) will best serve your individual problem. Most patients require a combination of treatments.
EVLT (Endovenous Laser Treatment):
EVLT is a laser catheter placed inside the diseased saphenous vein causing visible varicose veins. Under ultrasound guidance the laser then is used to seal the diseased vein shut. The procedure requires only a local anesthetic and no incision. The procedure lasts less than hour, after which the patient is able to arise and immediately begin normal activities. The procedure has been shown to be as effective as traditional vein stripping, yet much safer.
Ambulatory Phlebectomy (Microphlebectomy)
Microphlebectomy is performed if there are large visibly bulging varicose veins that persist after endovenous laser ablation. These veins are typically too tortuous for an endovenous catheter to pass through them and so they are treated after the laser ablation. The vein is anesthetized locally and then a small needle puncture over the vein. A "knitting hook" type instrument grasps the vein through the needle puncture and the bulging portion of the vein is pulled through the puncture. The patient only feels pressure. No scalpel is used and no stitches are needed. A bandage is placed on the leg which is removed two days later at which time most of the visibly bulging veins will have disappeared. Scarring at the puncture site is rare.
Ultrasound Guided Foam Sclerotherapy
Ultrasound guided foam sclerotherapy is a highly specialized technique pioneered in Europe and now used worldwide in the treatment of varicose vein disease. The procedure involves first doing an ultrasound map of the entire diseased venous network so that sources hidden in the skin are located. Then, under direct ultrasound visualization, a foamed sclerosant is injected into the diseased veins. This causes the diseased veins to close down immediately, and over time, the veins narrow to a fibrous thread which is invisible since it is beneath the skin.
| EVLT, Microphlebectomy and Ultrasound Guided Foam Sclerotherapy:
- allow treatment of even the largest varicose veins without surgery.
- permit treatment of varicose veins that have recurred after prior surgery.
- require no general or spinal anesthetic or narcotic pain medications.
- leave no scar.
- require minimal down time. Patients resume their normal activities quickly.
- are performed entirely as an outpatient treatment in the office of Dr. Douglass.
The procedures are exceptionally safe when performed in the hands of physicians trained and thoroughly experienced with the technique. Dr. Douglass is one of the most experienced physicians in East Tennessee to perform these types of treatment.