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.

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.

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.

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.

Arteries carry blood from the heart to the rest of the body. But sometimes arteries become blocked. When this happens, surgeons create a new channel to bypass the blockage. Doctors call it bypass graft surgery. It uses a working blood vessel from another part of the body -- the graft -- to channel blood around the blocked area.

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.

For individuals who have had a heart attack, bypass operation or angioplasty, an EBA can be done to check the conditions of the patient's heart arteries, the patency of post-bypass grafts or post PTCA vessels. The calcium score is also useful for it can provide a benchmark against which your doctor can measure any future progression of the heart disease.

If the veins were functioning normally, then yes! But since the veins are dilated and not working properly, they are doing more harm than good. Heart doctors do not use varicose veins for bypass surgery for this very reason! Most patients say that the procedure does not hurt at all. You will feel the pin prick of the needle as we inject the anesthetic, but then the area is instantly numb. You will not feel any of the “stabs”. You will not feel pain from the veins being removed.

Most surgeons recommend a daily multivitamin, calcium, and vitamin B12 for the rest of your life. B12 injections are sometimes suggested once a month for the first year and every six months thereafter. B12 may also be taken orally or sublingually (under the tongue) by most patients. The dietician will provide specific guidelines on necessary vitamin supplementation, dependant upon your surgical procedure.

Bypass surgery improves the blood flow to the heart with a new route, or "bypass," around a section of clogged or diseased artery. The surgery involves sewing a section of vein or artery from the leg or chest (called a graft) to bypass a part of the diseased coronary artery. This creates a new route for blood to flow, so that the heart muscle will get the oxygen-rich blood it needs to work properly. Coronary bypass surgery has proved safe and effective for many patients who have the procedure.

Coronary artery bypass surgery, the popularly-prescribed procedure in which blocked portions of major coronary arteries of the heart are bypassed with grafts from a patient's leg veins, has never been proven by properly controlled studies to offer much or an advantage over non-surgical treatments, other that relief of pain in a minority of patients who cannot be controlled with medicine.

The greater saphenous vein (along the inseam of your leg) is often used for bypass surgery, but only if it is a normal vein, not if it is a varicose vein. There are multiple alternative vessels to use for bypass grafting.

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).

The laser I use is quite effective for spider veins, but lasers have a limited role when they are the sole treatment for leg veins. Lasers only destroy what they "see." To prevent new veins from forming, the deeper high-pressure veins that feed the surface veins have to be eliminated, and those veins are usually invisible to the laser. If they are not eliminated, new veins readily form around the old ones, and you're back to where you started.

Yes. Most patients have had at least one of these procedures. They come for EECP because they still experience cardiovascular symptoms.

Bypass / Angioplasty are temporary solutions to increase the blood flow to the heart. They do not stop the disease process nor do they go to the root cause of disease. In bypass alternate passage is created as shown the blockages remains. After few years reblockages is quite common. In angioplasty the blockage is scrapped and stent is inserted so it is merely reduced in size. Hence with few months to 2-3 years problem occurs.

Gastric bypass surgery provides an effective tool to limit the amount of food eaten and to change how food calories are absorbed. It must be understood that the surgery is not magic: it works with you, not for you. By working consistantly to make appropriate food choices and behavioral changes, a successful, long-term health impact is possible.

The LAP-BAND® System is a silicone band that is placed around the stomach, creating a small upper stomach pouch that prevents a patient from eating excessively. It is only a restrictive device (not a malabsorptive one), and can be adjusted and/or removed, if necessary. The procedure to place the band is done laparoscopically on an outpatient basis, so our patients go home the same day as surgery in most cases.