Vein Treatments

In, Out, and On With Your Life.

Medical Treatment Process Timeline

Here is a generalized timeline of what the medical treatment process is when you have varicose vein treatment with Physicians Vein Clinics!

1. Free Vein Screening: This appointment is at no cost to you. It is done to determine if there is a medical vein issue versus a cosmetic vein issue.

2. Formal Vein Consultation: This appointment is billed to your insurance company. This consultation is needed for insurance purposes to prove medical necessity. It includes a full ultrasound as well as a visit with one of our vein doctors to go over treatment options and to get a prescription for compression stockings.

3. Trial period of compression stockings: Most insurances require a trial period of compression stockings. This is another way for them to see whether the vein problem is medical or cosmetic. Most trial periods last between 30-90 days.

4. Post-conservative treatment appointment: Repeat ultrasound and visit with the vein specialist to document that the compression stockings did not “fix” your vein(s) in your legs. This is a requirement before any vein treatments can begin.

5. Scheduling procedures: After the post-conservative appointment, you will be scheduled for your next vein treatment. Almost all patients begin with the EVRFA or an EVRF Procedure. We usually schedule these appointments at least 20 days out from your visit because you will need to get authorization from your insurance company. We will not proceed until we get insurance approval. It’s your responsibility to find out what your deductible/co-insurance, is.

6. EVRFA or EVRF procedure: If we are working on both legs, we will be scheduling them on two different days. This is an insurance requirement, as well as the safest process for you. You are required to bring your compression stockings with you to every visit. After the EVRFA procedure, you will wear the stocking for 2 weeks. More detail will be given at the appointment. You do not need a driver for these or any of our office appointments. You can go back to work afterwards, and any restrictions will be discussed at your appointment.

*Depending on your insurance company, you may need to have a recheck visit (ultrasound) after EVRF procedures to be able to proceed with the next steps of treatments for Sclerotherapy, Varithena, or Phlebectomy.

7. Sclerotherapy or Varithena procedures: We will treat one leg per day. These appointments are injections of a medication to treat the smaller veins that the laser couldn’t treat. You may have multiple injections and possibly multiple appointments for these treatments. Bring your compression stockings and plan on wearing them for two weeks afterward.

8. Recheck appointments: Normally we do recheck appointments after your first bilateral Varithena appointment to ensure everything is healing properly. You may or may not need a recheck if you are having regular sclerotherapy.

Normally we schedule injection appointments 30 days apart to give time for healing in the legs. For these treatments to be successful, all these steps are necessary in the process. The process can take several months to a year, depending on the severity of your condition and how much work is needed to complete your treatment. We want everyone to be aware of the complete process to avoid miscommunication between patient and provider.

Vein Treatment Options

Endovenous Laser Ablation

An Endovenous Laser Treatment (EVLA) is a minimally invasive method for treating large varicose veins. It uses laser and ultrasound technology to close the main vein from the inside with laser energy. We will apply topical numbing cream, making the injection of the local anesthetic almost painless. Local anesthesia and then a minute laser fiber is inserted directly into the vein through a catheter. Pulses of laser energy are released along the course of the vein to seal it completely. Once the laser has sealed the vein, the fiber is removed and a steri-strip or a stitch closes the area. Learn More.

Endovenous Radiofrequency Ablation (EVRF)

Radiofrequency Ablation is used to heat and irritate the inside of the saphenous vein, which causes it to scar and eventually clot off. The saphenous vein is the main superficial vein associated with varicose veins. The blood flow is then redirected to other healthy veins after this vein has been closed off. This will improve the look of varicose veins and can ease pain or uncomfortable symptoms that result from varicose veins. Learn More.

Ambulatory Phlebectomy

An Ambulatory Phlebectomy is a varicose vein removal procedure that usually takes about 30-60 minutes and requires little to no downtime. First, a local anesthetic numbs the area and your bulging varicose vein is extracted with a “micro-hook” through a very small incision. The incision almost always disappears completely after healing. Immediately after this procedure, you will need to wear a compression bandage and stocking. Learn More.

Varithena

Varithena is a drug and device combination that creates a microfoam. This microfoam is used for ultrasound-guided injection. The microfoam will cause the diseased vein to collapse, and then the foam is deactivated. When the malfunctioning or diseased vein collapses, blood flow shifts to healthier veins nearby. Those who suffer from superficial venous reflux disease or varicose veins may require Varithena to alleviate their symptoms.

Ultrasound-Guided Sclerotherapy (Chemical Ablation)

If you have varicose veins just below the skin’s surface, this simple procedure might be right for you. An FDA-approved medication is injected into the diseased veins using an ultrasound to guide the placement of the medicine directly into the vein. The medication causes the veins to collapse and die. This requires no anesthesia or sedation and you can return back to work immediately.

Cosmetic Sclerotherapy

Sclerotherapy is a medical procedure used to eliminate varicose veins and spider veins. The procedure involves injecting a solution directly into the vein. Once injected into the vein, the solution causes the blood vessels to swell and stick together. The blood clots, the vein becomes scar tissue and collapses. Over time, the scar tissue fades away.

The typical treatment lasts approximately 20 minutes depending on the size of the targeted area. After your Sclerotherapy Treatment, the varicose or spider veins should fade away within a few weeks. To completely eliminate the targeted veins, patients may need additional treatments spread out over several weeks.

After the procedure, you will be asked to wear compression stockings for 1 week or longer. The stockings can help reduce bruising and help keep the treated veins closed, which will contribute to the success of the procedure. Walking or mild exercise is helpful to increase blood flow but you should avoid intense activities for the first 24 hours. In most cases, you will be able to resume your normal activities immediately after the procedure.

Cosmetic Sclerotherapy

Spider veins are usually treated with a tiny needle that injects a solution into veins, causing them to collapse so that they are no longer visible. generally, normal activities can be resumed immediately after sclerotherapy. Medically prescribed compression stockings may need to be worn for several days to assist in the resolution of the veins.

Conservative Therapy

Most insurance companies are now requiring a trial of Conservative Therapy before considering covering the treatment of Varicose Veins. Compression stockings may help lessen the symptoms caused by varicose veins but they do not treat the underlying problem and must be worn indefinitely. Other therapies may include elevation of legs, exercising thirty minutes a day, and anti-inflammatory medications. Learn more.

Compression Stockings

One alternative form of therapy is to use compression stockings. They’re also known as support hoses. The primary function of compression stockings is to improve circulatory problems in the legs, as well as reduce the swelling in your legs. A properly fitted support hose will squeeze your legs and put pressure on them, which will then move blood out of the veins in your legs and into more centralized areas. Typically, a support hose can help alleviate symptoms and reduce swelling but does not resolve the underlying vein problem.

Lifestyle Changes

There are several lifestyle changes you can make to help improve your symptoms. Depending on your condition and your circumstances, you may want to try walking more frequently, losing weight, and possibly wearing more appropriate shoes. Although physical changes may improve your symptoms, they will not eliminate your varicose or spider veins.

Cosmetic Procedures

In addition to treatments for venous disorders, Dr. Lornell Hansen can help treat other skin issues, such as excess hair, wrinkles and fine lines, skin discolorations, unwanted tattoos, and sun damage through his aesthetic services. He even offers body sculpting, minimally invasive liposuction and professional-grade skincare products. All of this is available through Lazaderm and Lazaderm Laser & Aesthetics AZ, also owned and directed by Dr. Hansen.