Ambulatory Phlebectomy
Cornelius Celsus first described phlebectomy in 45 A.D. The technique was rediscovered and improved upon by Dr. Robert Muller in 1956. Ambulatory phlebectomy is performed on an outpatient basis under local anesthesia and entails the removal of varicose veins in segments through very tiny openings in the skin. There is minimal discomfort, scarring and a lower risk of nerve impairment in contrast to standard vein stripping. After the vein is removed, there are no lumpy tender areas because the vein is completely gone. Usually there is only mild local bruising that is gone within 10-14 days. Often, pain medication is unnecessary. Postoperative dressings include bandages and wrap or compression hose for 3-5 days. Walking is recommended starting the day of surgery and sporting activities can be resumed 14 days following the procedure.

Sclerotherapy
Sclerotherapy is considered the gold standard treatment for removing spider and some varicose leg veins. It is a very cost-effective procedure that seldom leaves a scar or produces adverse effects. The procedure involves the injection of a sclerosing agent into the varicose veins using a very small needle. This irritates the inside lining of the blood vessel and causes it to close off. The body then recognizes the vein as a non-working vessel, breaks it down, and reabsorbs it. For small veins done in our office, a solution was developed for our practice. It consists of a salt and sugar combination that has the lowest risk of allergic potential of all the sclerosing agents and has minimal side effects. As the vessels close up, they go through the inflammation process. This may feel lumpy and hard under the skin and may take on a bruised, tender appearance. This takes several weeks to resolve and it is common for the veins to initially look worse after the procedure. Sclerotherapy generally requires multiple treatment sessions. One to three injections are usually required to effectively treat any vein. The same area should not be retreated for four to six weeks to allow for complete healing, although other areas may undergo treatment during this time. Although sclerotherapy works for existing spider veins, it does not prevent new ones from developing.

Ultrasound Evalution

VNUS Closure
The VNUS closure is a minimally invasive procedure performed on an outpatient basis under local anesthesia. It involves the use of an ultrasound to guide a catheter into the Greater or Lesser Saphenous vein through a small opening in the skin. Radiofrequency (RF) energy is transmitted through the catheter tip to heat the vein, leading to shrinkage of collagen in the vessel wall. The narrowed vein then gradually becomes fibrous and seals shut, redirecting blood flow to healthier veins. Because the Closure procedure virtually eliminates reflux and unsightly varicose veins, it is ideal for patients suffering from symptoms of pain, heaviness and fatigue in their legs. Recovery is minimal and patients typically resume low-impact activities within one to two days.