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What conditions do we treat at the Vein Center?

Holy Family’s hospital-based center treats the following conditions:

 

Varicose Veins - a condition caused by weakened valves and veins in your legs. What causes varicose veins? Normally, one-way valves in your veins keep blood flowing from your legs up toward your heart. When these valves do not work as they should, blood collects in your legs, and pressure builds up. The veins become weak, large, and twisted. Varicose veins often run in families. Aging also increases your risk. Being overweight or pregnant or having a job where you must stand for long periods of time, increases pressure on leg veins.

  • Symptoms: Varicose veins look dark blue, swollen, and twisted under the skin. Mild symptoms may include: heaviness, burning, aching, tiredness, or pain in your legs. Swelling in your feet and ankles, and itching over the vein. Varicose veins are common and usually aren't a sign of a serious problem. But in some cases, varicose veins can be a sign of a blockage in the deeper veins called deep vein thrombosis. If you have this problem, you may need treatment for it.

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Spider Veins - Spider veins are red and purple blood vessels that occur in patches on the legs. The network of vessels is often as delicate as a spider's web, which is how they get their name but they can also resemble tiny sunbursts, branching trees or may be distributed in a linear fashion on the surface of the skin. Spider veins (referred to medically as telangectasias) and varicose veins are not the same -- and one does not lead to the other. Whereas varicose veins are large, swollen and occur only on the legs, spider veins are delicate and tend to develop in clusters. They are, however, caused by similar factors.

  • Symptoms: dull, generalized aching, throbbing pain, night cramps, tiredness, burning, tingling, heaviness in legs.

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Chronic Venous Insufficiency - Arteries bring oxygen-rich blood from your heart to the rest of your body and veins return oxygen-poor blood back to your heart. When your leg veins cannot pump enough blood back to your heart, you have chronic venous insufficiency (CVI). CVI is also sometimes called chronic venous disease, or CVD. We all have three kinds of veins: superficial veins, which lie close to the skin, deep veins, which lie in groups of muscles, and perforating veins, which connect the superficial to the deep veins. When you are in an upright position, the blood in your leg veins must go against gravity to return to your heart. To accomplish this, your leg muscles squeeze the deep veins of your legs and feet to help move blood back to your heart. Valves in your veins keep blood flowing in the right direction. When your leg muscles relax, the valves inside your veins close. This prevents blood from flowing in reverse, back down the legs. Sometimes, when you sit or stand, especially for a long time, the blood in your leg veins can pool and increase the venous blood pressure. Deep veins and perforating veins are usually able to withstand short periods of increased pressures. However, sitting or standing for a long time can stretch vein walls because they are flexible. Over time, in susceptible individuals, this can weaken the walls of the veins and damage the vein valves, causing CVI.

  • Symptoms: your ankles may swell and your calves may feel tight. Your legs may also feel heavy, tired, restless, or achy. You may feel pain while walking or shortly after stopping.

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Venous Ulcers (Leg Wounds ) - a venous skin ulcer is a shallow wound that develops when the leg veins don't return blood back toward the heart as they normally would (venous insufficiency). These ulcers usually develop on the sides of the lower leg, above the ankle and below the calf. Venous skin ulcers are slow to heal and often come back if you don't take steps to prevent them. What causes venous skin ulcers? In venous insufficiency, the valves are damaged, and blood backs up and pools in the vein. The blood may leak out of the vein and into the surrounding tissue. This can lead to a breakdown of the tissue and an ulcer.

  • Symptoms: the first sign of a venous skin ulcer is skin that turns dark red or purple over the area where the blood is leaking out of the vein. The skin also may become thick, dry, and itchy. Without treatment, an ulcer may form. The ulcer may be painful. You also may have swollen and achy legs.

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How we diagnose and treat

Holy Family Medical Center’s Vein Center offers a variety of diagnostic and treatment options that include:

Color Doppler Ultrasound - A Doppler ultrasound test uses reflected sound waves to see how blood flows through a blood vessel. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It reveals blood clots in leg veins (deep vein thrombosis, or DVT). During Doppler ultrasound, a handheld instrument (transducer) is passed lightly over the skin above a blood vessel. The transducer sends and receives sound waves that are amplified through a microphone. The sound waves bounce off solid objects, including blood cells. The movement of blood cells causes a change in pitch of the reflected sound waves (called the Doppler effect). If there is no blood flow, the pitch does not change. Information from the reflected sound waves can be processed by a computer to provide graphs or pictures that represent the flow of blood through the blood vessels. These graphs or pictures can be saved for future review or evaluation.

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Endovenous Laser Ablation (EVLA) - Endovenous ablation shuts down a large, long vein by targeting heat energy inside the vein to seal it shut. This heat can be created with a laser, known as endovenous laser ablation (EVLA), and replaces vein stripping procedures that had been used in the past. Advantages: EVLA is minimally invasive and highly effective, usually performed in a comfortable office setting, takes less than an hour, 98% success rate, immediate relief of symptoms, return to normal activities immediately, no general anesthesia, no scars. Only one large vein can be treated with laser ablation at a time. If you have more than one abnormal veins eligible for laser treatment, they can each be treated approximately two to three weeks apart.


Procedure Details
Here's what to expect from the procedure:

    1. Your doctor uses ultrasound to map out the vein to be treated.
    2. Local anesthesia is applied.
    3. A thin catheter is inserted through a tiny entry point, usually near the knee.
    4. Laser or radio frequency energy is delivered to seal the vein shut.
    5. After the catheter is removed, a small bandage is placed over the insertion site.
    6. Your compression stocking will then be placed on your treated leg; you should wear it for 1 week following the procedure.
    7. Walking around the clinic for 10-20 minutes immediately after the procedure is encouraged.
    8. Normal daily activity can be resumed; just avoid rigorous activities such as gym workouts or lifting weights with your legs for 1 week.
    9. There may be minor soreness and bruising.
    10. Any discomfort can be treated with over-the-counter, non-aspirin pain relievers as necessary.
    11. 2-4 days after the procedure, you will have an ultrasound of the treated vein to ensure is still closed.
    12. EVLA treats the large vein or veins that caused your varicose veins in the first place. They do not directly shut down those visible varicose veins themselves, although these may shrink in size and number after the ablation procedure.

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Ultrasound Guided Sclerotherapy - Ultrasound Guided Sclerotherapy is a safe and highly effective procedure that eliminates diseased veins that have traditionally required surgical removal. During sclerotherapy a solution is injected into your varicose or spider veins. This causes the vein to seal off from the other veins in your leg. The vein closes down over time and is eventually absorbed into your body The ultrasound provides a live view of your veins, ensuring the physician is injecting the sclerosant into the precise location for the best treatment results. A typical treatment session may last for 15 to 20 minutes and will consist of microinjections. Once the vein is closed, the blood that was circulating through the abnormal vein is naturally rerouted to other healthy veins. Over time, the treated vein is absorbed by the body. Normal blood flow is then rerouted to healthy veins. Unfortunately, varicose vein disease is not curable. Like many other chronic medical conditions such as diabetes or hypertension, it requires ongoing care and surveillance after the initial course of treatment gains control. Treatment in the earlier stages helps avert unpleasant complications (leg ulcers, dermatitis, phlebitis, blood clots), and relieve bothersome symptoms.

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Visual Sclerotherapy - This procedure is used to treat visible spider veins and small varicose veins near the surface of the skin. With a needle the size of a hair shaft, a painless liquid is injected into the veins, causing them to shrink, close off, and eventually disappear. A typical spider vein patient will need up to three, 30 minute treatments, but the results are long lasting. Sclerotherapy is a relatively simple procedure, requiring no anesthesia and performed in our office. In most cases, you will see near complete clearing of spider veins after three separate 30 minute sclerotherapy sessions. Sclerotherapy sessions are performed no less than 3 weeks apart to allow for interval healing.

What to Expect:

  • After changing, you will lie down on the examination table. The skin over your spider veins will be cleansed with an alcohol pad.
  • Our interventional radiologist will then inject a liquid sclerosing agent into your affected veins through a tiny needle.
  • We make about one injection for every inch of spider vein. As the procedure continues, you may feel tiny needle sticks often described as like a mosquito bite.
  • If more than one sclerotherapy session is necessary, we recommend at least 3 weeks between sclerotherapy sessions. After each treatment, you will notice further improvement in the appearance of your legs.

*Note that sclerotherapy treats only those veins that are currently visible - it doesn't prevent new spider veins from surfacing. With time, you may require “touch-ups” for new veins that surface.

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Elastic Compression Therapy- There are several options for compression therapy for vein treatment. The two methods most commonly used are compression bandaging and elastic graduated compression hosiery (support stockings).

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Compression Bandaging - Usually used when varicose veins produce symptoms of leg ulcers, compression bandaging utilizes a multi-layer system to bind, pad, and compress. Elasticized bandages provide graduated compression with the highest pressure placed on the ankle where it is most needed. Bandages may be left on or reapplied for several weeks until swelling has dissipated in the affected vein area.

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Compression Hosiery/Support Stockings - Elastic compression stockings are classified into different levels based on the amount of pressure placed on the ankle. Measurements of the lower leg should be taken to ensure proper fitting. Properly fitted stockings will produce an effective graduation in pressure and be comfortable to wear; they should not cause discomfort or trauma. Compression stockings work by compressing the superficial veins that are located right under the skin and in the fat layer underneath. The pressure exerted on the surface then pushes the blood into the deep venous system that runs inside the muscles of the legs and on to the heart, reducing the pooling that occurs in spider and varicose veins.

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Maureen Staunton, RN, Nurse Navigator

Our Patient Navigator will work with you every step of the way

Vein Center patients will be supported by a Patient Navigator who will work directly with your insurance provider to be sure your benefit coverage is approved before your first appointment and throughout your treatment process.

 

Call 877-RES-INFO for Nurse Advice, Doctor Referrals or Class Registration Monday - Friday 8 am to 8 pm • Weekends 8 am to 4pm

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