Comprehensive Vein Treatment

Approximately 25% of women and 15% of men worldwide have varicose veins. In the United States, more than half of adults over the age of 60 suffer from painful and unsightly venous disease.

Diagnosis
Upon your arrival to Image North, you will be asked to fill out a health questionnaire regarding your overall health and symptoms and especially the veins of your legs. The Image North physician will then review this questionnaire with you.

Physical examination of the legs is performed to assess varicose veins as well as any other physical signs that may be indicative of leaking veins, like skin discoloration, changes in skin texture, or ulceration.

Examinations may be performed both lying down and with the patient in the standing position to evaluate changes in the appearance of the veins.

If patient history and physical examination appear consistent with venous leakage, and the patient and your Image North physician contemplate treatment, a duplex ultrasound examination is usually performed.

This painless and non-invasive test typically takes 30-40 minutes and is specialized to allow the physician to visualize leaking varicose veins. The points of leakage also must be addressed.

Treatment
Following physical examination and diagnostic ultrasound exam, options for treatment may include one or more of the following non-surgical or minimally invasive alternatives:

Conservative Treatment
For patients who only want pain control, this option may provide satisfactory relief. Conservative treatment includes special prescription medical grade compression stockings that have slightly more compression of the leg at the level of the foot than at the level of the thigh. These help promote blood flow through the veins and may keep varicose veins compressed and collapsed. Conservative treatment also often includes leg elevation for extended periods of time, to allow blood to drain from the veins of the leg. This is particularly important in patients that have skin changes like ulceration, in order for these areas to heal.

Conservative treatment will often not be practical for many patients, particularly due to work requirements, and progression of varicose veins may occur despite proper conservative treatment. Unfortunately, for some patients with severe leakage in the deep veins of the leg, and a small minority of patients with venous disease, conservative treatment may be the only possible treatment option.

Ablation
Traditionally, patients diagnosed with venous reflux would undergo vein stripping surgery. Now, patients can be treated with the Cooltouch CTEV® procedure -- a minimally invasive alternative to painful vein stripping surgery.

Cooltouch CTEV® is a clinically proven, minimally invasive procedure that treats varicose veins and their underlying cause, venous reflux, with little or no pain. Cooltouch CTEV® patients can walk away from the procedure and be back to everyday activities – either at home or at work – typically within a day.

Experience the Cooltouch CTEV® Procedure. The Cooltouch CTEV® procedure can be performed on an outpatient basis using local anesthesia in which the physician numbs the leg before treatment. Currently, we perform this treatment in our offices. The treatment consist of four principal steps:

1. Mapping of the Saphenous Vein. A typical procedure begins with noninvasive ultrasound imaging of the diseased vein to trace its location. This allows the physician to determine the site where the laser fiber will be inserted and to mark the desired position of the fiber tip to begin treatment.

2. Insertion of the Laser Fiber. After the physician accesses the saphenous vein, the laser fiber is inserted into the vein and advanced to the uppermost segment of the vein. The physician then typically injects a volume of dilute anesthetic fluid into the area surrounding the vein. This numbs the leg, helps squeeze blood out of the vein and provides a fluid layer outside the vein to protect surrounding tissue from heat once the fiber starts delivering laser energy.

3. Delivery of Laser Energy and Withdrawal of Fiber. Noninvasive ultrasound is used to confirm the fiber tip position and the physician then activates the laser machine. As the vein wall is heated, the vein shrinks and the fiber is gradually withdrawn. During fiber pullback, which typically occurs over 4 to 10 minutes, the entire vein is ablated (or closed).

4. Confirm Closing of Vein. After treatment, ultrasound imaging is used to confirm closing of the vein. If a portion of the vein is not closed, the fiber can be reinserted and laser reapplied. After the procedure, the narrowed vein gradually becomes fibrous, sealing the interior of the vein walls and naturally redirecting blood flow to healthy veins. Experienced physicians often complete the procedure in 30 to 45 minutes.

Patients who have undergone the Cooltouch CTEV® procedure are willing to recommend it to a friend or family member.

Physicians generally instruct their patients to walk regularly for several days after the Cooltouch CTEV® procedure and return within 1 week for an ultrasound examination. Physicians may prescribe compression stockings to be worn for several days or weeks after the procedure. Compression stockings are prescribed as a routine item for vein procedures with the goal of enhancing patient comfort in the initial days after treatment.

Patients who undergo the Cooltouch CTEV® procedure typically resume normal activities within a day.

Cooltouch CTEV® Procedure Highlights
• Relief of symptoms
• Outpatient procedure
• Resume activities typically within a day
• Good cosmetic outcome with minimal or no scarring, bruising, or swelling

As with any medical intervention, potential risks and complications exist with the Cooltouch CTEV® procedure.

Preparation
Simply avoid taking any food or liquid two hours before the procedure.

How long before I see the results?
There may be some slight swelling right after the procedure, but you could start seeing results immediately.

Will they last?
Laser Treatment has proven to be 97% effective—an outstanding record of success. Therefore, you should experience no reoccurrence in the veins that have been treated. Follow-up procedures may be desired to obtain optimal aesthetic results.

Post Treatment
Following your endovenous ablation procedure, microphlebectomy, or injection sclerotherapy you will be encouraged to resume normal daily activities as soon as possible. You will be asked to walk immediately following your procedure and will also be asked to take at least two twenty minute walks per day in the several days following the procedure. While walking is strongly encouraged, we do ask that you refrain from stressful, pounding activities like weightlifting or aerobics for one week.

Some bruising or soreness is fairly typical 3-7 days following your ablation or phlebectomy procedure and is usually well controlled simply with oral nonsteroidal anti-inflammatory medications.

Following endovenous ablation, with or without microphlebectomy, you will be asked to wear a compression stocking on the treated leg for 7-10 days, from morning until bedtime. Along with walking, the stocking promotes good flow through the normal untreated veins of the leg and keeps treated veins collapsed while they permanently close down.

All patients who are treated with ablation or phlebectomy are typically seen in follow-up at Image North in 7-10 days. Sclerotherapy patients are usually seen for a follow-up visit or treatment in 2-4 weeks.