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Treatment.

ENDOVENOUS LASER ABLATION (EVLA)

EVLA is an innovative, minimally invasive procedure that effectively cures venous insufficiency and its consequences. By treating the source – venous insufficiency – the symptoms of venous disease, including varicose veins, will disappear.

Unlike painful conventional surgery, which is performed in a hospital under general anesthesia, EVLA is a safe and effective procedure performed in a clinic, and causing only minimal discomfort. No lengthy hospitalization or drawn out surgery preparation are required for EVLA, and there is no painful recovery period. To begin, our experts will meticulously assess your venous circulation with a Duplex ultrasound. Next we will make an accurate diagnosis based on the results of the ultrasound, and an individual and effective treatment plan tailored to your needs will be offered.

Depending on the intensity of your disease, you may need to have one or more procedures on each extremity. A custom approach may be recommended, in which different forms of treatment, such as compression therapy, microphlebectomy, sclerotherapy, etc are combined with ablation. EVLA involves accessing and treating the diseased vein from within. Using real-time ultrasound guidance, the diseased vein is identified and a catheter is inserted into the vein. At this point, local anesthesia is injected around the vein, first isolating it from surrounding tissues and numbing the vein area. Once the vein has been anesthetized, the laser is activated and the problem vein is completely ablated. Finally the extremity will be placed in a compression stocking or wrapped with multilayer compression.

RECOVERY

Unlike with surgical vein removal, the patient can immediately resume daily activities, work, and even exercise. In fact, we encourage physical activity. Walking or jogging after the procedure can contribute to a faster recovery and decreased bruising and discomfort.

Three days after the procedure you will return to our clinic so that we can examine the results of the treatment and assess further plans.

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CLARIVEIN® MECHANOCHEMICAL ENDOVENOUS ABLATION (MOCA)

Mechanochemical ablation is another new, revolutionary, safe, and effective treatment option for diseased veins. It is a good alternative or addition to EVLA or RFA (radiofrequency ablation), particularly in patients who are averse to local anesthetic, or when the diseased vein is in close anatomical proximity to nerves, arteries or other important structures. Initially we will assess venous circulation utilizing real-time Duplex ultrasound to diagnose. Next we will decide the plan and the means of treatment. Mechanochemical ablation involves accessing the affected vein from within using the standard needle and guide wire technique, combined with a real-time ultrasound.

Next a catheter is placed inside of the affected vein. At this point the catheter is connected to the motorized handle of the Clarivein device. The motorized device rotates the tip of the catheter inside of the vein complemented with injection of agent called sclerosant, which causes the diseased vein to close.
The whole procedure is performed in our clinic and takes 20-30 minutes. Afterward, the patient will be dressed in compression stockings or a multilayer dressing, and can resume daily activities immediately.

RECOVERY

Much like after an EVLA procedure, patients can resume their daily activities immediately. No major pain, discomfort or restrictions are expected after treatment. Patients usually come back to the clinic three days later for reassessment of the results.

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RADIOFREQUENCY ABLATION (RFA)

Another minimally invasive procedure that effectively cures varicose vein disease. Unlike EVLA, RFA is suitable for both main veins as well as so called perforator – smaller but very important veins that connect main veins (deep and superficial systems). Treating perforating vein is very important addition in order to acheive optimal successful results. Otherwise, If perforating vein remain untreated, can be source of incomplete recovery or persistent symptoms. Depending of intensity of your disease, you might need to have one or more procedures or complex treatment where we will combine other treatments.
Same as with laser treatment, RFA is involved treating the vein from inside, so no cuts or incision are made.
Using real-time ultrasound guidance, the diseased vein is identified and a catheter is inserted into the vein. Local anesthesia is injected around the vein, first isolating it from surrounding tissues and, then, making vein area numb. Once the anesthesia has reached the vein, the radiofrequency is activated and ablates the treated vein from inside. Finally the extremity will be placed into compression stocking or wrapped with multilayer compression.

RECOVERY

Virtually there is no recovery period involved with RFA treatment. Most of the patients will get back to their daily activities immediately. In addition, RFA treatment is significant for no pain and bruising. However, like with most other treatment forms we encourage physical activity, walking, etc along with some other post-procedure recommendations for optimal results. Third day after procedure we will call you to our clinic to check the results.

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MICROPHLEBECTOMY

For optimal cosmetic and medical outcome, ablation (EVLA, RFA, MOCA) can be complemented with microphlebectomy. This is a technique in which very superficial bulging veins are removed using tiny punctures. Initially, these bulging veins are marked with a marking pen while the patient is in a standing position to help identify the veins once the procedure begins.
Local anesthetics will be used to numb the area. Then a real-time ultrasound or translumination system Veinlite will be utilized to precisely identify the vein location. A 1-2 mm puncture incision is made on the skin at each of the problem veins, and they are removed.

RECOVERY

Microphlebectomy is most often performed in addition to EVLA or Mechano-chemical ablation, and therefore the recovery is very similar, with essentially no major restriction or discomfort. Patients are able to resume daily activities immediately.

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SCLEROTHERAPY

Sclerotherapy involves the injection of a medication, or sclerosant, into the diseased vein. The tissues of the vein will be damaged by the sclerosant, and will completely disappear after some time. Sclerotherapy is for the cosmetic removal of spider veins, or reticular veins, and it can be added to ablation for the removal of larger veins. Before any cosmetic injection, our experts will perform a comprehensive physical and ultrasound examination in order to rule out a possible underlying circulatory problem that may require a different approach in order to maximize results in the long-term.

After careful assessment, a sclerosant (medication) agent will be selected. The medication will be converted into a solution form (straight or foam), and a dose will be decided based on the size, type and location of the vein. We only use extremely safe and medically approved agents at our clinic. Next, a tiny needle – the smallest available for medical use – will be used to deliver sclerosant into the vein under visual guidance through a system called Veinlite. The injections are essentially painless and the process takes 20-40 minutes depending of the size of the treated area. The patient’s extremity will next be dressed in a stocking or multilayer compression dressing for 48-72 hours. The patient may require a course of 3-4 injection sessions to the same areas for optimal results.

RECOVERY

Once the injections are complete compression stockings must be worn for two weeks. After the procedure there are no restrictions and any activities can be resumed. Patient usually return to clinic in 10-14 days for reassessment and to continue sclerothrapy.

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CONSERVATIVE TREATMENT AND VENOTONICS

The important part of treatment of venous insufficiency is conservative. Unfortunately many vein professionals often underestimate this part of vein management. Along with conventional compression therapy, which is wearing specially designed compression stockings, at VeNA we proudly offer effective venotonics. Venotonics are nutritional supplements and medication that affect to venous health. Based on extensive European phlebology experience, where venotonics has been successfully used for many years, those are appropriate and valuable addition to complex therapy of chronic venous insufficiency at all levels.
Vasculera® (diosmiplex) is newly FDA approved nutritional supply on USA market. It is well studied, unlike many other supplements on a market it has shown to be effective and with fewer adverse reaction for treatment symptoms of venous insufficiency such as edema, stasis dermatitis, lymphedema, venous ulcers, etc. Results may appear in as little as one week but may not be seen for 4 to 8 weeks. VeNA clinic is among few clinics in the USA where Vasculera® offered to the patients for treatment of venous and lymphatic disease. Vasculera® should be taken under direct supervision of physician, therefore please call our clinic for appointment.