Yes. Dr. Hayes will review your medical history and discuss your condition with you. This, along with non-invasive ultrasound imaging, allows Dr. Hayes to determine the type of treatment required.
Ultrasound is an invaluable tool used in diagnosing blood clots and reflux in the deep, superficial, and perforator veins. Ultrasound is also needed to make an accurate assessment of the level and extent of varicose veins. It is non-invasive and usually takes about 30 minutes. Treatment is individualized, however, and not all patients require an ultrasound.
No. Since it is minimally invasive, endovenous thermal ablation and the other procedures we utilize can be performed at the Vein Center on an outpatient basis.
Most varicose vein procedures can be done with local / tumescent anesthesia and I.V. conscious sedation. You will be “awake”, and will remember the procedure, but you will be quite comfortable and “feeling groovy.” Even extensive, large veins can be treated in the vein center without general anesthesia.
Tumescent Anesthesia is a form of local anesthetic commonly used by dermatologists, plastic surgeons, and vein surgeons. It involves the use of a very low concentration of local anesthetic that is injected around the vein. It provides excellent anesthesia of prolonged duration and gives remarkably diminished post-operative discomfort. The really nice thing about tumescent anesthesia is that it eliminates the need for either a general anesthetic or a spinal anesthetic.
The procedure itself takes about an hour, depending on the extent of your disease. Be prepared to be at the vein center for a few hours, however, as it takes a while to make sure your vital signs, etc. are o.k. We also keep you under observation for about 30 minutes after the procedure to make sure you are stable and will do well at home.
Our procedures are done on an outpatient basis. We encourage our patients to get up and walk immediately. Most individuals can go back to work within two or three days. Vigorous lower extremity workouts should be avoided for about two weeks, as should hot baths and excessive sun exposure. You also need to wear compression stockings for about two weeks. We will perform a post-operative ultrasound a few days after the procedure to ensure healing is progressing as planned.
Potential complications include, but are not limited to bleeding, infection or inflammation, damage to adjacent structures, need for additional procedures, venous thromboembolism, hematoma, paresthesia, etc. EVLA is a safe procedure, which is why we can perform it in the Vein Center, rather than going to the hospital.
Medicare and most insurance plans generally cover medically necessary (non-cosmetic) vein treatments and procedures. Dr. Hayes will make a determination of medical necessity, usually at the initial consultation. Getting these procedures approved by the sometimes unenthusiastic health insurance companies can sometimes be a daunting task requiring nerves of steel. We have learned to get a “yes” or “no” from the insurance company before proceeding to the Operating Room. Venous insufficiency and large varicose veins typically qualify due to the debilitating symptoms they cause. Spider veins are considered cosmetic and are not covered.
Not necessarily, but careful evaluation with pre-operative ultrasound is most important. Before any procedures are done in this clinical setting, deep venous insufficiency and deep venous clots must be ruled out. Additional laboratory tests for clotting disorders may also be indicated.