Capitol Vein Blog

Saturday, November 26, 2011

Comprehensive Treatment for Varicose Veins


I recently searched the Internet for information on varicose vein care in our practice locations (Frederick, MD; Bethesda, MD; Leesburg, VA and Charles Town, WV) and up popped numerous options for vein centers. Patients use the Internet to find information and compare treatment options for their needs.  The vein centers I found employ physicians from diverse training backgrounds -  heart surgery, general surgery, thoracic surgery, emergency medicine, family practice, orthopedics, dermatology, OB/GYN, anesthesiology and plastic surgery - but there were no Peripheral Vascular Surgeons listed!

At Capitol Vein & Laser, Paul McNeill, MD and Garth Rosenberg, MD are Vascular Surgeons. Comprehensive vein care is not a primary component of the previously mentioned specialties as it is with Vascular Surgery. Vascular Surgeons are trained to care for the circulation of the lower extremities. The take-home message: a lot of vein care is being handled by physicians whose primary training is in other disciplines, and who have added or substituted vein care in their primary medical practice.

There are three basic components to a varicose vein problem: a main trunk vein that has valve reflux, connecting vein branches that have become dilated varicose veins, and occasionally some spider veins. In Vascular Surgery best practices, these conditions are best treated by ablation (VNUS Closure or EVLT), vein removal (phlebectomy) and sclerotherapy (injection of spider veins), respectively.

According to my quick survey, the vein removal step is absent from non-Vascular Surgeon attended vein centers. Instead, sclerotherapy is substituted for varicose vein treatment. This is less effective in eliminating large varicose veins and often results in the formation of blood clots that must later be removed. Retained blood in sclerosed veins can become a permanent skin discoloration. The sclerotherapy approach for varicose veins often requires months of treatment visits (instead of one visit for phlebectomy) and prolonged use of compression hose and restriction from exercise - for weeks.

By contrast, phlebectomy uses one to two-millimeter incisions that are invisible when healed. Compression hose are used for three days post-phlebectomy and most patients can return to exercise three days after procedure.

When searching for vein care on the web, look into treatment options and physician training. Peripheral Vascular Surgeons are most likely to deliver all components of vein care: ablation, phlebectomy and sclerotherapy. These treatments encompass the best options for comprehensive vein care.

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