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List of Procedures
Sclerotherapy
Sclerotherapy is the injection of the unwanted veins with a noxious
liquid. The injected liquid causes the vein walls to become
irritated and to collapse down. Spider veins (small red veins),
reticular veins (blue veins), and small varicose veins (bulging
veins) can all be treated with sclerotherapy. In some instances foam
sclerotherapy can be performed as well.
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Laser Treatment of Spider Veins
There are many lasers available to treat spider veins and reticular
veins. Texas Vein and Laser Institute uses the Dornier 940 nm laser
which targets the hemoglobin in spider veins. This laser causes the
hemoglobin in blood to heat. This minimal heat production is
transferred to the vessel walls and eventually causes it to
collapse. Surface treatments of these spider veins offers the
advantage of allowing treatment of very small veins which cannot be
cannulated with a needle. For needle-phobic patients, it is a nice
alternative to sclerotherapy.
Laser Ablation of the Saphenous Vein
The Greater and Lesser Saphenous Veins are the superficial veins
which bring blood back to the heart. When the valves of these veins
do not work, blood is not pumped in the right direction. When this
occurs, it is called reflux. Blood is then allowed to pool in the
superficial veins in the legs and these veins then start to bulge.
In the past the refluxing greater and lesser saphenous veins were
removed by vein stripping. Technology has advanced to the point
where heat can be delivered into the veins via special fiberoptic
wires. Once heated the wall of the vessels collapse. The delivery of
this heat is accomplished by using the Dornier 940 nm laser.
The fiberoptic wire is placed into the vein under ultrasound
guidance. This is very similar to the technique used to perform a
cardiac angiogram. Once the wire is in place in the greater
saphenous vein, the wire is withdrawn slowly and pulses of energy is
delivered to heat up the vein. Currently, this endovenous procedure
has been successful performed in the treatment of the saphenous
vein, hand veins, and other very large varicose veins.
Phlebectomy
Larger veins may not be amenable to sclerotherapy or by laser
treatments. In those instances, a vein can be removed through a
series of micro-incisions (2-3mm). This procedure is used in larger
varicose veins greater than 4mm or so in size.
Ultrasound Sclerotherapy
Ultrasound has allowed us to image structures below the skin
surface. In some instances the bulging varicose vein which is felt
on the skin surface is only the tip of the iceberg. If treatments
are performed only on the what is felt or seen, untreated “hidden”
veins may be responsible for recurrences. Ultrasound is used to
guide our needle below the skin surface to treat those “hidden”
veins.
Ultrasound
Ultrasound is the diagnostic tool used to diagnose the cause of
varicose veins and to direct the correct treatment. This exam is
performed in our office by either a Registered Vascular Technologist
or a Board-Certified Radiologist. It is a painless examination which
takes about 30 minutes. Insurance may pay for this examination.
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