Thanks to recent advancements in ultrasound imaging and the recent introduction of endovenous laser ablation, safe and highly effective treatment of varicose veins can now be performed as an outpatient. No more surgeries are necessary, as "vein stripping" is now a thing of the past!

Only a few steps are necessary to diagnose and treat your varicose vein disease.

1. Consultation - During your first visit we do a thorough ultrasound evaluation of all the veins in your legs. We not only map out what they look like, but more importantly, we locate all the veins that have damaged valves, which are causing your symptoms. Typically these veins can be mapped out like a tree, having a main trunk, branches, and leaves. The branches and leaves are what you might see on the skin surface with the branches representing the rope like bulging varicose veins. The leaves represent the spider veins. What is most important is finding all the trunks or leak points which are the main culprit in varicose vein disease. Sometimes there may be one such "leak pont", but sometimes there may be many, and in many places throughout the leg. Approximate time: 45-60 minutes
   
   
2. Insurance pre-authorization - We then submit all of our findings as well as photos of your visual varicose veins and your list of symptoms to your insurance company. Once we receive a pre-authorization letter, we will call you to schedule your outpatient procedure.
   
   
3. Treatment options:
   
   
   1. EVLA (endovenous laser ablation) - This is what we use to close off the largest varicose veins (typically the "trunks" and some of the larger branches). The procedure requires a catheter (very small tube) to be placed into the diseased vein. Once inside, a laser fiber is inserted through the catheter, and local anesthesia is administered. The laser then emits energy which shrinks and seals the vein wall. Afterwards, the "healthy" veins will restore normal blood flow in the leg. The dilated veins at the skin surface (branches) that are connected to the treated varicose veins will shrink after the procedure and your symptoms will improve. Approximate treatment time: 60 - 90 minutes.
      
      
      
      
      
   2. Ultrasound guided foam sclerotherapy - This is performed 1month after the laser procedure. Using ultrasound, we inject a sclerosant into the varicose vein branches (which come off the larger vein that was treated with the laser). The solution causes these veins to swell, stick together, and seal shut. If there are many of these branches to treat, a second treatment at 3 months will be performed. Approximate time 30 minutes.
      
      
   3. Light guided foam sclerotherapy - Once all the big and medium sized varicose veins have been treated and closed, we will add the finishing touches, by closing off the reticular veins (veins that connect to the visible spider veins). We inject these with a milder sclerosant. After these are treated the entire "diseased" venous tree has been treated. You will no longer experience any symptoms associated with the varicose veins and your legs will go back to having normal healthy circulation. Approximate time 30 minutes.
   
   
4. Additional cosmetic treatment – For those patients who do not have varicose vein disease but have extensive spider veins, we also offer treatment for these. These are treated with liquid sclerotherapy and depending on the severity and extent will require from 1 to 4 treatments.
   Approximate time: 30-45 minutes