Board Certified Vascular Surgeon-will take your questions

New Laser, less bruising and almost no discomfort!

2011-02-18T06:03:00.003-06:00

Laser Treatment for Varicose Veins

The Preferred Technology

The CTEV (cool touch endovenous therapy) provides an ideal treatment for endovenous ablation of varicose veins. The 1320 nm wavelength targets water in the vessel wall, not hemoglobin, which means a much more comfortable procedure for patients without post-op bruising or swelling.

Traditionally, varicose veins have been treated in several different ways. The most widely performed treatment has been to surgically strip and ligate the affected veins. Vein stripping can require hospitalization, is often very painful and frequently does not fully solve the problem, requiring additional treatments. Not to mention, surgical procedures can carry a higher risk of complications and can require significant patient downtime.

Fact: Laser therapy has demonstrated excellent clinical results and outstanding patient satisfaction compared to alternate therapies.

Laser technology offers a non-surgical, highly successful and cost-effective alternative to stripping, RF and sclerotherapy. This patient-friendly treatment is performed in an office setting under local anesthesia. Patients experience very little or no pain and are able to return to normal activity very quickly. Since the laser actually destroys the whole lining of the vein, the opportunity for new collateral veins to grow is greatly minimized, resulting in varicose veins reappearing in only about 4% of laser-treated cases. With stripping plus sclerotherapy, varicose veins reappear in about 30% of the cases and for sclerotherapy alone the recurrence rate is more than 70%.

The CoolTouch 1320 nm laser is able to produce similar efficacy to Diode lasers with far less risk and side effects, such as paraestheisa, increased brusiing, patient discomfort during and immediately following treatment and thermal injury to the overlying skin, when used for endovenous coagulation of blood vessels in patients with superficial vein reflux.

The Facts: The CoolTouch CTEV is a 1320 nm Nd:YAG laser with an absorption length of 300- 500 microns (0.3 - 0.5mm) in tissue. The chromophore for this laser is water (collagen is primarily water), resulting in a shorter absorption length than Diode lasers. Specific absorption of energy only in the vein wall results in a more controlled depth of vein coagulation than any other wavelength.

Patient Satisfaction

High treatment success rate

Advantage: The CoolTouch CTEV will allow you to confidently offer your patients a solution that has less pain, a quicker recovery period and better clinical and cosmetic results than other treatments available today.

The Facts: The CoolTouch CTEV offers patients a signficantly more comfortable and convenient solution for endoluminal varicose vein treatment. With the CoolTouch CTEV, patients experience little, if any, pain, bruising and swelling, and their recovery period is extremely fast with virtually no downtime. The CTEV has been very successful in obtaining closure of varicose veins with only one treatment in over 95% of patients treated.

2010-12-21T09:51:00.001-06:00

WHAT’S REALLY WRONG WITH YOUR RESTLESS LEGS?

- - Restless Leg Syndrome linked to veins, and can be alleviated with quick and effective CoolTouch CTEV™ treatment - -

Roseville, CA (June 20, 2008) - Restless Leg Syndrome (RLS) sufferers may finally be able to stop unwanted leg movement and twitching. New research indicates that RLS, a common medical condition characterized by uncontrolled leg motion, may be alleviated with the successful treatment of varicose veins.

RLS often makes ordinary activities, such as long-distance traveling or sitting, almost impossible, and can also make sleeping very difficult, leading to fatigue and chronic sleep deprivation. The causes of RLS are still widely debated, and diagnosis is generally based on a patient’s clinical history. However, recent findings from Dr. Clint Hayes’ research on Restless Leg Syndrome and venous disease point to a possible correlation and a solution.

Healthy veins return blood to the heart and lungs for re-oxygenation by using a system of one-way valves and muscle contractions, which allows blood to flow upward against gravity. When those valves fail, the vessels become diseased and blood flows backward, causing it to pool and stagnate in the veins. This is the cause of varicose veins and explains their familiar bulging, twisted appearance. Since 2004, CoolTouch has offered a minimally invasive, yet extremely effective method for the treatment of varicose veins. The CoolTouch CTEVTM system uses a 1320nm wavelength laser to gently heat and safely close the affected vein, after which blood is rerouted to other healthy veins. Doctors have reported that the endovenous procedure causes less discomfort, a quicker recovery period and better clinical and cosmetic outcomes at a lower cost than other available treatments.

Based on prior publications that described people experiencing relief from their RLS symptoms when being treated for vein deficiencies, Dr. Hayes and his team designed a study to investigate this effect more closely. The researchers examined 33 patients who had both RLS and varicose veins. Roughly one half of the patients received treatment for their varicose veins with the CoolTouch CTEVTM endovenous laser ablation procedure, while the other half of the group did not. The RLS discomfort levels for the two groups were then compared, and the results were remarkable. Of the group that received the CoolTouch procedure, 95% of the patients reported a significant improvement in their symptoms, and 31% of the group noted a complete relief from their RLS symptoms. Conversely, the group that did not receive the varicose vein treatment actually noted a slight increase in their symptoms over the course of the study. “I am very exited about demonstrating a possible link between my RLS patients and venous disease,” says Dr. Hayes. “Treating these patients with the CoolTouch 1320 nm laser to ablate their saphenous vein has shown a marked improvement in their symptoms.” While further research in this area is needed to better understand the cause of RLS, Dr. Hayes concluded his study saying that any RLS patient with venous insufficiency should be referred to a vein specialist for evaluation and treatment. Only in this way can these patients escape the nightly torment of chronic RLS.

why see a vascular surgeon for my varicose veins?

2008-04-05T23:34:00.004-05:00

Over half of patients with varicose veins have symptoms. Varicose veins tend to get worse with time and may cause disability if they cause venous ulceration. A Board-Certified Vascular surgeon with is the BEST person to see if you have a varicose vein problem. In addition to our training in General Surgery, Board-Certification in Vascular Surgery denotes completion of a rigorous fellowships (up to 2 years) with extensive examinations in their field. We are trained and skilled in the treatment of vascular disease. We have access to all treatment options for varicose vein problems, therefore, allowing us to provide a taylored and most successful approach for you.

how are varicose veins treated?

2008-04-05T23:09:00.012-05:00

Mild varicose veins often do not need treatment.

However, some people may choose treatment for cosmetic reasons or because the condition causes uncomfortable symptoms.

Removing or treating varicose veins does not cause circulation problems because veins can re-route themselves around a blockage.

Treatments for varicose veins include:

Compression Stockings

Your physician may recommend that you wear compression stockings-also called support hose-to reduce symptoms. These are elasticized stockings worn from the toes to the knee or sometimes to the top of the leg.

Compression stockings improve circulation by putting pressure on the leg muscles that squeeze the veins, thus improving the flow of blood back to the heart. Hence, there is less swelling, tiredness, and achy feeling. Elastic hose will not, however, cure varicose veins. Rather, they only help control symptoms.

How-To Information:

Compression stockings:

Put the stockings on as soon as you get out of bed, before gravity gets a chance to cause pooling of blood in varicose veins. Keep the stockings on all day. Take them off when you are lying down, with your legs raised above the level of the heart.
You can buy compression stockings in most drug stores. For women who suffer from varicose veins during pregnancy, special prescription vascular-compression pantyhose are available.
Elastic stockings for women are available in a variety of colors and degrees of sheerness. For men, calf-high support hose come in different colors and are made to look like dress socks.
Support hose must be replaced when they begin to lose their compressive power, about every three to four months.

Need To Know:

People with varicose veins should not attempt to wrap their legs with elastic bandages. If bandages are applied too tightly, they may act like a tourniquet, cutting off blood flow to the region.

Injection Therapy

A type of injection therapy, called sclerotherapy, may be used to close off damaged veins without the need for surgical removal. Sclerotherapy is usually performed in a doctor's office and works like this:

Using a fine needle, the doctor gently injects an irritating chemical (the sclerosing agent) into the varicose vein.
To minimize discomfort, the doctor may mix a local anesthetic with the sclerosing agent.
The sclerosing agent creates scar tissue inside the vein, which blocks off the flow of blood to that vein, shutting it down permanently.

Need To Know:

Injection treatment is especially useful for treating small varicose veins below the knee. It may also be useful in treating some cases of spider veins.

Sclerotherapy is not suitable for:

Large varicose veins
Varicose veins extending up to the groin

After the procedure:

There may be some discomfort and redness of the skin at the injection sites.
Your doctor will apply a compression bandage to the area. You will need to wear this bandage for about three weeks.
Walking is an important follow-up activity.
Most people are able to return to work and daily chores within 24 hours, if not immediately.

Need To Know:

Women who undergo sclerotherapy should not take oral contraceptives for six weeks before and six weeks after this procedure, because of an increased risk of hemorrhage (bleeding).

Surgery

Surgical treatment of varicose veins may be required to alleviate pain and to put a halt to recurrent bouts of phlebitis.

Surgery is especially beneficial when the large veins of the legs are involved. Surgery may also be chosen for cosmetic reasons.

There are two main types of surgical procedures used to treat varicose veins:

Ambulatory Phlebectomy

Larger varicose veins can be treated with a surgical procedure known as ambulatory phlebectomy. In this procedure, a surgeon makes a series of tiny puncture holes along the vein and then takes out small segments of the vein.

The tiny incisions require no stitches. Most people experience very little pain after the operation and are able to walk immediately following surgery.

Nice To Know:

Ambulatory phlebectomy can be performed in one 45-minute session under local anesthesia in a physician's office or an outpatient center. The surgery rarely leaves scarring.

Vein Stripping

Varicose veins can be removed by an operation known as vein stripping. Vein stripping is the only option for removing the saphenous veins (the largest surface veins in the legs) that serve as the major channels for blood among the superficial veins in the leg.

A person undergoing this procedure may receive either general anesthesia (to be asleep for the procedure) or an epidural (a local anesthetic injection into the back that numbs the lower half of the body).

The surgeon makes two small incisions-one in the groin and the other near the ankle.
The surgeon then ligates (ties off) the saphenous vein and its branches at the groin incision.
The surgeon then passes a flexible wire through the vein from the ankle incision. A number of small incisions in the skin are sometimes needed along the vein to guide the wire along the length of the entire vein.
When the wire reaches the groin incision, the surgeon pulls the wire out, bringing the entire vein with it ("strips the vein out").

Recovery

Many patients are able to leave the hospital on the same day as the surgery--or at the most, the day following surgery.

It usually takes two to six weeks to recover from the operation. During that time, your physician may ask you to:

Keep the leg or legs bandaged for several weeks following surgery.
Take several short walks, starting with five minutes each time, and slowly increasing the time and distance covered each day.
Lie down frequently and keep your leg elevated above your heart.

The bandages and any stitches used will be removed by the end of the first week, during a follow-up visit to the surgeon's office.

Most people are able to return to work within one to two weeks of the operation.

Nice To Know:

Some physicians believe that the saphenous vein should never be removed, because it is the primary source of veins used for heart bypass operations. However, other surgeons feel that if the saphenous vein is thoroughly damaged, as in more severe varicose veins, it is usually not suitable for use in bypass surgery.

Nice To Know:

About 85 percent of patients experience long-term relief of varicose veins following vein stripping.

EVLT Procedure

A procedure to treat varicose veins called the EVLT procedure was recently approved by the Food and Drug Administration (FDA).

The procedure involves inserting a small laser fiber into the defective vein through a small skin puncture. The fiber delivers laser energy to the vein wall, causing the vein to shrink and seal shut. Once the diseased vein is closed, neighboring healthy veins take over to restore normal outflow of venous blood from the legs. As normal blood flow returns, symptoms typically are reduced.

The EVLT procedure is a minimally invasive procedure. It can be performed in a doctor's office and allows the person to resume normal activity immediately after the treatment. Bruising, which is a common side effect of any invasive procedure, is minimal.

see video: EVLT VIDEO

Treatment of Ulcers

Treatment of a varicose vein ulcer consists of warm wet dressings, bandaging, exercise, and elevation of the affected leg.

It may take several weeks or months for complete healing, and sometimes much longer. Sometimes plastic surgery is required to cover the ulcers with full thickness skin grafts or even thicker flaps of skin taken from elsewhere on the body.

To help prevent recurrences, wear elastic stocking support and immediately treat any skin injuries to the leg.

what are the symptoms?

2008-04-05T22:57:00.001-05:00

You will usually see varicose veins before they cause symptoms.

They are like wriggly lines above the surface of the skin on the legs. You may find that they start to ache as the day goes on. you may also notice that your feet and ankles swell towards the end of the day, especially in hot weather.

If varicose veins get very bad, they can cause ULCERS (skin sores) on the ankles.

They can also get sore and inflamed (phlebitis), causing redness of the skin around them.

Varicose veins can cause all sorts of symptoms, and almost always get worse with time.

An ache in the affected area
Swelling of the feet and ankles due to the fluid from stagnant blood leaking through the walls of the veins into surrounding tissues
A feeling of heaviness, tiredness, and aching, especially at the end of the day or after periods of prolonged standing
Persistent itching of the skin over the affected area
Changes in skin color-the skin over the affected area may turn a brownish gray color, especially around the ankles

who gets varicose veins?

2008-04-05T22:56:00.001-05:00

Women suffer from varicose veins more often than men.

You may find that varicose veins appear, or get much worse, when you are pregnant.

If you are on your feet all day, (especially standing still a lot of the time) you are more likely to suffer from varicose veins.

In general, half of people over 50 years of age will suffer from varicose veins.

what are varicose veins?

2008-04-05T22:51:00.001-05:00

Arteries carry blood away from the heart and to the rest of your body. Veins carry blood back to the heart.

Varicose veins are swollen veins on the surface of the leg. They usually start on the calf, but can be found right up to the groin. They are caused by the "back up" of blood.
They are more obvious when you stand up.