Definitive treatment for spider veins involves injections. Some will claim that superficial lasers or radiofrequency generators can do the job…but, in my opinion…based on experience…I would recommend starting with sclerotherapy first and use those other modalities as a last resort or to treat veins too small to enter with a needle. Sclerotherapy Centuries old, the concept of injecting solution into varicose veins in order to get them to scar down and shrink is still a mainstay in the armamentarium of phlebologists. Like thermal ablation, the goal is to achieve irreversible damage to the cells that line the walls of veins, causing local inflammation and ultimately scarring down and resorption of the vein itself. Too little, the body can ultimately heal the damage and allow blood to continue to flow through diseased veins. Too much can allow the sclerosing agent to flow into normal healthy veins and cause unwanted damage.
Wow… a three-parter. Makes me think of “3-Peat”, which makes me think of the glory days of Da Bulls. I’d like to think of myself as the Michael Jordan of vein docs here in my arena at Rosen Vein Care, conveniently located in Northbrook. About the closest I’ll ever come to making a slam-dunk is a metaphorical one relating to endovenous ablation of varicose veins…and I think I can be satisfied with that. True, I might not have a pair of Nike shoes designed especially for me (though the “swoosh” kinda looks like a tortuous vein). True, I may not have a cologne bearing my name on the counter at Macy’s […what on earth would it smell like? Ablated vein? Ew.] But…here in my office at Rosen Vein Care…I feel like a man in the prime of his career…standing at my equivalent of the 3 point line (next to the comfy table in my procedure room)…firing off one at the buzzer to score a victory against my arch nemesis: superficial venous insufficiency. Though you can’t see it under my surgical mask, my tongue is sticking out in true Jordan fashion. Maybe I should embroider a #23 on my scrub shirt?…. Ahem…let’s get back to our lecture, shall we? We left off with definitive treatment options for superficial venous insufficiency that were non-surgical, minimally-invasive and well-tolerated. Namely, we talked about endovenous laser ablation (EVLA) In comparison to surgical options of yesteryear, EVLA rocks and it rocks hard. Ironically the discomfort associated with the procedure relates to the use of local anesthetic; once the anesthetic is placed, patients feel no discomfort…only boredom. However, in the spirit of wanting to make the patient experience better and more comfortable, newer state-of-the-art procedures have arrived to deal with incompetent saphenous veins that DO NOT REQUIRE TUMESCENT LOCAL ANESTHESIA. Today’s veinblog post will introduce you to Mechanical Occlusion with Chemical Assist (MOCA…or, as it is known by its trade name, Clarivein®). This procedure has been around for about 5 years now and data is amassing about its efficacy. Similar to EVLA, Clarivein® is a minimally-invasive means […]
Long before my career as a vein doc performing varicose and spider vein treatments in the North suburbs of Chicago began, I worked a series of jobs and volunteered for many organizations around Chicagoland before and during my undergrad years: Lifeguard, delivering meals-on-wheels for the elderly, crisis hotline counselor, keyboardist in a band, operating room assistant. A pretty diverse set of experiences. Each informed and impacted upon my decision of which route to take in terms of a career choice. Starting to post on this blog has forced me to reflect on a great many things. And, just like looking at a reflection in any mirror, we not only see the image as it is in front of us, but also as we would like it to appear. This dissonance is what compels us to grab a brush…start a diet…seize the day. Looking through the retrospectoscope, I can’t say that I have always made the correct decisions…but I have always tried to operate on the premise that making the best decisions starts with having the best information at hand. In the medical world there is the concept of informed consent. This means that in order for patients to agree to procedures, they need to be informed of the risks and benefits involved. This is true for brain surgery as well as vein procedures. On the doctor side of the equation, I have to choose which treatment methods to add to my armamentarium by analyzing the evidence available from research as well as my experiences and those of my colleagues. Having sifted through the data, there is a clear winner to treat superficial venous insufficiency: endovenous ablation. But it’s not enough for me to be certain of the benefits. I need to present the information to you as clearly as I can…including the alternatives…in order for you to make an informed decision that you feel comfortable with [see my previous Vein Rant #1 blog post]. My previous treatment post described conservative treatment options. As you recall, all of them are practical, but none are definitive as they can’t fix the underlying problem of venous […]
Some people living in Chicago and the Chicagoland Suburbs who happen to suffer from varicose and spider veins take comfort in the fact that for 8-9 months out of the year it’s too cold to wear shorts…and therefore they can avoid wearing shorts along with everyone else around them. This just illustrates one of the more significant effects of venous disease: lifestyle limitations. Not to discount the fact that untreated disease can lead to things like blood clots and skin ulcers…but sometimes the emotional discomfort of having unsightly legs can be just as limiting and profound as the physical discomfort. Why should a completely fixable problem keep people from engaging in activities that they would otherwise love to do?! I want you to feel happy about parading your legs around town! They’re literally like walking billboards for Rosen Vein Care…show ’em off! That’s why I am on a mission to educate. As the Greek philosopher Epictetus said, “Only the educated are free”. I want to help free people from such limitations. Therefore I’m using the first postings of my blog to get you up to speed on the current understanding of venous disease. Once you understand the underlying problem and the state-of-the-art treatment options we provide at Rosen Vein Care, you’ll be better equipped to make a decision, to make a significant change. Enough preamble…let’s get down to business: How and What Leg Veins Do Arteries carry blood Away from the heart. The heart’s job is to keep on pumping and get the nutrient-rich blood to all the areas of the body. Arteries get all the press. “Hypertension” this….”Coronary artery disease” that…yadda-yadda “aortic dissection”. Most people, physicians included, rarely stop to think about how the body returns the blood back to the heart through the veins. The blood from the head is easy to get a handle on…gravity just drains it downward toward the heart. Fair enough. What about the legs? It’s not as if there is another heart in your lower extremities that pushes the blood upward against gravity. Well, actually there is! When the muscles in your calf […]