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Micro-Phlebectomy is a procedure commonly performed to remove large, bulging varicose veins. Prior to the procedure, the doctor will trace the varicose veins on your leg with a surgical marking pen while you are in the standing position. You will then be asked to lie on the exam table where your leg will be cleaned and covered with sterile drapes. Next, the doctor will inject numbing medicine in the skin around the varicose veins. He will make several small incisions (so small that they will not require stitches, resulting in little to no scarring). Using a small hook, he will remove the diseased veins through these tiny incisions. After the procedure, the leg will be bandaged, compression stockings will be applied and the healing process will begin. Blood flow will reroute through other healthy veins.
Following your procedure, we recommend that you keep your leg elevated for the rest of the day to reduce your risk of bleeding and bruising. After the first 24 hours, you may remove the compression stocking and the gauze dressings to shower. Continue to wear the compression stocking for the remainder of the week, removing the stocking only to shower or to sleep.
Following that first day of leg elevation after your procedure, resume your normal level of activity. Short walks are encouraged. Refrain from strenuous activities, or prolonged standing or sitting, for one week after your procedure. Avoid very hot showers and do not submerge the treatment area in baths, hot tubs, or pools for one week.
Endovenous Thermal Ablation (EVTA) is a treatment that is typically used on incompetent saphenous veins, which are usually not visible but are a common cause of varicose veins. The procedure uses radiofrequency or laser energy to close these abnormal veins in the legs. During the procedure, the doctor will inject a small amount of numbing medicine in the skin. He will then make a very small incision (so small that it will not require stitches, leaving little to no scarring) and will introduce a small plastic tube into the vein Next, he will gently advance a long, thin radiofrequency catheter or laser fiber through the small plastic tube to the top of the diseased vein. He will then inject more numbing medicine along the entire length of the vein. Finally, he will use the catheter or fiber to deliver heat to the vein wall, causing it to shrink and seal the vein closed. The closed vein will then be reabsorbed by the body, and the blood will reroute through other healthy veins. Once the abnormal vein is closed, visible varicose veins in the area may go away on their own, but additional treatments may be required.
After the procedure, you will have gauze applied to the incisions and compression stockings placed on your legs. You may remove these to shower after 24 hours. There will be steri-strips over your incisions that will need to remain in place for one week and during this time you will need to continue wearing your compression stockings, removing them only to shower or sleep. Maintaining your normal activity level and taking short walks after the procedure is encouraged, however we ask that you avoid strenuous activity and prolonged sitting or standing for one week. It is also recommended that you avoid submersion in baths, pools and hot tubs for one week.
Varithena™ is an injectable foam treatment for varicose veins that can effectively treat veins of many types and sizes both above and below the knee, including twisted (tortuous) veins. It is a suitable treatment for patients with dysfunction in the great saphenous vein and may also be used to retreat veins that didn’t respond to other therapies.
Varithena™ treatment takes less than an hour. Your doctor will examine your legs and provide a local anesthetic to ensure your comfort during the procedure. Then, using a specialized needle Dr. Wise will inject the Varithena™ foam medication into the damaged vein or veins. This causes the vein to collapse and seal itself closed as blood flow is redirected through healthier veins. Over time, the collapsed veins are absorbed by the body. When your treatment is complete, compression stockings are applied to your legs and you can drive yourself home. There is virtually no downtime. We do recommend walking and low-intensity exercise after the procedure, but in general you should avoid strenuous exercise and heavy lifting for two weeks.
After your Varithena™ treatment, you need to wear compression stockings for at least 48 hours continuously to help your treated veins remain closed as the medication takes effect. After 48 hours you can remove the stockings and any bandages, shower, then continue to wear compression stockings during the daytime only for up to two weeks.
VenaSeal™ is an injectable treatment for varicose veins. Unlike other treatments for varicose veins, VenaSeal™ doesn’t use heat or a foaming medication to close and seal damaged veins. Instead, it uses an adhesive substance to help varicose veins close and remain shut. It is a minimally invasive outpatient procedure.
During the VenaSeal™ procedure, Dr. Wise provides a local anesthetic to ensure your comfort. He will then make a small puncture in you leg allowing him to guide a catheter into the diseased vein. Next, he slowly withdraws the catheter while simultaneously injecting the adhesive substance along the length of the vein. Once the adhesive is in place, light external pressure is applied to adhere the vein walls together. Finally, the catheter is removed and a single bandage is applied to the puncture site (stitches are not required).
When your treatment is complete, you can drive yourself home. Unlike other varicose vein treatments, VenaSeal™ treatment does not require you to wear compression stockings afterward. You can return to your regular exercise routine in 48 hours. We recommend walking at least 10-15 minutes per day to promote healthy circulation. There is virtually no downtime. We do recommend walking and low-intensity exercise after the procedure, but in general you should avoid strenuous exercise and heavy lifting for two weeks.
Sclerotherapy refers to the use of a medication called a “sclerosant” that is injected into diseased veins. The sclerosant will irritate and scar the veins from the inside, causing them to collapse and eventually close. The closed veins will then be reabsorbed by the body, and the blood will reroute through other healthy veins. More than one treatment may be necessary to achieve complete closure of the diseased veins. The procedure can be either visually guided (when the physician injects smaller veins visible on the surface of the skin) or ultrasound guided.
Ultrasound guided sclerotherapy is a form of sclerotherapy that works better for larger veins because it utilizes a foam medication that can reach a larger area. During the treatment, an ultrasound machine to guide the procedure for maximum accuracy and safety as your physician uses a small needle to inject the foam medication into the diseased veins.
Immediately after your procedure, you should walk or perform calf raises for 5 minutes before getting in your car. For the remainder of the treatment day, walk or perform calf raises for 5 minutes every hour. After the first 24 hours, you may remove the compression stocking and the bandages to shower. Continue to wear the compression stocking and take frequent walks for the remainder of the week, removing the stocking only to shower or to sleep. For one week after the procedure, you will need to avoid strenuous activities, prolonged standing or sitting, sun exposure of the treated areas and hot showers or submersion in water (baths, hot tubs or pools).
Microneedling involves using fine needles to create hundreds of tiny, invisible puncture wounds in the top layer of skin. This minimally invasive treatment can be very effective.
The micro-injuries stimulate the body’s natural wound healing processes, resulting in cell turnover and increased collagen and elastin production, therefore reversing as well as preventing signs of aging. In fact, according to a 2009 study, almost 100% of micro-needling participants reported a noticeable difference and vast improvement in the appearance of their acne scars after a treatment.
Patients who have been diagnosed with restless leg, diabetic neuropathy, or other conditions who are not showing improvement with treatment may want to seek a second opinion. With these and other venous conditions, the symptoms are often very similar and a misdiagnosis can extend the time that a patient suffers from a painful condition. If patients from Orange County or the greater Los Angeles area are concerned that their treatment is not as effective as it could be, they should make an appointment with Advanced Vein Center. Our doctors are truly experts in their field and are among the leading physicians treating venous conditions in the United States.
Our doctors conduct thorough assessments to determine whether a patient’s symptoms are actually caused by varicose veins versus another condition. For example, many patients who have venous disease also have arthritis and back problems with sciatica. This means their pain may be a result of these other conditions and not associated with their varicose veins. At Advanced Vein Center we will never perform a treatment unless we know for certain it is the right approach for a patient’s symptoms.
Patients should never feel guilty for asking questions, inquiring about additional treatments or feel pressured into making a quick decision. Second opinions give the patient the ability to make the best choice for their specific condition.
Get a Second Opinion IF:
⦁ Your vein doctor is seeking to perform treatment immediately
⦁ Your vein doctor is recommending multiple endovenous ablations.
⦁ Your vein doctor is not willing to provide a copy of your ultrasound image (not just the report)
⦁ Your vein doctor’s ultrasound tech is incentivized to find abnormal vein problems