Vein disease is progressive and will worsen over time if left untreated. Dr. Robert Cutchen advises all individuals who are suffering from varicose veins to seek treatment sooner, rather than later, to prevent more complicated medical conditions from developing.
After the presence of vein disease has been diagnosed via the venous Doppler ultrasound test, Dr. Cutchen will develop your individualized treatment plan tailored to the extent and severity of your specific venous condition. Most patients require a combination of treatment options for the best possible results. A series of treatments over several appointments may be necessary, depending on the severity of your vein disease. Some procedures are performed under local anesthesia while others require none. Patients should return to normal activity immediately with minimal restrictions.
Endovenous Laser Treatment (EVLT)
The Endovenous Laser Treatment (or ablation) procedure is performed in Dr. Cutchen’s office under local anesthesia. This procedure closes refluxing saphenous veins, which are often the cause of the visible bulging superficial varicose veins on your legs. These are the same veins that were previously treated with surgical stripping. When performing EVLT, the skin is first numbed, then using ultrasound guidance a thin laser fiber is inserted through a few steps into the vein through a tiny incision and advanced to the top of the vein. After placement of local anesthetic around the vein, the laser is activated, which delivers heat to the vein wall, causing it to heat, collapse and seal shut. The vein will then disappear over 6-12 months.
In some cases, other treatments, including ambulatory phlebectomy and endovenous chemical ablation, are used in combination with endovenous laser ablation to achieve the best possible medical and cosmetic results.
Endovenous Chemical Ablation (ECA)
Also known as ultrasound-guided foam sclerotherapy, endovenous chemical ablation is another treatment method for the elimination of varicose veins. This procedure targets and eliminates varicose veins that are hidden from the naked eye and only seen by ultrasound. During an ECA treatment, a chemical irritant, called a sclerosant, is injected into the vein while Dr. Cutchen observes the injection process on the ultrasound screen. The sclerosant damages the lining of the vein wall, collapses the vein and eventually leads to the body reabsorbing the destroyed vein. The sclerosant typically has a foamy, frothy consistency.
Ambulatory Phlebectomy, micro-phlebectomy, or “hook” phlebectomy is a micro-extraction procedure used to remove bulging varicose veins that are close to the surface through very small (~1/8 inch) micro-incisions. The micro-incisions are so small that they seldom require a stitch. Local anesthetic is injected all along the course of the bulging veins making it a painless procedure. Once removed, patients are amazed how good the leg looks with the “ropey” veins gone. The tiny incisions heal very well and the scars are nearly invisible at one year in most patients.