Vein Treatment: St. George and Cedar City

Radiofrequency ablation is an ultrasound guided, minimally invasive treatment option for superficial venous reflux. A thin catheter is inserted into the vein through a small opening. Using radiofrequency energy, the catheter disrupts the tissues of the vein wall as it heats and seals the vein shut. This is an in office procedure done in 30-60 minutes, with local anesthetic only and no down time after the procedure. Our patients are able to walk right out of the office with no need for a recovery period. Following the procedure, a simple compression dressing is placed on the treated leg to aid in healing. A compression stocking will be worn for a short period of time post procedure for optimal results. You will be encouraged to avoid prolonged standing or sitting in addition to any extremely strenuous activities for a period of time. Closure of the saphenous veins may also be done by a procedure known as laser ablation where laser energy is emitted inside the vein to close it down. However, studies have shown that those treated with radiofrequency ablation experienced less leg pain, less bruising and less complication resulting in a faster and less painful recovery than those treated with laser ablation. Also reported was improvement of their quality of life up to four times faster than those treated with laser ablation. For this reason, we provide radiofrequency ablation in addition to what is known as VenaSeal as our treatment of choice for closure of saphenous veins. Radiofrequency ablation is covered by insurance once all requirements are met. Individual insurance requirements can be discussed with Heart of Dixie Vein and Vascular team.

For more information regarding the technology used at Heart of Dixie Vein Center visit www.medtronicendovenous.com

Perforator veins serve as connections between the two networks of veins in the legs: the superficial venous system and the deep venous system. Perforator veins allow the blood near the skin (our superficial veins) to drain into our deep veins, which then leads the blood back to the Heart.

All our veins, including perforator veins have one-way valves designed to keep the blood flowing in one direction: toward the heart. When those valves no longer function properly and reflux occurs, the buildup of blood and pressure can cause perforator veins and associated superficial veins to become incompetent, or to backflow. Perforator veins in the lower leg and ankle are particularly vulnerable to distention and incompetence, and the resultant circulatory problems create an increased likelihood of edema, skin discoloration, dermatitis and skin ulcers in the immediate area.

Although the majority of varicose veins, and venous insufficiency develops from the saphenous veins, perforator veins are a common contributor to wounds, swelling, skin changes, and large varicose veins. They may also be the cause of continued symptoms even after saphenous vein ablations have been completed. Thus, we take a comprehensive approach and continue to follow up with each patient after treatment has been completed. If you have symptoms of burning, fatigue, edema, heaviness, itching, skin changes, ulcerations, or visible varicose veins in your legs, or have been diagnosed with venous insufficiency you may need an ablation of refluxing perforator veins performed.

Our office uses the ClosureRFS stylet to treat perforator veins using radio-frequency ablation. It is the only intravascular ablation device specifically intended for the treatment of incompetent perforator and tributary veins. We perform this minimally invasive procedure in our office. There is no need for general anesthesia, and no down-time or recovery period. Using ultrasound guidance, a fine needle is passed into the perforating vein through the skin. The area is locally anesthetized (numbed). The radio-frequency current heats the inside of the perforator vein causing it to shrink down and discontinue the reflux, or backward flow between the deep veins and varicose veins. The whole process takes approximately 20-30 minutes per perforating vein. Patients return to activities the same day, and most report minimal pain, and little or no scarring after the procedure.

1. Oblonsky E. Incompetent Perforator. Premier Vein Center Arlington Heights Illinois. http://www.thepremierveincenter.com/conditions-incompetent-perforators-arlington-heights-illinois.html. Accessed October 17, 2017.

2. Covidien ClosureRFS™ Stylet | Venefit™ Procedure by Covidien. http://venefit.covidien.com/pages.aspx?page=Products%2FStylet. Accessed October 17, 2017.

The VenaSeal closure procedure improves blood flow by sealing or closing the diseased vein. The system delivers a small amount of specially formulated medical adhesive to the diseased vein. The adhesive seals the vein and blood is rerouted through nearby healthy veins.

For more information regarding the technology used at Heart of Dixie Vein Center visit www.medtronicendovenous.com

Advantages of VenaSeal

In the VenaSeal procedure, there is no need for multiple needle sticks. Instead, the vein is accessed with one needle stick and the catheter is properly placed under ultrasound guidance. There is no use of heat associated with this treatment. This avoids the risk of thermal damage as no heat source is present. Unlike Radiofrequency Ablation, the VenaSeal procedure does not require use of compression stockings post procedure.

After treatment of the saphenous veins via radiofrequency ablation or VenaSeal, most varicosities tend to flatten out and are not as visible as they one were prior to treatment. In some cases, these varicosities are fed by other branches of veins and need to be treated individually. Heart of Dixie Vein and Vascular Center can treat these varicosities in our office as all other vein procedures, with a minor procedure known as phlebectomy.

Microphlebectomy is removal of varicose veins through tiny incisions on the leg. No stitches are necessary. This procedure is minimally invasive, leaving no scarring and uses local anesthetic only. Coverage by insurance can be discussed with Heart of Dixie Vein and Vascular team.

Sclerotherapy is an injection of a medical solution into varicose and spider veins leading to collapse and subsequent reabsorption of the veins. This procedure can be done for spider veins, called cosmetic sclerotherapy, or can be used to treat the larger veins in which we use ultrasound to guide us as we inject sequential locations along the veins. Hypertonic saline was previously used as an agent for sclerotherapy but caused a painful sensation as it was injected. We now use a formula called Polidocanol which is more effective, has a proven history of minimal side effects, and is less painful when injecting. This medication has been formulated to appear as a white color under ultrasound which allows us to identify the proper injection of the sclerotherapy into targeted veins. Sclerotherapy agents work by irritating the inner lining or endothelium of the vein. This causes disruption of the cell membrane, which leads to collapse of the vein. This works most effectively if the solution continues to adhere to the wall of the vein. For this purpose, we ask our patients to wear compression stockings for one week following treatment, compressing the veins and improving the binding of the medication. Over the first few days it is not uncommon for the veins to appear red, inflamed or irritated as this therapy takes effect. This can take up to several weeks to resolve.  It is also important to recognize that most patients will need two or more sessions of sclerotherapy to achieve optimal results.

Sclerotherapy is an important adjunct to treat varicosities and tributaries of the saphenous veins where catheters and guide-wires cannot reach to ablate, or seal incompetent veins. Our providers are highly experienced in performing these procedures. This can be done as an outpatient in-office as no anesthesia is needed. The procedures generally take between 20 and 60 minutes. Patients can return to normal activities the same day as the procedure.

Sclerotherapy is a minimally invasive in-office procedure, where a sterile solution known as a sclerosant is injected through a small needle directly into your vein. This solution causes it to close down. To compensate for the loss of the vein, blood circulation is re-routed through healthy veins. Sclerotherapy for spider veins is not covered by insurance as it is considered cosmetic.

Heart of Dixie Vein Center provides a full range of vein treatment options in St George.  For any questions about our technology or procedures contact us today.