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Varicose Vein Treatment: What Is An Interventional Radiologist (IR)?

Before you undergo any vascular treatments, you should fully research the procedure and any language you might hear from your vein specialist. Several key terms associated with varicose vein treatment may confuse patients. The following definitions should help you understand the important words for a more informed discussion with your doctor and/or vein specialist.  

Interventional Radiologists

An interventional radiologist, or IR, is a physician who specializes in utilizing imaging guidance to diagnose and then treat using minimally invasive procedures. They treat diseases in nearly every organ system in the body, especially in arteries and veins.

Interventional radiologists use several types of imaging including ultrasound, x-ray fluoroscopy, CT scans, and MRI. One of the unifying themes of all interventional radiologists is performing procedures using minimally-invasive techniques.

Minimally-Invasive Treatment

You probably hear the term minimally invasive treatment, procedure, or surgery said a lot, but you might not know what it actually means. A minimally invasive approach involves the least possible damage to the body, typically requiring only a small incision or nick not much bigger than a needle. Advantages of using minimally invasive techniques abound – less risk of bleeding, lower chance of infection, less painful procedures requiring minimal if any sedation, smaller incisions leading to smaller scars, often no sutures required, and less overall risk of the procedures.  

Thermal vein ablation is an example of a minimally-invasive treatment. Generally speaking, minimally invasive procedures such as ablations are strongly preferred by nearly all patients and have made more invasive surgeries obsolete.   

Chronic Venous Insufficiency

Chronic venous insufficiency is the condition associated with varicose veins. Veins carry blood to your heart from the rest of the body. Blood valves in the legs prevent the blood from refluxing, or going back, down towards the feet instead of to the heart. With venous insufficiency, the blood cannot properly flow to the heart, so it pools in the veins and can cause bulging, painful varicose veins.

Varicose Vein Treatment

Patients have several options for varicose vein treatment. For most patients, varicose vein surgery is unnecessary and has been nearly rendered obsolete; instead, they can undergo minimally invasive procedures. Some of the most common treatment options include:

  • Vein Ablation: Also known as radiofrequency ablation (RFA) or endovenous laser ablation (EVLT), this procedure uses radiofrequency heat or laser heat to close the varicose veins.  
  • Venaseal: The latest vein treatment is actually a vein adhesive or medical grade glue. Venaseal works by gluing the veins closed instead of heating them; eventually, the varicose veins will fibrose and disappear.
  • Microphlebectomy: Microphlebectomy or ambulatory phlebectomy uses small punctures in the skin to remove varicose veins. It is used on smaller veins and produces minimal scarring.
  • Sclerotherapy: This procedure involves directly injecting a medicine called a sclerosant into troublesome veins to close them down. Ultrasound is often used to guide the therapy, which is known as ultrasound-guided foam sclerotherapy.

If you have any questions, we’d be happy to discuss vein treatment further. You can also contact us to schedule a consultation

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What You Need to Know About Venous Insufficiency

Chronic Venous Insufficiency (CVI) is a medical condition in which the veins in the legs have trouble getting blood back to the heart. CVI is especially pronounced in the legs because veins in the legs are furthest from the heart and must work against gravity to get blood back to the chest.

This condition is usually caused by failure of the valves in these veins. Valves function by preventing the backward flow of blood, and when they do not work, they allow blood to pool in the leg veins, causing bulging veins and a number of different symptoms.

relaxing Venous Insufficiency

What is venous insufficiency?

Symptoms of Venous Insufficiency

Initially, venous insufficiency may not have any symptoms at all save the appearance of pronounced or even bulging veins in the legs. However, if the condition worsens, it can cause pain or discomfort, as well as an assortment of other symptoms. Some of these include:

  • Leg heaviness and fatigue
  • Swelling of the ankles and calves
  • Itching of the skin around the veins
  • Muscle cramps/Charlie horses
  • Restless legs at night
  • Skin discoloration or breakdown

Treatments for CVI

Elevating the legs, exercising, and wearing compression stockings may provide some relief from minor cases of venous insufficiency. You can also alleviate the pain somewhat by avoiding sitting or standing in one position for a long time to help prevent blood from pooling in the legs.

More serious chronic venous insufficiency may require medical intervention. Vein doctors prescribe several different treatment methods depending on the severity of the condition:

  1. Conservative treatment
  2. Medical grade compression stockings
  3. A minimally-invasive procedure to effectively eliminate diseased veins and improve venous circulation of the legs

Are Other Treatment Options Available? →

Is This a Serious Medical Issue?

About 40% of the US population is affected by venous insufficiency to some degree. When diagnosed and treated early, venous insufficiency rarely results in serious complications. Even long-standing chronic venous insufficiency can be reversed with prompt treatment.

If you are worried about varicose veins or other vein issues, talk with your vein doctor or sign up for a free vein screening to find out if you need treatment.

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Is Restless Leg Syndrome (RLS) a Symptom of Varicose Veins?

Varicose veins are usually recognized by their unsightly appearance – large bulging veins, either green or bluish purple – most commonly found on the legs, although they can appear anywhere on the body. But these relatively small veins are actually a medical issue (covered by insurance) rather than cosmetic (not covered by insurance) and can cause moderate to severe health problems.

The symptoms of varicose veins may seem minor at first but may indicate serious conditions that can escalate quickly if the veins are left untreated.

Many patients are surprised to learn that one of the most common symptoms of varicose veins is Restless Leg Syndrome (RLS) – the irresistible feeling to move your legs, especially at night while trying to sleep. How can the two different conditions be related?

We’re first going to discuss the causes and symptoms of varicose veins a little more in-depth, then explain how RLS is connected to varicose veins, and last, what patients can do to find relief.

Causes of Varicose Veins

Varicose veins are caused when valves in leg veins malfunction and lose the ability to maintain proper blood flow. Eventually, blood starts to pool in the leg veins, causing them to bulge out. This condition is generally more pronounced in the legs where the veins are furthest from the heart and must work against gravity to return blood to the chest cavity.

Many people connect varicose veins with pregnant women, but varicose veins can happen to anyone of any demographic. Yes, pregnant women often develop varicose veins because of hormonal changes increasing the volume of blood in the body. While these changes protect the growing fetus, they can have adverse consequences. In reality, any adult can suffer from varicose veins – and may not even know it!

Symptoms of Varicose Veins

Especially in the early stages, symptoms of varicose veins are not particularly pronounced. Many people don’t even have bulging veins at all. However, many common issues may develop the longer the veins persist, including:

  • Swollen ankles
  • Itchiness around the shin region
  • Dull, aching pain that worsens as the day progresses
  • Legs always feeling tired and heavy
  • Muscle cramps, usually at night
  • Inflammation or reddening of the skin
  • Restless legs when trying to sleep at night

Varicose veins can become severely uncomfortable so patients are encouraged to find early treatment.

Check if you have the symptoms of varicose veins →

Varicose Veins and Restless Leg Syndrome

Although not everyone understands the symptoms of varicose veins, many do know the telltale signs of RLS. The sensations associated with this condition include:

  • Throbbing
  • Itching
  • Pulling Sensation
  • Aching
  • Creeping (prickly feeling)

Restless leg syndrome affects about 10-15% of Americans, though not all of these cases are caused by varicose veins. However, varicose veins do appear in many RLS patients. If you suspect you have RLS, it’s possible that varicose veins are causing them. Treating varicose veins leads to an improvement in RLS most of the time.

Find Treatment

If you are concerned about how the symptoms of varicose veins and RLS are affecting you, visit your doctor or vein clinic for a diagnosis. We offer free vein screenings to help educate patients on what varicose veins are. If you have any questions or concerns, please call 585.200.5363 for more information and we’d happy to help in any way we can.

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Why Do Spider Veins Need Multiple Treatments?

Many patients ask why they need several treatments for spider veins (technically known as telangiectasia). Cosmetic sclerotherapy, a minimally-invasive procedure designed to improve the appearance of spider veins, generally requires multiple treatments. Why can’t treatment be complete in only one session?

To help you understand spider vein treatment, let’s first talk about what spider veins truly are.

What Are Spider Veins?

Spider veins are characterized by a web of dilated veins most often found in the legs, though they can appear anywhere on the body. They resemble a spider web or thin tree branches that are either red, purple, or blue.

Spider veins are commonly found with varicose veins, which are blood vessels that have filled with pooled blood, but can be isolated as well. Although similar in appearance, spider veins and varicose veins are not the same. Spider veins are smaller (less than 1 mm) and are generally asymptomatic and only a nuisance aesthetically, although they can occasionally cause itching, burning, or stinging. However, unlike varicose veins, treatment for spider veins is typically considered cosmetic and is not usually covered by insurance.

What Causes Spider Veins?

Spider veins are thought to be hereditary and occur more often in women than in men. They are frequently caused by various life conditions such as puberty/growth spurts, pregnancy, occupations that require frequent standing, a history of blood clots, menopause, and weight gain. Spider veins occur most often around ages 30-50 but increase with age.

Cosmetic sclerotherapy has proven to be the most effective solution to treat spider veins, known as the medical gold standard, even earning an 88% Worth It rating within the last 24 months.

Cosmetic Sclerotherapy: Treatment for Spider Veins

During cosmetic sclerotherapy, a specialized solution called a sclerosing solution is injected directly into the problematic spider vein via a very tiny needle. The solution irritates the vein lining, causing fibrosis, and thereby closing the vein. The vein typically disappears in 2-6 weeks.

The number of treatments necessary to clear spider veins depends on each individual. In most cases, patients need 2-5 treatments to completely eliminate the appearance of spider veins. If the spider veins are bigger and more prevalent, additional treatments may be necessary. If new spider veins appear, patients will have to revisit their vein doctor. Always discuss with your vein specialist before beginning the procedure.

Spider veins require a slightly different treatment than varicose veins. Vein doctors generally treat underlying venous reflux and perforator venous reflux that contributes to the cause of the spider veins prior to actually performing cosmetic sclerotherapy. This will help prevent spider veins from coming back after treatment and potentially lessen the number of treatment sessions.

Ask Your Doctor

If you’re still not sure if cosmetic sclerotherapy will benefit you and how many treatments you’ll need, set up a consultation with your vein doctor. A professional vein specialist will be able to tell you if cosmetic sclerotherapy is a good option for you.

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Does Minimally Invasive Treatment for Varicose Veins Really Work?

Vein Stripping vs. Ablation Treatment for Varicose Veins

treatment for varicose veins

Do you think you might be suffering from varicose veins? You’ll know by taking a look at the various symptoms of this disease. The most obvious signs of varicose veins are:

  • Visibly bulging veins anywhere on the legs
  • Veins have a dark blue, purplish color
  • Dull, aching, and/or throbbing leg pain that gets worse as the day goes on
  • Your legs are heavier and more tired after extended periods of standing
  • Nighttime cramping or charlie horses
  • Restlessness at night, just can’t get your legs in a comfortable position
  • Swelling around the ankles (“cankles”)
  • Skin discoloration around the shins with open ulcers

Fortunately, patients with chronic vein insufficiency (CVI) do have hope – there are multiple treatment options available for varicose veins. How do you know which procedure is right for you? We will discuss the older method of vein stripping and compare it to modern, minimally invasive methods of varicose vein treatment.

Vein Stripping

Surgical vein stripping is generally performed in a hospital under anesthesia. During the procedure, the patient undergoes numerous incisions to pull the diseased vein out. The surgery usually leaves visible scars along the leg. Given how invasive the procedure is, patients oftentimes reported significant post-procedural pain and discomfort.

The recovery for this older procedure was difficult. Most patients were out of work for potentially long periods of time, accompanied with many restrictions. The stripping method also had a high recurrence rate where the veins grew back, often more severe, years after the procedure.  

Disadvantages:

  • Performed in an OR requiring anesthesia
  • Multiple large incisions requiring stitches
  • Sometimes required inpatient hospital stay
  • Higher risk of infection and bleeding
  • Visible scars
  • Significant recovery time/requires time off of work  
  • Post-operative bruising and pain
  • High recurrence rate
  • Veins can grow back

Thermal Ablation: RFA (radiofrequency) and EVLT (laser)

Thermal ablation relies on heat energy that is carefully delivered into the diseased vein to form scar tissue, which sufficiently closes off the bad vein. This method is done in a comfortable office setting with only local anesthesia or mild sedative for the affected leg. Patients are awake and they can listen to music or watch TV. Most are able to walk around immediately after the procedure.

There are no major incisions, only a tiny nick in the skin where the catheter is inserted into the vein, which is then covered with a small bandage. The nick is so small that it does not require stitches and heals very quickly. There is generally no scarring. Most patients experience an easy recovery, returning to their jobs, social events, and normal daily activities immediately following the procedure, with only minimal restrictions. Thermal ablation has lower recurrence rate due to the minimally invasive nature of the procedures.

Advantages:

  • Outpatient procedure – patients return home immediately following the procedure
  • No anesthesia
  • No major incisions, just a tiny nick to the skin, so small that it does not require a stitch
  • No blood loss
  • Minimal if any scarring
  • Immediately return to most regular activities
  • Easy recovery
  • Low recurrence rate

Radiofrequency Ablation (RFA) and Endovenous Laser Ablation Therapy (EVLT)

At the initial consultation, all the incompetent varicose veins are mapped out via ultrasound and the procedure details are discussed. On the procedure day, the interventional radiologist numbs the skin and then makes a small nick. A small catheter is inserted using direct ultrasound guidance. After numbing the entire length of the vein, the doctor delivers the RFA or EVLT energy to directly heat the diseased vein. Following the treatment, patients must wear a compression stocking for up to two weeks but can otherwise return to most routine activities right away. In fact, they are encouraged to exercise right away. During follow-up visits, the interventional radiologist uses a duplex ultrasound to ensure the vein is closed.

Still Not Sure If You Need Vein Treatment?

If you’re not sure if you have varicose veins or if you would be a good candidate for treatment, sign up for a free vein screening! You’ll learn more about the symptoms and causes of varicose veins, what treatment is like, and how best to find relief. We’ll perform a limited ultrasound on your legs and educate you if treatment can help. Contact us if you have any questions.

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Why Do My Legs Hurt?

Treating Vein Insufficiency and Leg Pain with VenaSeal™ Closure System

Do you often experience unrelenting pain in your legs? Perhaps an achy feeling or restlessness that won’t go away? You probably assume, “I’ve had a long day. I just need a moment to sit down and put my feet up, and then I will feel better.” You probably don’t think anything is out of the ordinary, but these are all common symptoms of venous insufficiency, or varicose veins.

Unfortunately, up to 40% of people in the US suffer from varicose veins, but many don’t even know it! Varicose veins are often ignored or misunderstood, even by healthcare providers. Fortunately, if you suspect that you are indeed suffering from varicose veins, you have many treatment options available today. If you’re not sure if you have varicose veins or not, sign up for a free vein screen screening and find out for sure. The most revolutionary of all varicose vein treatment options is the VenaSeal™ Closure System.

What is VenaSeal?

VenaSeal is an FDA-approved, medical-grade adhesive used to close veins to stop chronic venous insufficiency (CVI) and to cure varicose veins. Unlike industrial super glue, which is tacky, hard, and seemingly impossible to wash away, VenaSeal is soft, flexible, and gentle, and completely harmless to the body. Medical glue has been used in the healthcare industry for decades, so it should be no surprise that physicians have now begun to use it in the VenaSeal Closure System.

What is the VenaSeal Closure System?

The VenaSeal Closure System uses this non-toxic medical glue to seal diseased veins, preventing backward blood flow and stopping varicose veins. Clinical studies have proven this treatment option to be perfectly safe, with high success rates.

  • No swelling
  • No heat
  • No stripping
  • No sclerosant agents
  • Minimal needle injections
  • No anesthesia
  • No hospital stay – procedure is done in comfortable office setting

What to Expect During the Procedure

First, an ultrasound confirms the location of the varicose veins. Your vein doctor will numb the target area, so you may feel an initial tiny needle prick. Patients usually find themselves to be comfortable throughout the procedure.

Next, VenaSeal is inserted intravenously into the vein via a long hollow tube, or catheter. An ultrasound guides the placement of the tube at the diseased vein. VenaSeal is intermittently placed at varying locations along the vein. Your vein doctor will apply gentle pressure to the skin to press the seal closed and allow the medical glue to dry, which is fairly instantaneous. Once the medical adhesive comes into contact with blood, it polymerizes and is eventually absorbed by natural body processes.

What Happens After a VenaSeal Closure Procedure?  

Once the physician extracts the catheter, a small bandage is placed on the entry site. Bruising is uncommon. For most patients, there is no downtime once the procedure is complete. Your vein doctor can help you decide if you need a rest period. Patients usually return immediately to home, work, or the gym. The diseased vein shows visible improvement very quickly.

Many patients prefer the VenaSeal closure system over traditional treatment options for varicose veins, such as stripping and radiofrequency vein closure. Patients finally have a treatment option that eliminates the need for anesthesia (other than numbing at the target area), includes no risk of damaging nearby nerves, requires only minimal needle injections, and does not require the use of post-procedural compression stockings.

If you aren’t sure you have varicose veins, schedule a vein screening completely free of charge at our next available time slot!

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Dr. Pyne Addresses Varicose Veins at Society of Interventional Radiology (SIR)

Raj Pyne, MDDr. Raj Pyne recently had the honor of being invited to host a webinar for the Society of Interventional Radiology (SIR) to share his experience in developing a vein practice that concentrates solely on the proper treatment of varicose veins.

The Society of Interventional Radiology is a professional organization of over 5,400 physicians, scientists, and allied health professionals that share a common goal of improving public health through minimally invasive, image-guided procedures, such as varicose vein treatment.

Dr. Pyne shared his expertise in vein anatomy, disease, and treatment with dozens of viewers across the country. To view the webinar, click here.

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Latest “Super Glue” Vein Treatment Performed at The Vein Institute

Do you remember the 1980s ads featuring the construction worker whose helmet was Krazy Glued to a steel beam? Or, maybe you’ve seen the more recent ad where a man goes bungee jumping using a harness secured with Krazy Glue? Either way, the product is aptly named – those ideas seem crazy! Catchy marketing aside, super glues such as Krazy Glue in general have proven useful in countless household applications. We’re betting that there’s probably a bottle or tube of it in your house somewhere.

TVI-Glue-500xBut, we’re also betting that using super glue to fix varicose veins is probably something you’ve never considered. You may have just made a face at that idea, and rightfully so! The super glues we know are industrial, stiff, stinky, and don’t wash off your hands for days. How can it be used in the human body? Continue reading

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RVT Added to Sonographer Credentials

MichelleThe Vein Institute is proud to announce that sonographer Michelle Hook, RDMS, has added the Registered Vascular Technologist (RVT) credential to her name.

Highly respected and recognized worldwide, the RVT distinction is earned by passing the American Registry for Diagnostic Medical Sonography’s board examination in Vascular Technology.

The board evaluates sonographers in several areas of vascular imaging, including the peripheral venous system, to the highest of standards.

Congratulations, Michelle!

Meet more of our team >

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What Sets Interventional Radiologists Apart?

Best TVI GroupDid you know that there are over 45 medical specialties in North America that are recognized by the American Medical Association? You can probably name several – family medicine, pediatrician, cardiologist, gynecologist, dermatologist, and general surgeon are a few that readily come to mind. One you may not have named is the Interventional Radiologist.

You may have heard of radiologists as the doctors who read X-rays. They also commonly read CT (also known as cat scans), MRI, mammograms, and ultrasounds. They make a diagnosis based on their interpretation of images. A subset of radiology involves doing procedures using imaging guidance. The doctors who perform those procedures are Interventional Radiologists. Continue reading

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