High ligation is another surgical procedure done in the operation room under local or general anesthesia. It involves a groin incision (possibly on both sides). The tissue is dissected by the surgeon down to the greater saphenous vein (GSV)/femoral vein junction. The greater saphenous vein is then clamped and tied off. The idea is to sever the connection between the superficial system (the GSV) and the deep system (the femoral vein).

VNUS closure got to market about two years before the first vein laser. Some insurance companies approve both technologies, some only VNUS (as of now). The VNUS device is more complicated and considerably more expensive to use. Both technologies are FDA approved. I have found that the laser is almost 100% successful in closing average-sized saphenous veins, and it is definitely more effective than the VNUS device for closing large saphenous veins.

It is true that many times the greater saphenous vein is used in cardiac surgery; however, if the vein is diseased, as is the case with varicose veins and chronic venous insufficiency, it is typically unusable for heart surgery. In addition, there are other possible sources of veins or arteries in the body to use for that purpose.

No. Generally the saphenous vein is only destroyed when it is thick and thrombosed. The vein in this state is almost useless and non- functioning and there is no harm in removing it. However, a normally functioning saphenous vein with no leaky valves should not be treated. A normal saphenous vein should always be preserved because it may be required in the future for open heart surgery.

In theory, blood flow can resume. However, the probability of the saphenous vein reopening appears to be no more than 10% out to 2 years. One published report found that at 2 years 90% of Closure treated veins were invisible to ultrasound, suggesting permanent obliteration.

A few. We request that patients limit activities that require contraction of the abdominal muscles because that causes an increase in venous pressure in the legs for 7-10 days. Such activities include jogging, heavy lifting, sit-ups, crunches and excessive stair climbing. Since we want the treated vein to close, we want to subject it to as little pressure as possible till it has a chance to heal. Walking is encouraged. You'll be back to your more strenuous activities in ten days to two weeks.

In most cases, yes. Also, remember, there are no separate hospital or anesthesiologist charges to pay because these procedures are done in our office. One of our services is to obtain pre-certification from your insurance company. Usually no, because they consider sclerotherapy to be a cosmetic procedure (ultrasound-guided sclerotherapy can often be an exception to this rule).

No limitations are placed on normal activities. The incision needs to be kept dry until the stitches are removed, which is usually three days after your surgery. During this time you will need to shower. Bruising around the incision line is normal. No pain medications are usually required or prescribed so please have an over-the-counter analgesic (such as Tylenol or Motrin) available at home to be used if needed.

Patients who have multiple risk factors for heart disease (such as male gender, smoking, high blood lipids, hypertension, a sedentary lifestyle or a strong family history of the disease) may need to preserve one of the saphenous veins, assuming that it is not already too abnormal. By combining ligation (tying the vein at the source of abnormal flow) and sclerotherapy, varicose veins can be removed while the saphenous vein is preserved.

Just about anyone. Heredity plays the biggest role. 10% of men and 50% of women totaling over 80 million Americans are affected. As might be expected, any condition that puts strain on flow of blood from the legs toward the heart can aggravate the condition. This includes, but is not limited to pregnancy, standing for long periods, obesity, and extended sitting. For each individual, it is important to accurately identify the cause of their particular situation.

Essure is a new tubal ligation technique we provide in which you receive no incision and no abdominal surgery or laparoscopy is required. It is just as effective and just as permanent as the old fashioned tubal ligation through the abdomen. It can be done in the office under a local anesthetic and minimal sedation thus requiring no hospitalization and no general anesthetic. The recovery is very quick and you are back to your normal activities in 1 to 2 days.

Sometimes it's easy to determine what causes the veins to develop. The known factors include heredity, pregnancy, female hormones (especially progesterone), obesity, and standing all day at work (hairdresser, sales, etc.) Often we don't have a clue. Varicose veins develop more frequently on the left for reasons unknown.

Theoretically anyone can get a DVT after any surgical procedure. However, the risk of DVT after EVLT is very low (less than 1 in 400).

After the procedure, a compression stocking should be applied that cannot be removed except on your follow-up visits. Cast protectors can be purchased to cover the stocking and allow you to shower. No limitations are placed on normal activities with your stocking in place. On occasion, temporary skin pigmentation changes may occur following sclerotherapy. Limited sun exposure or use of 30 SPF sunscreen is advised until this staining resolves.

Laser vein removal is not painful. It has been described as "a gentle burning sensation along the vein followed by a sharp pinch at the end" as the vein is sealed.

In addition to their embarrassing, unsightly appearance, symptoms can include burning, itching, pain, leg fatigue and heaviness, throbbing, swelling, muscle cramps, even ankle sores and bleeding. Unfortunately, many physicians do not recognize vein problems as the cause of many of these symptoms.

Many physicians in different specialties practice Sclerotherapy. An experienced physician with a full time commitment to vein treatment is preferable. You are assured of better results. Ask to see Before and After photos of your doctors’ work on problems similar to yours.

Shut your eyes while you are standing, and feel your legs. If you cannot feel the veins, you have a spider vein problem. If you can feel the veins, and they push in easily but bounce right back out, you have varicose veins.

Also a non-invasive office procedure, ligation and/or a phlebectomy is used to disrupt or tie off a vein. Simple office testing will determine if you require any ligations or phlebectomy. It is done to disrupt the flow of blood feeding into other areas. The procedure consists of marking your leg at the areas where there are points of maximum reflux. (Reflux means the backflow of blood down the leg.