Have you been diagnosed with a type of vein disease? Are you in pain or perhaps simply tired of dealing with every doctor having a different rhyme or reason – and nothing is working?
Venous disease is one of the most underdiagnosed and undertreated disease in the world. So many patients of all ages, gender and backgrounds suffer from a spectrum of venous disease ranging from small cosmetic spider veins to severe leg swelling and ulcers, and in some extreme cases blood clots that can lead to amputation of the leg or a fatal pulmonary embolism.
What To Look For In A Vein Doctor?
Overall, it should be a comprehensive evaluation and there should be ability and willingness to treat all types of venous disease in their distinct presentations. I want to talk about the superficial venous disease and we will delve into the deep venous disease at a different session! Meet Dr. Omar Saleh HERE
Superficial venous disease:
Many patients will come with pain, swelling or “ugly” bulging veins in the legs. The initial evaluation is to get a good history and physical, and then almost always to check the veins with ultrasound for venous reflux. The ultrasound exam for venous reflux needs to be done by an experienced ultrasound technologist. So many times, I see reports of missed reflux done at imaging centers that are just trained to look for a DVT or blood clot, completely different exam!
In the setting of abnormal reflux, one may be able to treat the greater saphenous vein, anterior accessory saphenous vein or the small saphenous veins and perforator veins.
First we will try compression therapy with tight leg stockings such as 20-30 mmHG or 30-40 mmHG, These can provide relief but it doesn’t cure or reverse the disease process. One of my mentors, Dr Harper , told me that vein disease is like a ticking clock and compression therapy can slow down the clock but it cant go backwards!
If compression therapy fails or not tolerable, do not despair; We have a wide variety of treatment to offer such as RF and/or laser ablation as well as using adhesive glue. These different therapies have their advantages and we are able to decide which is best on a case by case basis. Also, we can remove some of the large ugly varicose veins with stab phlebectomy. These are all minimally invasive procedures and just requires local anesthesia and patients can leave right after the treatment.
Once the superficial truncal veins are treated, then we are able to address the more superficial reticular and spider veins. We treat these with sclerotherapy using a small chemical injection into the vein such as Asclera 0.5% or 1%. The very small spider veins in the legs or face can be treated with our Veingoph machine which just requires application of a ice pack for 10 seconds before administering the treatment performed using ohmic thermolysis. Check out their instagram page for a demonstation: